Ambien order did I make a mistake - page 3
by nakinok 3,914 Views | 22 Comments
The order reads Ambien 5mg 2tabs po qhs, mrx1 what do you think this is? I thought original Order of two 5mg tabs can be repeated once if needed. I was told you only repeat with one 5mg tab. I am confused. What do y'all think?... Read More
- 0Dec 5, '12 by samadams8The order doesn't meet the safety guidelines. Even if you repeat 10mg x 1 nothing will in all probability happen to the patient--but you never know. What if they climb out of bed, tear out their lines, fall, whatever. The first person they look to for assigning blame is the nurse.
So, if it is dubious in any way, which it is, just get the darn thing clarified as per the safety standards. Sometimes you have nudge a newer doc along in this regard. You speak it back to them and ask if that is what they want, or you say, do you want the 5mgs or the 10 mgs repeated * 1? I have simply re-stated the rx by what is acceptable and protocol, and they would be like, "Yea. That." No if it is outside the protocol, and there is a good reason for it--like this is what the patient usually does at home, or whatever, fine. Write and Read the exact order back, get affirmation from them, and observe and document how the patient tolerates it.
This is a lesson to teach you that you have to get things covered correctly; b/c the next time it could be a medicine that could do major damage if transcribed or followed incorrectly.
You can also say, "I see that the usual dose is blah, blah, blah. Is that what you want or something different?" Always carry a software program or have access to pharmaceutical substances you will administer--and also refer to the hospital or institution's formulary. Clarifying with a doc goes so much better, as well, when you address something intelligently and without an attitude of either timidity or arrogance. No extremes.
Cover yourself, and get a correct order for everything. And I say this, and I have worked in critical care units where we were given a ton of autonomy compared with the floors--and a tons of autonomy especially compared with pediatrics or PICU or NICU (You kind of give up the same kind of autonomy to work in those areas, b/c there is less tolerance for error.).
At the end of the day, however, EVERYTHING NEEDS A CORRECT ORDER. You will be called on the carpet over it. So, if you take off the order, or you go to follow it, but you do not make sure it is a correct/acceptable order--or that it is at least clarified and noted as such, it will fall back on you.
Thous shalt cover thine arse.Last edit by samadams8 on Dec 5, '12
- 0Dec 5, '12 by samadams8Quote from CrystalSSAI know one thing, Ambien sure made me do some crazy things. Just ask my kids. I stopped taking it. I was afraid I'd end up driving around the neighborhood naked. So I don't touch the stuff.I would call to clarify because 4 ambien is a heck of a big dose. I rarely see two given.