Hello! I am a new RN. I had an order to hang a bag of XXX today. Before I hung it, it said to check the patients levels. I did. They were in normal range. I talked with my preceptor about it and she asked me what did she think I should do. I said I would not hang it. She said call the doc. to verify the order. I did.
Doc. started out the conversation with "Are you new?" I said yes. The doc. proceeded to tell me what the normal range for the mineral was. I said 'Yes. I know this. I am very familiar with this drug. I am fine and know it well." I asked her if the patient had a history of this element being low, etc. She explained why she wanted to keep him on it. I said "Ok. I understand. I was just double checking as the pat's range was normal. I said "thank you." And with that the doc. slammed the phone down and hung up on me. Cut off. That was it.
I guess the doc. DID NOT like me calling and questioning the order. BUT the range was normal and I did not want to hang the med. and harm the pat. My system lite up in BOLD letters when I scanned the med. and said to CHECK THE LEVELS BEFORE GIVING. AND... they were normal. So I did what I thought was right.
My family is scared the doc. will go to my boss and have me written up or fired. Can docs. do this?? Oh my. I am sure I will not be on their favorite list from here on out....
The doctor cannot fire you unless he/she is the one that hired you and it's their office. I've been "fussed" at a couple of times and I SERIOUSLY doubt the doctor even remembers it.
I work at night and we only have to deal with a select few doctors whom I adore and the residents which change yearly.
Thanks everyone! I REALLY APPRECIATED all the feedback here. And NO... it has been a few days and nothing has happened. I have seen that doc. and have even conversed with her on another pat. and all went Ok. Saw my boss too and nothing... thanks for "chilling me out!"
Hello! I am a new RN. I had an order to hang a bag of XXX today. Before I hung it, it said to check the patients levels. I did. They were in normal range. I talked with my preceptor about it and she asked me what did she think I should do. I said I would not hang it. She said call the doc. to verify the order. I did.
Doc. started out the conversation with "Are you new?" I said yes. The doc. proceeded to tell me what the normal range for the mineral was. I said 'Yes. I know this. I am very familiar with this drug. I am fine and know it well." I asked her if the patient had a history of this element being low, etc. She explained why she wanted to keep him on it. I said "Ok. I understand. I was just double checking as the pat's range was normal. I said "thank you." And with that the doc. slammed the phone down and hung up on me. Cut off. That was it.
I guess the doc. DID NOT like me calling and questioning the order. BUT the range was normal and I did not want to hang the med. and harm the pat. My system lite up in BOLD letters when I scanned the med. and said to CHECK THE LEVELS BEFORE GIVING. AND... they were normal. So I did what I thought was right.
My family is scared the doc. will go to my boss and have me written up or fired. Can docs. do this?? Oh my. I am sure I will not be on their favorite list from here on out....
Physicians work on contract, they are not employees of the hospital and they do not have the ability to fire or write you up.
If they think you need disciplinary action, they go and see your Nurse Manager who makes that determination.
However, here is a point to ponder:
You have to use your critical thinking when reading levels of electrolytes or other elements.
Lets say you have a patient that is receiving sodium supplements. You notice that they have been on this supplement for DAYS and even though their range is normal, it's on the LOW side of normal.
You can critically think, that the reason they are within normal range is because of the supplementation, not that they no longer need it.
The levels, I check for, I look at the last labs and see if they are high...if they are within normal range or of course, low, I give the med/hand the IV/give the supplementation, whatever.
Your perceptor should have guided you without allowing you to throw yourself under the bus like that...that is bad percepting. When she asked you what you should do, and you answered, she should have agreed to disagreed and then tell you how to proceed...only if it was TRULY necessary, should a physician have been called...and in this case, it probably was not and that is why the physician got irritated.
If anyone is probably going to get in trouble, it's going to be your perceptor.
I am a new RN. I had an order to hang a bag of XXX today. Before I hung it, it said to check the patients levels. I did. They were in normal range. I talked with my preceptor about it and she asked me what did she think I should do. I said I would not hang it. She said call the doc. to verify the order. I did. 
Oh my. I am sure I will not be on their favorite list from here on out.... 
:redbeathe 
Caffeine_IV
1,198 Posts
The doctor cannot fire you unless he/she is the one that hired you and it's their office. I've been "fussed" at a couple of times and I SERIOUSLY doubt the doctor even remembers it.
I work at night and we only have to deal with a select few doctors whom I adore and the residents which change yearly.