Published Feb 19, 2009
zuzi
502 Posts
"Coverd by doctor order" is another crepy think that I seen here.
Is a vicious circle between a nurse assesment and judgment and the doctor order. So... you asses the patient, document, inform the doctor, YOU are are accountable of what do you tell to doctor and the doctor is accountable about what he ordered to you. Any other mixed in this link is just a DEVIANCE.
Accountability in nursing profession is all that we NURSES we have.
Clarify is for patinet well beeing. If somenthing is unclear...CLARIFY! Bothering by someone with your questions...is just DEVIANCE.
Let me to give you and exemple a case to study...looool
Patient admitted at 1pm with suspected DVT lover extremities. Postive DVY dopller at 5 pm. Dr orderd anitcoagulants. 1 am midnight... patient is NOT on anticoagulants! 3 RNs was there working with, 3 charge nurses worked with and many others.....looool
Pharmacy transcribed doctor order anticoaglaion therapy to be started with NEXT!!!!!!!!! day in the afternoon. More than 24 hour patinet with DVT confirmed not coverd with anticoagulants!!!!!!
You need to TALK! TO CRY TO SHAKE! Is a patient life there! But I am just a foreign RN with my kuku musical mind, loool who bother others, loool.
Applying american standards... need to write up people and don't care, loooool. I preferd to clarify and to do the good staff, and i was lucky to have logical mind close to me. I will miss so badly them....
I could not stay and work in a terror working place to be. I am scared to speak up ....I am scared also to work....coverd by THESE type of trinscribed orders... and i don't care style to be....
Tell me about you... about... "coverd by doctor order"...
kellykelly
76 Posts
Any good nurse would know that in that case the anticoagulants should have been started right away. It's a question of knowing what you're giving and WHY. For anyone to say otherwise is just silly. Do you actually have co-workers that were unhappy that you questioned them about this? Rather than taking it so to heart, try gently educating them about WHY it needed to be started right away and not the next day.
Not to be rude but maybe one of your main issues is a language one. Do you find it difficult to get your point across to your co-workers? You seem very upset about this issue, like it's been building up for some time.
ghillbert, MSN, NP
3,796 Posts
I don't understand your post at all.
leslie :-D
11,191 Posts
no zuzi, it's not because you're foreign.
it's because these nurses have no standards, provided they knew about the orders.
who cares how they react?
and if this pt went w/o anticoagulants x 24 hrs, then an incident report must be written.
i certainly would, that's for sure!
let them get as angry as they want.
my concern is for the pts AND make sure by butt is covered at all times.
hold your head up and keep it up.
flash your most magnetic smile and tell them to bite you.
if you don't let these jerks drag you down, you'll be absolutely fine.
and remember - keep that head up, chin out!!:icon_hug:
leslie
You seem very upset about this issue, like it's been building up for some time.
there have been some people at work, that have been giving zuzi a hard time for a while now.
zuzi has a big heart and struggles to understand malicious coworkers....
and malicious people in general.
Keysnurse2008
554 Posts
Exactly....you are right. Patient ideally should have been started on anticoagulant immediately. But were there other issues? Did they have liver failure/cirrhosis.....were the PLTs crisis level low? That is one scenario I can see Pharmacy holding the anticoagulant till the next set of labs are drawn....but they always communicate their rationale to the nurse if this is the case.Hmmmmmm.......not starting the anticoagulant ( if coags were wnl) could have resulted in movement of that DVT....can anyone say PE?
there have been some people at work, that have been giving zuzi a hard time for a while now.zuzi has a big heart and struggles to understand malicious coworkers....and malicious people in general.leslie
Iam so sorry. I hate to say this....but it may be professional jelousy. It sounds like they may be a lil lacking in current knowledge of what can happen when a DVT moves. A PE has a high mortality rate. Maybe ....if they cant appreciate you....then you should look for another job. Life is just to short to be unhappy....tons of nsg jobs out there.
Thankful RN,BSN
127 Posts
I couldn't read your post because your spelling is AWFUL! sorry
Atheos
2,098 Posts
No need to be rude.
Zuzi made herself PERFECTLY clear. Communication isn't about spelling. It's about being receptive eh...
Anyone with a semi decent command of the English language can tell what she is saying. Pfft........
steelcityrn, RN
964 Posts
Best to notify your supervisor about it. They have the time to investigate it and figure out where the system failed. Then, the correct person could be held accountable.
truern
2,016 Posts
changed my mind.
lpnflorida
1,304 Posts
Zuzi, writing up an incident report ,med error of omission , is what needs to be done.