2 Nurses needed???

Nurses Safety

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sjoe

2,099 Posts

Specializes in Corrections, Psych, Med-Surg.

This has been the, largely ignored, policy at most places where I have worked. The function of the written policy is to cover the butts of management personnel, but in practical terms there is not usually a second person nearby to verify the dose of heparin or insulin.

debmsn01

15 Posts

:eek:

Yes it is an outdated policy, but it is making a come back due to many medication errors!! Having someone double check your meds, your calculations & such for meds, is an avenue of protecting yourself. When we stop taking it as a personel affront to our competence & look at it as a way to ensure safety to our patients, then we can see how benefitial it is to our practice. Just because we haven't been doing it, doesn't mean it is RIGHT. We falsely assume that because it is not required, we will be covered in case of an error-that has cost many nurses their right to practice or the lingering doubt of "if only, I would have checked it", & that is difficult to live with.

AstudentLPN

12 Posts

:) It is old school but a good idea I think . fTO ERR IS HUMAN!!:)

sbic56, BSN, RN

1,437 Posts

Specializes in Obstetrics, M/S, Psych.

But, first...there must be adequate staffing to even utilize this old practice! Where the hec ya going to find that nurse to double check you everytime you give a dose of heparin or insulin?? Oh, but then, if facilities were adequately staffed we would not be so harried as to make the mistake in the first place and the old policy could be put to bed. This is an old idealist rule that in theory is beautiful; in reality is laughable. Bottom line defense in preventing medication errors of any type is to have adequate staffing. We are competent singularly or as a group only when there are enough of us to perform the job competently.

Long Term Care Columnist / Guide

VivaLasViejas, ASN, RN

22 Articles; 9,987 Posts

Specializes in LTC, assisted living, med-surg, psych.

My hospital reinstated this policy last month, and it's a pain in the patoot to have to go find another nurse to check insulin with, but it's no different than having to find someone to witness a narc waste. When I first started working there, I'd been in LTC for a long time where we ALWAYS checked insulins, and thought it was bizarre that we didn't do it in the hospital where it's so easy to make mistakes due to being rushed, distracted etc.

Now we have to sign off as well, which means dragging the insulin bottle & syringe, the pt's chart AND the diabetic flow sheet all over so the other nurse can check both the order and the dose. Lots of fun when you've got 3 or 4 diabetic patients on your team......but ya know, I've always made a habit of checking ANY med I'm not sure of with another RN, so it doesn't really bother me all that much even though I've always taken extra care with insulin, heparin, IV antihypertensives etc. I think it's just good policy, even if it IS inconvenient for us nurses....I mean, how "convenient" is it to deal with the aftermath of a med error?

debmsn01

15 Posts

There in lies the answer, nurses must bring to light that the effectiveness of these changes & quality patient care are only feasible with adequate staffing. So speak up for staffing issues with your state nurses assoc., legislators & whomever else can help. :eek:

nurse62

36 Posts

WOW...I work at in LTC and when I first received my license I would have another nurse check it. They would give me the funnies look, like I was crazy. I know this is how we are taught however it is never done at my facility. I think I will look it up in the policy book...thanks.

melbnurse

29 Posts

It is Policy at our facility, to double check all insulin, anti coags , and IV meds

LydiaGreen

358 Posts

Alright Coag, perhaps in your opinion I am only a lowly student, but it is POLICY at the hospital I have done placement in for three years and will be working at when I graduate in May, to have a co-signer for heparin/insulin/narcotics. As a student in my final year I verify and cosign for seasoned, experienced nurses, and I have caught errors. When a nurse has ten patients in the average shift (even though they are only supposed to have a maximum of six), it is understandable that errors occur.

There are now SEVEN rights:

1) Right patient

2) Right dose

3) Right drug

4) Right time

5) Right route

6) Right documentation

and

7) Right day (this is major source of med errors for drugs that are given qod, or q3d). Although some individuals may lump it in with right time... this is where the med error occurs... day should not be lumped in with time.

Also, for the individuals who state that they have difficulty in finding another nurse to cosign, verify their med - does your facility use individual med carts on the floor? Our hospital uses one central med room on the nursing floor. Since heparin/insulin meds are given at routine times, there is always another nurse or two or three or four in the med room drawing up the same meds for their patients.

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