Did i handle this situation correctly???

Nurses General Nursing

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Im a fairly new lvn with about 6 months expierience working in ltc. Well i worked prn at a ltc facility.so wat happened is a pt had just come in yesterday evening so the am nurse asked me if i could get an order for the pts cpap machine so i called the md on call and got the order.then later on when i checked the pts bs it was at 168 and pt was scheduled 45 units of intermediate insulin and had a sliding scale apart from that which he was supp to get 3 units from his bs reading.pt asked me if he could only take 25 units of the intermediate since he was worried his bs would become low due to him have to take the 45 units and sliding scale.i told him i didnt have the power to give him the 25 units i had to follow mds orders.pt was concerned because he said he started feeling lightheaded at about 100ish bs so i told him id call the md and ask his opinion and see if hed give permisssion for the 25.well to make story short the md on call pretty much reamed me a new one.he said that he was not changing any orders that pt had to take order as is or nothing at all.he was pretty much a jerk.i understand he was upset cause i had called him about the order earlier but i feel he overreacted.did i handle the situation right or wat could i have done differently???

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and yes my eyes didnt water a bit...guess i needa grow a backbone

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i mean DID

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Specializes in ED, ICU, Education.

You did what you thought was best and in my opinion was not by any means wrong or incompetent. It sounds like this doc needs to go to finishing school! Don't sweat it when a doc freaks out on you. Best of luck!

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Specializes in Wound Care, LTC, Sub-Acute, Vents.

i would have not called the md for the second time. i would have asked my fellow nurse on the floor or the house supervisor whether this request warrants a call to md. that's what i did when i was new like you.

some doctors can be as*es so make sure you have all your ducks in a row when calling such as the recent vs, previous labs, meds they're on, etc...to minimize the md getting annoyed at you.

angel

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the doc even told if the pt wanted to handle his diabetes since he wanted to adjust his dosages.sheeshh im just afraid of doing something wrong and losing my license somehow.thats one of the parts i hate about nursing.=(

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Given the situation I believe you handled it ok. You did not just brush off the client's concern, which is a good quality. However, I feel you should have explained to client the importance of the ordered dose to ease his concern. If you did not understand the requirements of order, then it would have been appropriate to contact Md immediately.

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Specializes in Wound Care, LTC, Sub-Acute, Vents.
i would have only given the 25 units and documented "per patient request."!

i am pretty sure you cannot do that. that is called prescribing without a medical license.

will you give a pt who is asking for aspirin not in the mar and document it as "asa given per pt request."?

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i am pretty sure you cannot do that. that is called prescribing without a medical license.

will you give a pt aspirin if it is not in the mar and document it as "asa given per pt request."?

see thats what i was thinking...i didnt think i could give him 25 units when the order read give 45 units so thats why i called the md to see if he would give the okay to give 25 units cause thats what the patient wanted but seems i cant get any leadership anywhere well not from him lol

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Specializes in ED, ICU, Education.

In my experience a patient has the right to refuse any medication. The patient was refusing almost half of the ordered dose. My hospital policy states that it is allowed.

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in my experience a patient has the right to refuse any medication. The patient was refusing almost half of the ordered dose. My hospital policy states that it is allowed.

thank u...hopefully this situation will teach me how to handle these kinds of situations further in the future.

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thank u...hopefully this situation will teach me how to handle these kinds of situations further in the future.

*better*...man i better go to bed im misspelling everything lol

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