Could she do this?

megananne7 · Apr 24, 2007

No, she doesn't and if she disagrees with the doctor, she needs to be unassigned to your mother. I'd go to the DON/Nurse Manager or even the doctor.

The only time a nurse should withhold meds would be if the dosage is wrong and might cause death/injury or similar situation.

Halinja, BSN, RN · Apr 24, 2007

I don't think it matters that she's an LPN. I think it does matter that she is overriding the doctor's orders on an issue that does not constitute immediate harm. (withholding the meds because she's allergic, or because its something that will spike her blood pressure when the blood pressure is already sky high, or withholding dig because her apical pulse is below 60, stuff like that)

This is not a small thing. What other orders will she override? This is something that needs to be dealt with immediately, by her managers. I'm not sure but what it wouldn't be a reportable to the BON thing. (not sure on that)

Trauma Columnist · Apr 24, 2007

Please take this up with the DON and administrator. No, this nurse (doesn't matter if she is an LPN or RN), does NOT have the authority to withhold care/tx.

tatgirl · Apr 24, 2007

This nurse shouldnt have witheld the antibiotic. How does she know it isnt working? Were labs recently drawn? If that was the case, she should call the dr and let him know. Definetly let the DON know what has happened. And I am not mistaken, this could be considered neglect that could be reportable to the BON.

Wendy

LPN

TazziRN, RN · Apr 24, 2007

Nurses of any level are not allowed to withhold meds because they don't think the meds are working. There are certain meds that can be withheld under certain conditions, such as holding an antiarrhythmic for a heart rate below 60, or BP meds for a systolic below (insert dr's desired number). Or if there is a reaction to the med. That's it.

RNsRWe, ASN, RN · Apr 24, 2007

We withhold stuff like Milk of Mag if the patient is pooping liquid like a firehydrant, but that shows the med IS working

Like the others here have said, if giving the med is likely to cause harm, such as BP/cardiac meds, even IV fluids if the person is suddenly bloating and the rate is 150 an hour, but for that last one you'd call the doc and get that rate changed pronto. Not decide to change it and figure it'll all work out in the end!

As soon as this nurse shows her MEDICAL license, she can go ahead and change the atx or cancel them. Meantime, get to the DON and get the ORDERS followed.

TazziRN, RN · Apr 24, 2007

You can also let the doctor him/herself know that the orders aren't being followed. Let him/her know how many doses were missed so that the problem can be fixed.

first_lobster, RN · Apr 25, 2007

I, personally, am especially fond of withholding reglan in my C-Dif patients, and Narcotics in my Overdoses (Especially the ones that have overdosed on them), But I can't say that I've ever had the desire to withhold an antibiotic because "I didn't think it was working". That's just wrong. :trout:

firstaiddave907 · Apr 25, 2007

No, she doesn't and if she disagrees with the doctor, she needs to be unassigned to your mother. I'd go to the DON/Nurse Manager or even the doctor.
The only time a nurse should withhold meds would be if the dosage is wrong and might cause death/injury or similar situation.

Thats a very good point that you made.

psalm, RN · Apr 25, 2007

I, personally, am especially fond of withholding reglan in my C-Dif patients, and Narcotics in my Overdoses (Especially the ones that have overdosed on them), But I can't say that I've ever had the desire to withhold an antibiotic because "I didn't think it was working". That's just wrong. :trout:

Huh? Why would you withhold reglan for C-diff pts? I don't follow you. Thanks in advance.

first_lobster, RN · Apr 25, 2007

Reglan increases GI motility. If my pt is already poopin goosey style, I'm not sure I want to increase the gi motility and cause them to poop more. Generally frowned upon.