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Nurses Safety

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just wanted to air my dirty laundry,i am a registered nurse with 19 years experience, i am presently in some hot water about a patient care issue.

working in the er on a extremly busy evening shift we had 30 patients jammed in 21 beds and were utilizing every available hallway space for 9

more.the wait time was in exsess of 2-3 hours with 16-18 patients in the waiting room waiting to come back.............you all know what it's like!!!!!

a 2 year old was wheeled in mom's arms straight back from triage, you could hear wheezing and he was tugging to breathe, i was asked by the charge nurse if i could get him started,i agreed and she asked if i thought he needed a treatment, my reply was "listen to him,what do you think" she had the clerk call respiratory, i wrote for albuterol/atrovent treatment on the chart and began taking care of a patient in my assigned area that had a hemaglobin of 3

the doctors were busy and nowhere to be found........after passing the family in the hallway about 10 times on my way to the med room for lasix and tridil for my patient with the hem of 3(he went in to flash pulmonary edema after he got his 2nd unit of blood with me pretty much standing at the bedside the entire time).i ordered a cxr for my 2 year old just to be doing something while waiting for a doc to see him. 1/2 hour later i spoke with a doc who agreed and gave me verbal order for the neb and cxr. 40 min later he had still not seen the doc. the family went to the desk and complaint that they had not been seen yet and why they were waiting so long. 21/2 hours later they were seen by another doc. a passing charge nurse wrote me up for practicing outside of my scope of practice and i was suspended and probably being terminated and reported to the state board of nursing. please offer any advice you can and help me defend myself, i did what was reasonable and prudent under adverse conditions.i talked with a doc but only after the treatment and cxr were done. what would have happened if i did nothing but put the kid in a bed??????the child did well and was disch as soon as a doc saw him....thus expediting care and movin them thru the maze faster.....and now i'm paying the price by lossing my job.........thanks in advance for you responses....i need you guys help by mon at 3 pm when i sit down with the hosp to grieve my termination :angryfire :angryfire :angryfire :angryfire

I'm sorry, but you did practise outside of your scope. I don't see what you can do to avoid termination. It's sad, but you do need a doc's order before starting treatments or doing tests. Was this common practise in your ER?

Specializes in er, pediatric er.

That sucks for you, I am sorry. Maybe it will work out. I work in a peds emergency department as a nurse extern, our nurses have standing orders for treatments and xrays, if a kid comes in with wheezing or respiratory distress. We can put the orders in the computer under the attendings name and he signs off on them. If we have a hem/onc kid come in with a fever, we can go ahead and access the port and get blood cultures and blood work on them before the doc comes to see them. This works better for us, that way the treatment gets started immediatley. It is a win-win for us, as well as the patients. Anyway, I hope everything works out for you in the end.

Specializes in Nephrology, Cardiology, ER, ICU.

We have standing orders for nebs, cxr. Does your ER not offer this?

just wanted to air my dirty laundry,i am a registered nurse with 19 years experience, i am presently in some hot water about a patient care issue.

working in the er on a extremly busy evening shift we had 30 patients jammed in 21 beds and were utilizing every available hallway space for 9

more.the wait time was in exsess of 2-3 hours with 16-18 patients in the waiting room waiting to come back.............you all know what it's like!!!!!

a 2 year old was wheeled in mom's arms straight back from triage, you could hear wheezing and he was tugging to breathe, i was asked by the charge nurse if i could get him started,i agreed and she asked if i thought he needed a treatment, my reply was "listen to him,what do you think" she had the clerk call respiratory, i wrote for albuterol/atrovent treatment on the chart and began taking care of a patient in my assigned area that had a hemaglobin of 3

the doctors were busy and nowhere to be found........after passing the family in the hallway about 10 times on my way to the med room for lasix and tridil for my patient with the hem of 3(he went in to flash pulmonary edema after he got his 2nd unit of blood with me pretty much standing at the bedside the entire time).i ordered a cxr for my 2 year old just to be doing something while waiting for a doc to see him. 1/2 hour later i spoke with a doc who agreed and gave me verbal order for the neb and cxr. 40 min later he had still not seen the doc. the family went to the desk and complaint that they had not been seen yet and why they were waiting so long. 21/2 hours later they were seen by another doc. a passing charge nurse wrote me up for practicing outside of my scope of practice and i was suspended and probably being terminated and reported to the state board of nursing. please offer any advice you can and help me defend myself, i did what was reasonable and prudent under adverse conditions.i talked with a doc but only after the treatment and cxr were done. what would have happened if i did nothing but put the kid in a bed??????the child did well and was disch as soon as a doc saw him....thus expediting care and movin them thru the maze faster.....and now i'm paying the price by lossing my job.........thanks in advance for you responses....i need you guys help by mon at 3 pm when i sit down with the hosp to grieve my termination :angryfire :angryfire :angryfire :angryfire

I can not understand that your ER system does not have standing orders, hard to understand how would function without. Please get an attorney, you need to protect yourself and your yrs of experience. I saw somewhere on this website about a legal site for nurses only, looked very professional. I just do not remember name of website. This was a place for nurses in trouble just like you to get REAL help. I am so sorry you are going through such a difficult time. Please pm me anytime, let me know how all is going. All is going to be fine. Please no matter what, get legal help.

Specializes in Critical Care.

Does your ED have protocols? Most do, if not offer to be on a committee to establish reasonable and prudent protocols for nurses to initiate. Own up to your error, even with good intentions if you don't have protocols/standing orders to begin treatment then you did practice outside your scope. You may be able to pull it off by offering to head up a committee to help institute protocols. Good luck to you.

Specializes in MS Home Health.

Oh geeze, I am sorry. I have been in spots like that and was always covered by the doc..

Get a lawyer............

Hugs,

renerian :icon_hug:

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