gonzo1 15,906 Views
Joined Jun 8, '05.
Posts: 1,672 (45% Liked)
Good luck on your first job. Sounds like you have a good outlook and should do well. I had my teeth out and only needed 1-2 days recovery.
The first thing I do is look to see if the medication order came with any parameters. Often blood pressure meds will say hold if systolic less than 90 etc.
I just completed a legal class while working on my BSN and that class teaches/preaches that you must always notify the MD that you are holding, or want to hold a med.
This is easy where I work nights (ICU) because we have a secure messaging system where you send the doc a text message that you have done something and they can reply or not, but at least you have notified them. This helps cover your a$$.
A couple of weeks ago I got a new admit. I always go over the meds that I'm giving a pt before I give them. The patient said he doesn't take one particular med so like an idiot I didn't give it, and I didn't call the doc to talk to him about it. Turns out it was a new med ordered for the pt. The doctor wasn't mad at me or anything (I got lucky). But I should have called the doc and clarified the med before I held it on my own.
Unfortunately this is a system breakdown because our docs don't talk to the nurses about their plan of care for the patient (ICU). If our docs would say "you're getting this pt and I'm doing this and this" it would provide for a more seamless transition from ER to ICU.
I lived near this hospital as well for most of my nursing career and worked in it in another capacity. I never considered working there as a nurse. I know numerous people who live within a ten mile radius of it but drive twenty five miles or more to work in other hospitals. I also have several friends who worked there for a short time and quit due to the poor environment.
To be fair I do know one person who worked there as a nurse and loves it.
You very well may have saved that patients life. I've been on coumadin and 12 mg daily is a massive dose for almost any patient. The other people are mad at you because they are now on the hook for fraudulent charting, having charted it given when it was not. The fact that the wrong doctor was called is on the RN, not you. But kudos to both of you for addressing this problem. Hold your head high at work and do not speak of this issue further with anyone, you are legally in the right and don't owe them any explanations.
Your future patients are lucky to have you as their nurse and their advocate.
I would never work without it. I get mine from NSO. A few years ago I was called to testify about a case and I was scared so I called NSO and they sent me a lawyer just to hold my hand and walk me through the process, even though I was not being sued. Just testifying.
I think they are great.
I have been a nurse long enough to see many thrown under the bus, so I don't trust anyone to cover me. I get my own and feel safer
They are going to love you. Most ER nurses are not happy about having psych patients, they scare them. You will be greatly appreciated because you have a level of confidence with them that ER nurses don't. You'll learn the ER stuff quick enough. Good luck and enjoy. I work ER, ICU and psyche and they are always excited to have a psych nurse around to take the pressure off. Funny enough the psych unit is always excited to have an ER, ICU nurse around because it makes them feel safer.
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