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Nurses General Nursing

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I am an ER nurse. I came on shift and received report on an elderly pt. with dementia. There was an order for 2.5mg haldol IM. I was told by the provider not to give the pt. the haldol because she had a history of "going downhill fast" and that the pt.'s husband was on the way to pick her up anyway. While I was in another pt.'s room and without asking me, a coworker of mine gave the pt. 5mg of haldol IM and didn't document it. I only found out after finding the empty vial and finding 2 other staff members who admitted that they witnessed it. The pt's husband showed up to take her home. Should I have said anything?

Heres what I did... I asked the nurse who gave the injection to let the provider know it was given, to let her know that twice the ordered dose was given, and to document it. She got mad at me, but she told the provider. She refused to document it. The provider held the patient's discharge to observe.

Was I wrong? I'm looking for serious feedback. The other nurse is really mad at me because the provider "reported" her. And to top it off, management told me that it was I who failed to communicate. The other nurse wasn't even working in my area; she was just passing through!

7 hours ago, Pixie.RN said:

So who the heck in nursing ever refuses to document a med that they gave? I couldn't get past that part of it. "Yeah, I gave it, and I gave the wrong dose, but I ain't writin' that down!" Ummmm, hi ... you're fired, kthnxbye. This is just bizarre.

Yes, I agree. I honestly think she gave it and had no intention of telling anyone or of documenting it. I think she got mad because I called her out on it.

1 Votes
Specializes in LTC, assisted living, med-surg, psych.
2 minutes ago, jinct said:

Yes, I agree. I honestly think she gave it and had no intention of telling anyone or of documenting it. I think she got mad because I called her out on it.

I'm sure she did. But what I can't figure out is why she would have given the patient the Haldol in the first place. Was the patient acting out? IOW, was the patient agitated, screaming, combative etc.? There's still no justification for what she did, and if she did it in the absence of behaviors it's even worse. It's illegal as well. Doesn't make any sense to me.

2 Votes
Specializes in ER OR LTC Code Blue Trauma Dog.
40 minutes ago, PollywogNP said:

Why another nurse would do anything on patient not assigned to her or not know anything about with out asking the nurse assigned that patient I don’t get it.

Because the only logical conclusion is they are doing it to make the other nurse look bad. They are not trying to help.

I was always instructed communication is a critical component of delivering patient care. The structure is always, "message - sender - receiver." You know, doing things like a verbal "confirm and verify" with one another when implementing procedures.

Heck, even the military does this and it's done so they don't start shooting at each other by mistake. In nursing, this communication process is done so mistakes and errors are immediately identified and avoided.

Apparently, the fact nurse B didn't communicate what they were doing with nurse A, seems to suggest some people either didn't get that training, or missed those classes in their entirety. This lack of communication is simply negligent behaviour any way you want to look at it.

2 Votes
Specializes in Med-Surg/Tele/ER/Urgent Care.
2 hours ago, Crash_Cart said:

Because the only logical conclusion is they are doing it to make the other nurse look bad. They are not trying to help.

I was always instructed communication is a critical component of delivering patient care. The structure is always, "message - sender - receiver." You know, doing things like a verbal "confirm and verify" with one another when implementing procedures.

Heck, even the military does this and it's done so they don't start shooting at each other by mistake. In nursing, this communication process is done so mistakes and errors are immediately identified and avoided.

Apparently, the fact nurse B didn't communicate what they were doing with nurse A, seems to suggest some people either didn't get that training, or missed those classes in their entirety. This lack of communication is simply negligent behaviour any way you want to look at it.

Yup, that's what was happening to me as a fairly new nurse, that charge nurse & I butted heads all the time, she gave me the worst assignments! (40 years later I still remember her name, her wrinkly face & gray curly hair), I knew she was screwing with me but I was young & energetic & quick thinking & working on my BSN, and did not have time for idiots like her to get in my way!!

1 Votes
15 hours ago, Oldmahubbard said:

apparently it can be crushed and snorted

Amazing what people think of these days.

1 Votes
Specializes in ER OR LTC Code Blue Trauma Dog.
2 minutes ago, DextersDisciple said:

Amazing what people think of these days.

Say, speaking of amazing, have you heard about the latest wasp spray craze the kitchen chemists are using to paralyze their central nervous system for a quick buzz?

https://abcnews.go.com/US/west-virginia-residents-wasp-spray-meth-alternative-police/story?id=64398833

Specializes in PICU.
21 minutes ago, Crash_Cart said:

Say, speaking of amazing, have you heard about the latest wasp spray craze the kitchen chemists are using to paralyze their central nervous system for a quick buzz?

https://abcnews.go.com/US/west-virginia-residents-wasp-spray-meth-alternative-police/story?id=64398833

I wish there was an "I am shocked" emoji. I reallly do not want to know what will be next.

4 Votes
Specializes in ER OR LTC Code Blue Trauma Dog.

I guess the general takeaway here is opioids are becoming less prevalent and available for many addicts, so many are turning to crazy alternatives such as Wellbutrin, and yes even Wasp Spray.

I wouldn't be surprised to hear more incidents of non scheduled meds being diverted for nefarious purposes in the future.

2 Votes

If only such creativity were used for better purposes instead of finding ingenious ways to get high. I wonder what strange thing will be next.

1 Votes
Specializes in Critical Care; Cardiac; Professional Development.
14 hours ago, jinct said:

Yes, I agree. I honestly think she gave it and had no intention of telling anyone or of documenting it. I think she got mad because I called her out on it.

This reminds me of a nurse in trouble here in Texas for murdering patients by injecting air into their art lines. He would go into the rooms of patients not assigned to him, inject and then respond to the code when the assigned nurse called one. Too many patients were dying, of course, who had no risk for embolism and they reviewed the video to find him going into these rooms not long before they coded. Makes you wonder if it all started with first doing other, nonlethal or less likely to be lethal, things before he escalated to outright murder. Like giving meds inappropriately.

1 Votes
14 hours ago, PollywogNP said:

Why another nurse would do anything on patient not assigned to her or not know anything about with out asking the nurse assigned that patient I don’t get it.

14 hours ago, Crash_Cart said:

Because the only logical conclusion is they are doing it to make the other nurse look bad. They are not trying to help.

Yes, maybe trying to look like a better nurse than the OP or just be a team player.

Some of the comments on this thread make me think people haven't been in an ED lately. Everything is about how fast patients can be moved through, and taking responsibility for "helping" coworkers is a big part of that. The care is very piecemeal and is provided by whomever is immediately available for the task at hand. Any available RN who can check any box that moves any patient closer to out the door is expected to do so. Although we all know that communication is still paramount, it has taken a backseat to the #1 goal as far as admin is concerned (a charge also evidenced by the crappy admission report process these days). CNs are expected to call one nurse to go do something for another nurse if that nurse can't implement an order within minutes basically. It's nothing to be asked to go give someone else's meds or to walk into your own room and find someone pushing something or doing something to your patient. This is how things keep moving.

-Not defending, just reporting.-

I'm guessing the nurse in question was not "passing through" from Mars (another unit/floor), but from another area/group/pod in the ED. Noticed a problem, saw there was a PRN order and did the "responsible" thing of not "walking past" a situation. There is massive pressure for this type of behavior. You have to be internally strong and prudent to continue doing things in a responsible manner (such as talking to your coworker before "helping").

Of course there could be something nefarious or much less innocent with this nurse's actions, but those problems are rare (even though everyone has "heard of someone who...."). My money is still on basic 2019 ED craziness.

I think the hospital is playing games with the OP because they know they encourage this kind of behavior, and now it has gone wrong.

Specializes in Critical Care; Cardiac; Professional Development.

You are likely correct, JK, but then why the refusal to document and the overdose? Is that also just part of things in the ED now? And what would make someone jump in out of the hallway to give Haldol like that anyway? Its just weird. It isn't the helping that is strange. Its the refusal to document that baffles me.

3 Votes
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