I was written up and put back on orientation

Nurses Safety

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I am an rn at a small rural hospital 4 months in. I had a pediatric post op ruptured appendectomy patient. He was npo about 5 hrs of having him his bowel tones returned so I let him have ice chips he handled that well so I let him have a few sips of apple juice about 2 hourd after tje ice I did not call his doctor to okay this and I have been reprimanded and put back on orientation if I have any more mistakes or complaints from docs or coworkers in the next 30 days I will be terminated. I thought this was what I was supposed to do.

Specializes in dementia/LTC.

NPO is NPO as the others said. Don't let it get you down. Every new nurse is scared. I had an instructor say once if a student or new nurse isn't scared at least somewhat that it scared THEM. Fear in moderation is a good thing as it means you still know you don't know everything and keeps you double checking so you don't make mistakes. Don't be scared to ask questions and don't beat yourself up over it. A CNP I work closely with told me (after the other nurse working my unit had just had a med error) that she would rather have a nurse taking care of her that had had a med error in the past than one that never had bc the nurse that had had a med error before was more likely to be far more careful in the future.

Trust me you won't make the same mistake again. If the hospital seems overwhelming consider going into LTC for a year or 2. That's how I got my start and I'm glad I did bc I'm very proficient in dealing with family, drs, passing meds, orders, treatments, managing my staff/time/patients. And I still get to do more 'nursery stuff ' as I call it. When I make my move to the hospital I feel like so much of it will be easier.

Specializes in Critical Care; Cardiac; Professional Development.

I was taught that ANY time there is an issue with the gut the first intervention always is NPO status. This is for suspected bleed, pancreatitis, appendicitis, postoperative abdominal surgeries, etc. The rational as I understand it is to rest the gut, minimize inflammation, allow for less agitation/peristalsis in order to promote the body's natural healing process. If you put food/fluids in there, the gut must perform its natural function and is no longer at rest, which can interfere with healing. Any time I have explained this to the patient or their family members I get a bit of an "a-ha" moment from them. They may not like it any more than they did before but at least they now know it is not arbitrary or bureaucratic on our parts, but rather a part of the healing process. In the case of an agitated parent, you can liken it to letting little Johnny get up and run around on a fractured leg because he was restless sitting still. It is unlikely most parents would question the need to stay off a freshly fractured leg. Kids aren't capable of understanding rationales sometimes but if you engage the parents they can hunker down into the waiting it out, make him comfortable, keep him distracted phase of healing and hopefully partner with you for their child's best outcome instead of fighting you. If there is no parent around, at least you yourself will know you are doing what is best for the child as the poor thing goes through it and you deal with their distress.

We all have had to learn some things the hard way. You will recover from this and undoubtedly will know better next time you have a postop abdomen! Who knows, someday you may even be mentoring a new nurse and share your story to teach and encourage! Chin up!

Specializes in HH, Peds, Rehab, Clinical.

It sounds like you didn't have an order to give anything orally if patient was NPO. I'd say you were in the wrong, sorry

Kalicokats, don't give up too soon.

First, nursing is a continuum of learning. Everybody screws up eventually, if this is the first time in four months, you are doing okay.

Was the child harmed because you gave him the juice? Did he have to go back to surgery?

Unfortunately, too often, management jumps to writing up people for errors rather than using these situations as teaching opportunities.

I guarantee you that I have seen MANY senior nurses give pts sips and chips on an NPO order. It isnt right, but it does happen.

For future reference, just remember orders and procedures are the law of the land.

If you must call a Dr. at night because a parent or pt is driving you nuts, if the Dr. complains, just tell him "Dr. I am just trying to help you care for your patient". That usually quiets them down.

Hang in there, you will be surprised at how many of your patients appreciate you, even if your manager doesn't recognize all the good that you do.

Blessed Be

On the mouth swab things - you have to watch patients when they are independent with the mouth swabs. A lot of nurses will leave a pile of swabs and a cup of ice water for the patient to do his own swabbing. I have seen patients "drink" multiple cups of water by transferring the water to their gullet via a swab. They think it's OK because they are using the sponge. If they realize it's not really OK but are sneaky enough to do it anyway, they will ask multiple staff members to refill their "swab cup" so the nurse many not even know it's happening.

Had a patient with an NG to LIWS doing this, and what tipped us off was the giant full cannister of clear fluid he filled up in a matter of hours!

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

I know how awful this is for you. Chalk it up to a lesson learned. We all learn some things the hard way. Don't let it demoralize you. I know you feel badly, and I won't add to that. I am here if you need an ear to listen.

You guys are great thank you for the words of encouragement but most importantly thank for the suggestions for improving my knowledge.

About the policies, there is a binder which is a jumbled up mess of policies, pages are torn missing etc. They just began the process of getting this fixed and computerized so it is currently not something I can reference while they are working on it and the binder is in someone's office.

Volunteer to be part of the "they." That binder will need sorting, policies that are old will need updating, and there will be things missing that are listed in the table of contents. Oh, no table of contents? They'll need that too.

You will learn a lot, see what's missing, and earn some serious brownie points.

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