Hey, I just wanted to get something off my chest, and get a little feedback because something happened this week that has never happened to be before and as a newer nurse I'm not sure how I should handle it if I get called this week about it.
I work weekends 6a-6p, during my shift saturday I get a call from the lab on one of my patients with a critical BUN. They said they were going to fax it over. An hour passes, maybe two, I still don't have this lab so I call them again and ask them to fax it. Then I wait some more. And then I wait and wait. I go over to the fax machine, BAM, no paper, so I put some in, and then I did get ONE copy (so I know they faxed it once, regardless of the paper situation)
Anyways, by this time its about the end of my shift, I'm passing meds and finishing up, I write the orders pertaining to the BUN, and hand the lab off to the night shift nurse. Well, I didn't address the INR with the doctor. It was 1.9.
Typically what I should have done was address the INR and put something on the coumadin flow sheet in the mar. I didn't write ANYTHING on the flow sheet in the mar but I guess the night shift gave the coumadin anyway on saturday evening and sunday evening, THEN, she turns around and calls me at about 5AM monday morning asking me about this INR that is technically out of range.
My first instinct is to complusively apologize for everything, all the time, no matter what, and take responsibility for everything but I cannot help but feel like this is not my fault entirely. I told this nurse exactly what I had addressed with the doctor, I handed the labs off to her, I wrote NOTHING on the flow sheet about it and frankly, I'm shocked she gave it anyway without calling the doctor for new orders. I feel like what really happened is she probably just gave the pills in the cart and didn't even look at the mars.
I don't know. My unit manager is extremely effective, and a little bit scary. I don't know what to do. Do I stand up for myself and tell her that night shift needed to have called the doctor and that I did not sign off on the out of range INR, or do I just take it on the chin and say I am the only one who had a responsibility to call the doctor and take the fall for a medication error?