Forgot to carry out an order? Reportable to the BON?

[Cola89]

Hello, so my unit goes over charting with a fine-tooth comb. I have only been at this job for three months and have gotten called in to the office 2x already because say in admission documentation "patient education" was not documented on (I didn't document it because there was only 2 hrs. left in my shift when I got this admission from surgery and it was actually NOT a good time to do patient education).

There was a new order to do orthostatic BPs on a patient 1x/shift and I didn't do them. Did the routine BPs, but not an orthostatic. I just completely forgot because I had such a hectic

day... many huge changes in status and just, it was terrible. So I forgot that one thing. As far as I know, that's all I forgot to do.

Is this something that is reportable to the BON?

[mmc51264, BSN, MSN, RN]

1.) we have a policy that states admissions need to be completed in 24 hours upon admission. I have heard the JCOH is targeting education and care plans this year.

2.) we have a "blame-free" policy in our facility, if we find something missed, we can report it so that there are ways to prevent it in the future. We use for everything from low blood sugars to med errors to inappropriate behavior by a physician. It encourages people to not hide mistakes.

As far as diversion/abuse issues, I have not had any experience with that as of yet.

Mistakes get made and we need to learn from them, not be traumatized by them. Most of us are harder on ourselves if we make a mistake and hope that no harm is done.

[Larry3373]

My experience with this has been "I just wasn't able to get to that today". This could pertain to bed baths, dressing changes, etc. I usually reply with "that's fine, I'll take care of it. This is a 24 hour facility." I understand some things are time sensitive, but we must use common sense when prioritizing what will get done on our shift.

[anon456, BSN, RN]

In the future you may want to cover yourself by stating why you didn't follow orders. I know it's a waste of time, but it covers you. For example you could say in your nurse notes "Patient education not performed; patient sedated." On my unit we have to perform oral care every four hours on patients who are ventilated, including ones with trachs who are on a vent all the time (even at home). Sometimes the families refuse this at night so the patient can sleep. I always document that so I'm not dinged during an audit. If you just plain forgot to do something, don't chart that you forgot. Just leave that area blank, and it's a good idea to tell the doc if you realize your mistake.

[Cola89]

My experience with this has been "I just wasn't able to get to that today". This could pertain to bed baths, dressing changes, etc. I usually reply with "that's fine, I'll take care of it. This is a 24 hour facility." I understand some things are time sensitive, but we must use common sense when prioritizing what will get done on our shift.

I WISH my coworkers were as realistic as yours sound... Night shift is kind of scary about picking our charting and care apart... isn't it usually the other way around?! 9/10 I get the crappiest reports from some of these people who demand the sun on a platter when they come into work... I think it's their direct supervisor pushing them to act this way. She has worked on this unit for 10 YEARS ... all night shift. WON'T work days but seems to take great delight in picking us apart ... the busiest shift on the hospital's busiest unit... there are constant tests, admissions, discharges, new orders...

[sugarwahine10]

No not important enough to be reportable that you didn't do ortho bp x1. If pt too weak to stand, unable to due to pt condition, or refuses because wants to sleep then document that and reschedule them for later your shift or next shift. Pt education can always be done if they are going to be petty about it--just document education as shown how to use call light and educated not to get up on own without assistance--to push call light. Something like that and then you will always have that education documented--that is educating pt & we are suppose to show them how to use the lovely call light.

[FolksBtrippin, BSN, RN]

Haha. My state's nurse practice act is so long, so vague, and in such barely discernable English that I mean, I have no idea. But thanks for your vote of confidence! :)

Cola89 did not say "read the nurse practice act." S/he said go on the website and see what actual nurses are actually suspended for. They publish it in a list format. It looks like this:

Nurse Cratchet license #100000030303030282789 suspended for narcotic addiction

Nurse Bologna license# 37868968967896789678678 suspended for narcotic addiction

and on and on. 99% of them are for narcotics. I saw one that said something else, it was psych related. I hope that nurse got her license back. I checked one day after reading a lot of license paranoia here.

If you believed the stuff you read here you would see reasons like, "Gave a stool softener without an order." "Gave a kid her inhaler during an asthma attack without written consent from mom" "Did not find another nurse to cover her usual shift when out of work with the flu" "Quit her job without notice"

I saw drugs, drugs, drugs, drugs. Not even a single abuse case.

[Cola89]

Oh my gosh... Invitale, you made me LAUGH OUT LOUD!! On a serious note, I will try that and see ... what people are suspended /revoked from nursing for.

[Larry3373]

I WISH my coworkers were as realistic as yours sound... Night shift is kind of scary about picking our charting and care apart... isn't it usually the other way around?! 9/10 I get the crappiest reports from some of these people who demand the sun on a platter when they come into work... I think it's their direct supervisor pushing them to act this way. She has worked on this unit for 10 YEARS ... all night shift. WON'T work days but seems to take great delight in picking us apart ... the busiest shift on the hospital's busiest unit... there are constant tests, admissions, discharges, new orders...

My coworkers are a mixture of understanding, and not so understanding. This is the attitude that I have toward them. Influencing your culture starts with you. Is there a committee at your place of employment where you can provide feedback. I personally expect dayshift, or nightshift not to be satisfied with what I was able to get accomplished, just so I'm not disappointed either way. I always give others the benefit of the doubt, that they were not able to get to it on their shift. I think this is a helpful attitude.

[RegularNurse]

Daily orthos are not a big deal. Nobody cares about that.