when you forget to carry out an order on your pt

kiszi, RN · Oct 29, 2007

acknowledge you screwed up and beg forgiveness.

Next time, try to do a quick once-over of new orders before shift change to see if anything was missed/forgotten. (I know, easier said than done.) but everybody forgets stuff now and then. Don't be too hard on yourself.

RainDreamer, BSN, RN · Oct 29, 2007

We all make mistakes. It's ok to make mistakes. The key here is to learn from the mistakes you make.

If it happens, apologize and make sure next time you review all the orders. Time management gets better with time too.

If you continue making these mistakes it's not ok. Sure there will be times when it's extremely busy and you get behind, not having time to completely follow up with something. But if this becomes something that happens all the time or more often than not, then it's not ok and the oncoming nurse has EVERY right to be pissed, as that's not fair to them, it creates more work on top of the work they already have (if you didn't have time to do it, what makes you think they'll have time to do it?)

potatomasher · Oct 29, 2007

People make mistakes from time to time and that's normal.

But sometimes there are people that drive you too hard and don't acknowledge that you're not perfect. I remember a staff nurse one time (during my student nurse days), that nagged me a lot. Instead of giving help to me with the patient (she knew that I was totally dumped upon by work on OUR patient), she just nagged me..."Why did you do this and that?"

I was doing my best that time...but I became a laughingstock of my classmates.

:-(

oldiebutgoodie, RN · Oct 29, 2007

I personally think that nursing is a 24/7 job, and if you were so busy you didn't get to it, the next shift should pick up the slack. Obviously, if you do this all the time, the next shift might get upset about it, but for once in a while, the oncoming nurse should not get his/her shorts in a knot.

Unfortunately, we all know that nursing has a really weird culture, and that this doesn't happen. One reason I don't do floor nursing any more. When I was a floor nurse, if the previous shift didn't get something done, there was usually a really good reason (or the reporting nurse looked like she had just gotten hit by a truck) and I always said I would get it done. However, this was seldom reciprocated.

The shifts need to work like a team, and not get all snarky with each other.

Oldiebutgoodie

TrudyRN · Oct 29, 2007

It depends on whether or not the patient was harmed by your missing the order.

Also, if you do this routinely, that's not so good - again, depending on what it is that gets missed.

And are you missing it, as in overlooking it, or are you prioritizing, deciding what can wait and what has to be done ASAP?

anonymurse · Oct 29, 2007

Whenever you're caught up, offer to help others. I mean, aggressively go from nurse to nurse and ask if they need any help, starting with the most harrassed-looking. Then when you're in need, as soon as you realize that the slack is evaporating from your available time (something is taking longer than you thought, or you have something new fall on you), that very moment that you know you're pushing the limits of your available time, find someone who's caught up and ask them to do one thing for you. Nothing involving ongoing assessment because that would be rude, plus impossible to track, just finite things, like restarting an IV or ambulating a pt for 10 min, etc.

PS, going back to your original question, if you don't have time to review your pts' orders to see what you have to do and make sure you've covered everything, then you're behind and need help.

RN1989 · Oct 29, 2007

Remind the irritated nurse that only God is perfect but that you are continually striving for excellence in your work, as you know she is doing also. Then ask her for any tips she might have for you to achieve absolute excellence. (Bet she won't know what to say and might be a bit nicer:)

SuesquatchRN, BSN, RN · Oct 29, 2007

Whenever you're caught up, offer to help others. I mean, aggressively go from nurse to nurse and ask if they need any help, starting with the most harrassed-looking. Then when you're in need, as soon as you realize that the slack is evaporating from your available time (something is taking longer than you thought, or you have something new fall on you), that very moment that you know you're pushing the limits of your available time, find someone who's caught up and ask them to do one thing for you.

I've tried that. Was flat out ignored, every single stinking time, in every single stinking situation. For a long time, at every nursing job I've had.

poppy07 · Oct 29, 2007

I feel like the last day I worked was a mess... the preceptor wasn't there when I needed them, but screwed up a few things without telling me when I was doing something else... (not documenting a med given, turning off a pressor without telling me, etc.) I overlooked a couple things from the prior shift orders, and did not do them. (Prior shift was to give "now" doses of med and did not even acknowledge the order...but I didn't either.) I didn't realize there was a new order to continue to check CVP...I got a poor reading, and never had time or bothered to change out the pressure bag/transducer. It took forever to get another IV pump so I could finally hang the other piggyback meds, so those were a little late. It was a rough day.

nyapa, RN · Oct 29, 2007

I feel like the last day I worked was a mess... the preceptor wasn't there when I needed them, but screwed up a few things without telling me when I was doing something else... (not documenting a med given, turning off a pressor without telling me, etc.) I overlooked a couple things from the prior shift orders, and did not do them. (Prior shift was to give "now" doses of med and did not even acknowledge the order...but I didn't either.) I didn't realize there was a new order to continue to check CVP...I got a poor reading, and never had time or bothered to change out the pressure bag/transducer. It took forever to get another IV pump so I could finally hang the other piggyback meds, so those were a little late. It was a rough day.

Ah haa. So it wasn't just you. You didn't have backup from your preceptor, and she stuffed up...and you can't help lack of available equipment that worked. Just document what happened. With regards to the CVP reading, surely you should have been informed verbally.

You have acknowledged your short comings. And that's good. But also, look at the whole situation. 'K?

lvnnars1 · Feb 25, 2011

has anyone ever had a doctor come in the facility and made an order change while you were doing med pass and you didnt even notice the doctor come in so you had no idea there were any new orders/changes in the chart?