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Discussion

Doctor's order

Hello, i am nurse in an ICU here in batangas. I just have a question regarding an order i recieved. The order was: d/c all iv antibiotics execpt for metronidazole.

However they have d/c metronidazole earlier that day. They were also considering sepsis. Should i have reaumed the metronidazole without an order??? Or should i have let it be and discontinued all antibiotics letting the patient have no standing order of anibiotics??? Please help me. Thank you

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    • Experts

    You need to call the MD and clarify.

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    • Guides

    What did you do? Because I'm assuming you pursued some course of action before asking your question here. I'm assuming you are looking for some feedback on what you already did. I refuse to believe you are coming here to ask what you should do, because if that's the case, you're wrong already.

    Whenever I get an order that is unclear, I may run it past another nurse just to see if I'm not being flighty and misunderstanding something. No matter what, I'm calling the doc before I do anything. That's what you're taught to do. Sometimes doctors make mistakes, such as (in your case) possibly forgetting the metronidazole was already d/c'd or poorly wording the order or giving an incomplete order. But you must clarify with the doctor.

    Going to the internet for answers is always the wrong answer.

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    • Author

    Yes ma'am. I did clarify. I also consulted to my senior staff. We were supposed to start meropenem once with the approval of the pedia reaident. Therefore, during the time without an ok from the pedia resident there will be no antibiotics available. And as i have said the patient is considered septic. I asked the junior resident of the ordering physician for clarification. He told me to continue the present antibiotics until confirmation for meropenem is available. But, there was no written order. But still i followed the junior resident.

    What was on my mind then was if the patient is considered septic, why would i d/c all antibiotics until there was an approval of meropenem??? I was just wondering if that was the right decision.

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    • Guides
    Yes ma'am. I did clarify.

    Thank goodness, because I know we have gotten nurses on here before asking questions of us on the internet instead of asking their coworkers :eek:

    I would have asked the resident if "continue the present antibiotics until confirmation for meropenem is available" could be put in as a written order, either by himself or by you. That would help cover your butt.

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    I would have confirmed it with the resident who wrote the latest order. If he/ she is unavailable, I would ask the other residents and have them write another order to make sure that everything is properly documented. I would also write a detailed charting about it so we can have a good reference when something goes wrong.

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