We all had a horrible week. Acuity is extremely high, we dont have enough nurses. Everyone is burned out and overworked.
On my last day of many consecutive days in a row I missed that my patient should have been on a type of respiratory modality overnight. It was a new order given at change of shift, but I had the patient the night before and she was already on it the night before, so I didnt really think about notifying RT. I didnt catch this until the following morning. I immediately told the charge nurse and head nurse and called the doctor.
I said it was all my fault. I know I read the order. I just was so exhausted that I missed the fact that RT never started the treatment. The patient was respiratory-sound so I didnt have any respiratory distress or desatting to jog my memory.
This is my first really big mistake and I feel horrible, but Im also putting it in perspective, that I need to move on and learn from this. I think there were two major factors to my mistake:
1) being exhausted and overworked
2) getting orders at the beginning of my shift when I will review them quickly because I am stressed and busy
So anyways, I call the doctor and he doesnt yell. He just continues to hang up one me
. Even when I had to call him later about another patient who was in 10/10 pain, he continued to hang up on me. I was almost brought to tears when this guy kept hanging up on me while my patient who had major abdominal surgery is suffering because a doctor is mad at me
about a totally different patient. I charted all of this and told the charge nurse. Luckily this all happened before change of shift, so the oncoming nurse was able to deal with the client's pain and get orders where I could not.
I feel like Im in a bind having this Dr. be so mad at me. He is our intensivist and guides the overall care for most of our patients. I call him at least once a shift and he charts on our unit. I dont know how to deal with him now.
What if when I come in to work again he continues to ignore me? How will I ever get any orders for my patients? What if he comes on the unit and acts like nothing happened? Or even worse, what if he sees me on the unit and chastises me further?
Thanks for the advice.
Aug 9, '10
Could you have called the surgeon and asked for pain management orders? If not, you could ladder up the medical chain of command. Call the MD house officer, say I've called this MD twice, he's hung up on me, I need pain management for this pt. And then also talk to the intensivist the next time you see him.
Last edit by GoldenFire5 on Aug 11, '10