queenjean 8,663 Views
Joined Mar 23, '07.
Posts: 997 (34% Liked)
We all have our own PCA key. Just like we have our own key to the med drawers.
Eh, I don't see what the big deal is. Our PCA doses are monitored every four hours, any change has to be co-witnessed, and wastes need to be co-wasted. Any discrepancy (like, if the PCA says there should be 10 cc to waste and there is only 5) goes to our clinical nurse specialist for monitoring.
We used to have to pull the key out of the pyxis, but people didn't always return them immediately so you would have to hunt them down (who has the pyxis key?), and it was a pain to have to run back all the way to the end of the hall (where the med pyxis is, poor design, yes) to grab the key to make a change or add more time, etc. It was simply a waste of time. When we floated to the surgical floor, we would have to chase down another nurse, because they all carry their own and therefore don't have one in the pyxis.
I would be insulted if the hospital thought I was untrustworthy enough to not carry my own key. If someone is going to steal narcs, what is going to stop them from pulling the key from the pyxis pocket or asking the charge nurse for it and then doing it then? If you have an untrustworthy nurse who is stealing narcs, she's going to do it with or without her own personal PCA key.
Antibiotics/drips/whatever.... Your start time of the drug is when the drug is actually going in to the patient's venous circulation. Not when you hang it. My preceptor looked at me like "***" when I ran my Vanco wide open when I hung it. I promptly slowed it to my rate I wanted once I ran it through the 1,000,000 miles of IV tubing. Then I noted the time. They just hang the drug and it takes about 5-10 minutes (depending on the rate) for it to travel to the patient.
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