The agency I'm with has now announced that they won't be putting the ML's to give on the MAR. They will put the dose on the MAR in whatever form that is (mg, mcg, gtts, etc). I think that will lead to major med errors and possibly become life threatening...leading to lawsuits from families. We were told its corporate and the whole company will be doing it. But I'm wondering if its only local or even just our office.
We all have run in to that nurse that we know couldn't do the math! What if that nurse gives a wrong dose at the end of their shift and then you are the next nurse? The patient is overdosed. Or maybe doesn't get enough of a seizure med and has a seizure. Of course, you don't know what the nurse did. You can only respond to the situation you've been put in to. What if the nurse before you gets scared because s/he can't do the math and fails to give the med at all? Of course, the nurse before you has documented that the patient was stable or VSS prior to leaving their shift. 30min later the med has had time to start taking effect. Now the office is saying the child was fine when the other nurse left and is now questioning you. What about emergency meds? I'd rather calculate them ahead of time and have the ML's to give written down so I don't have to do a calculation in an emergency. That could waste valuable time. If the nurse is slow at calculations, then what?
I feel very confident doing med calculations. But I'm human and could make a mistake. Even with the ML's to give on the MAR I do the math to make sure its right. I've caught others med errors doing that.
Opinions?? If this sounds familiar, please post. I'm curious if this is agency wide or just local. I'm not going to mention agency name at this time.
Sep 25, '11
I do the MARs for my cases. I put both, and always have. Ex: 20 mg (10 ml). I also include the units of measure and both the generic and most common (or applicable) trade name. I never get criticized for making the MAR this complete. Apparently your agency does not believe it is paying out enough in lawsuit settlements, so they are going to rectify the situation at the expense of field nurses.
Last edit by caliotter3 on Sep 25, '11