Do you sometimes feel like awful, horrible, dangerous nurse? I sometimes have feelings like that.. to make story short, had a new patient today (I work home health). Lady, eighty something, , lives upstairs by herself, on several BP meds as well diabetic on oral pills (metformin). Husband just recently passed away, son and daughter in law lives downstairs, seen mice in her apartment, forgets or doesnt take her meds on daily basis, last time she had her meds refilled was in january 2011, yet most of the pills lie untouched in her bottles meaning she hasnt been taking her meds as she suppose, blood sugar today was normal, checked her BP 160/100. Wanted to giver her the BP meds (she takes 3 in the morning one in the evening). Couldnt do that because she wasnt sure whether she took those meds (my intuition tells she has not touched those pills for BP today). Was ready to give it (based on my intuition). Confirmed with son. Son has no idea whether the mother took her meds today. I called my boss, boss adviced me to not to give those meds today since I may double dose her, so I witheld the meds. Set up a medication box,refilled all the necessary meds in the box instructed the daughter in law to administer those meds to patient daily starting tommorow, phewwwww close call. Yet forgot to tell the son to remove all the medication bottle from the patient's table (in case she wakes up and decides to take her diabetic pills and bp pills).
You are FAR from an awful nurse but I think all of us feel that way sometimes. Don't beat yourself up over this and keep being the caring individual you obviously are;)
Yes. In fact I've felt like this lately because in the last 3 out of 4 days I've worked, I've had a patient go into some kind of respiratory distress. I keep replaying what I could have done differently, but honestly there isn't anything I could come up with. At least I didn't code people 3 out of the 4 days.
We have PCAs that do vitals, but I still get vitals on some of my patients. We also do bedside reporting, which has helped. My schedule is something like this:
1900-2000 bedside reporting, looking over charts (just the last couple of pages, I don't want any surprise 2am orders), and any "clean up" (which could involve, actually cleaning up, restarting IVs, removing trays/getting fresh drinks, putting in outstanding orders, etc). Then I pull meds. Our 2100 meds can be given 2000 and 2200. I try and arrange this around pain medication/sleeping pill/antibiotic/insulin. With all my meds pulled I go pt to pt, assessing and passing meds. Ideally this takes about 15 minutes a pt. If it takes longer I take a moment every hour to let every pt know what's going on. (IE: I have your night medication ready, but since your pain medicine isn't due until 2130, I'll get them all to you at the same time. Are you doing okay? Is there anything I can get you before then?).
Of course, admissions, bad patients (either in bad health or just being bad), co-workers that need help with a high priority patient... all those can throw a wrench in my plans. However, most of the time I am able to arrange those first few hours like that and take the rest of the night as it comes. Sometimes I don't chart until 2am- although that's rare- but I do put charting as last priority.
dimpledRN
14 Posts
You are FAR from an awful nurse but I think all of us feel that way sometimes. Don't beat yourself up over this and keep being the caring individual you obviously are;)