A few months ago, my 80 year old lady rang her call bell to tell us that the patient next door walked into her room, peed on the floor, and left. She was a good sport about it - she laughed and said she just wanted to make sure he was okay.
Thank you for posting your experience. The worst med error I have ever encountered was when I had a patient that had an insulin drip on one pump and on another pump had IVF and apparently had an IV med run as a secondary during day shift. When I was about to change the bag of the insulin drip three hours into night shift, I realized the medication attached to the pump was an antibiotic. I looked at the rest of the patient's IV setup and found the insulin bag connected to the IVF as a secondary.
I completely freaked out - naturally. I wanted to puke, cry, and poop my pants all at once. Thank freaking GOD my patient was alive. I felt pretty crappy for not catching this sooner but I was grateful the patient was okay. I knew I needed to move on from this to get through the rest of my shift and care for my other patients.
Anyways, I think what completely baffled me the most is this drip went on for several hours with two RNs cosigning to titrate the drip every hour, merely looking at the medication and rate on the pump. Since this incident, especially with high alert IV medications, I not only look at the pump but look at how everything is set up. Unfortunately we learn at our patients' expense sometimes, and the best thing you can do is forgive yourself and learn from it.
And just a note, I would not ask a provider if it was ok to give pain meds if a patient is hypotensive.
Interesting - I would've done just this to cover my own behind. I don't want to be at fault if the patient's BP happens to tank after getting Dilaudid.
I read your other post, and I think the bigger issue you need to tackle is your anxiety. How long have you been a nurse? Have you recently started a new job?
I don't know about an ice pack - all I can really think of is bringing ice cold drinks to clinical to keep yourself cool. If personal hygiene is a concern, you could bring a travel sized antiperspirant.
Depends. I try to medicate and meet the other needs of my patients before leaving the floor. However, there are certain situations where I may not necessarily do that (i.e needing to eat something ASAP because I am dizzy, seeing black spots, and not willing to have a syncopal event in front of my patient) - in those situations you need to put yourself first. Instead I would ask another RN to give the med for me.
Honestly I don't blame the RN - I would say anything to my psych patient to get the psych med they need for both their safety as well as my own. xD
Instead I might've said something like "this medication will help relieve your symptoms" or "it'll make you feel more comfortable". That way you are technically not lying...
I don't run into this too often - I am pretty open with my patients and don't mind talking about my life story briefly and in general terms. If I happen to run into a patient who asks questions about my religious, political, or sexual preferences, I'll probably just say "Enough about me, what about you? What can I do for you right now?"
I would've done the same. You covered you behind by notifying the surgeon, and you did what you were instructed to do. The day nurse was in the wrong here by d/c'ing that central line without an order. Your coworker sounds like a moron - don't even worry about it.
I'm not sure how much orientation you've had, but I do have some tips:
+ Patient safety is #1. Is everyone pink and breathing? Are your confused patients bed alarmed?
+ Chart as you go.
+ Cluster what you can. Give your 8/9/10am meds at 9. While you're at it, pull their pain med that you KNOW they will want. Oh yeah, they haven't pooped in a week - let's pull their PRN laxative. You'll get better at this as you get more comfortable with your routine.
+ Ask if your patients need anything before you leave their room - are they comfortable, do they have everything they need? I've written out lists of needs for my needy, call bell happy patients.
+ Delegate and utilize your CNAs. As much as you'd like to toilet/repo your patient while you are in there, sometimes you just don't have time for that.
A few months ago, my 80 year old lady rang her call bell to tell us that the patient next door walked into her room, peed on the floor, and left. She was a good sport about it - she laughed and said she just wanted to make sure he was okay.
I go by the mL amount on the tube.
Thank you for posting your experience. The worst med error I have ever encountered was when I had a patient that had an insulin drip on one pump and on another pump had IVF and apparently had an IV med run as a secondary during day shift. When I was about to change the bag of the insulin drip three hours into night shift, I realized the medication attached to the pump was an antibiotic. I looked at the rest of the patient's IV setup and found the insulin bag connected to the IVF as a secondary.
I completely freaked out - naturally. I wanted to puke, cry, and poop my pants all at once. Thank freaking GOD my patient was alive. I felt pretty crappy for not catching this sooner but I was grateful the patient was okay. I knew I needed to move on from this to get through the rest of my shift and care for my other patients.
Anyways, I think what completely baffled me the most is this drip went on for several hours with two RNs cosigning to titrate the drip every hour, merely looking at the medication and rate on the pump. Since this incident, especially with high alert IV medications, I not only look at the pump but look at how everything is set up. Unfortunately we learn at our patients' expense sometimes, and the best thing you can do is forgive yourself and learn from it.
I would've waited until the patient was back in bed for the above reasons.
About one week, sometimes two weeks. I would keep doing what you're doing.
I read your other post, and I think the bigger issue you need to tackle is your anxiety. How long have you been a nurse? Have you recently started a new job?
I don't know about an ice pack - all I can really think of is bringing ice cold drinks to clinical to keep yourself cool. If personal hygiene is a concern, you could bring a travel sized antiperspirant.
Depends. I try to medicate and meet the other needs of my patients before leaving the floor. However, there are certain situations where I may not necessarily do that (i.e needing to eat something ASAP because I am dizzy, seeing black spots, and not willing to have a syncopal event in front of my patient) - in those situations you need to put yourself first. Instead I would ask another RN to give the med for me.
I had a nurse forget to give me report once - she gave her report to me on the phone, we laughed about it, and moved on. NBD
Honestly I don't blame the RN - I would say anything to my psych patient to get the psych med they need for both their safety as well as my own. xD
Instead I might've said something like "this medication will help relieve your symptoms" or "it'll make you feel more comfortable". That way you are technically not lying...
Both classes are very work intensive. If you absolutely need to take both in the same semester, keep the rest of your workload light.
I don't run into this too often - I am pretty open with my patients and don't mind talking about my life story briefly and in general terms. If I happen to run into a patient who asks questions about my religious, political, or sexual preferences, I'll probably just say "Enough about me, what about you? What can I do for you right now?"
I would've done the same. You covered you behind by notifying the surgeon, and you did what you were instructed to do. The day nurse was in the wrong here by d/c'ing that central line without an order. Your coworker sounds like a moron - don't even worry about it.
I'm not sure how much orientation you've had, but I do have some tips:
+ Patient safety is #1. Is everyone pink and breathing? Are your confused patients bed alarmed?
+ Chart as you go.
+ Cluster what you can. Give your 8/9/10am meds at 9. While you're at it, pull their pain med that you KNOW they will want. Oh yeah, they haven't pooped in a week - let's pull their PRN laxative. You'll get better at this as you get more comfortable with your routine.
+ Ask if your patients need anything before you leave their room - are they comfortable, do they have everything they need? I've written out lists of needs for my needy, call bell happy patients.
+ Delegate and utilize your CNAs. As much as you'd like to toilet/repo your patient while you are in there, sometimes you just don't have time for that.