Am I In trouble? - page 3

I worked last Tues,night shift (7pm - 7am). An lvn was the one who endorsed me the patients that i will be taking care during my shift.One of the pt has an order of vancomycin iv q tuesday and it was... Read More

  1. by   gwafuh_rn
    the rn who was covering for the lvn that time just called me a while ago.She told me that the lvn didnt told her that there was an order for a vancomycin.Anyways,the reason I didnt call the doctor because the pt had a prn med for elevated temp. I got worried when the pt had an elevated temp at 0400 am.That's the time I called the doctor.The rn told me that its not the reason why the pt had a sepsis because 1 bag of vanco wasn't given.
  2. by   SuesquatchRN
    Honey, stop worrying. You won't let something like this slide again and really, that's all you can do.

  3. by   gwafuh_rn
    sorry.thanks for the help.
  4. by   island40
    One dose of Vanco is not going to keep a guy from going septic. He would probably have ended up in ICU anyway. You should have called the MD again. No response in a "reasonable" amount of time and you are required to do something about it. i.e. call him/her again, call the house superivisor and tell them you can't get in touch with the attending MD, contact the supervising MD whatever the hospital's protocol is for the chain of command so to speak. This patient deserved to have an MD on his case 24/7 while in a hospital. As the patient's advocate you were required to get him that care. As a legal consultant I would urge you to know your procedure and don't let too much time lapse from first attempt at contact to the next step.
  5. by   SuesquatchRN
    Quote from gwafuh_rn
    sorry.thanks for the help.

    No need for a sorry. I just don't want you twisted up over this. Learn to let this stuff go or nursing will eat you up.

  6. by   leslie :-D
    Quote from gwafuh_rn
    the pharmacist wrote the order 0200 pm. with the word pm on it.
    i didn't know pharmacists could write orders...
    am i missing something here?

  7. by   kanzi monkey
    It sounds like a systemic error to me--that is, everyone involved was partially responsible. But only for the missed dose--not the sepsis. Don't put that on yourself.

    As far as calling the doc with the temp--I'd recommend notifying someone with a temp over 102 (that varies based on the patient--sometimes I'd let them know with something lower, sometimes I'd give some tylenol, check the temp in an hour, then notify.)

    A vital sign that abnormal requires a little closer attention.

    Again though--the sepis...not your fault.

    Learning experience experienced
  8. by   angel4gramma
    Pharmacist can and do write orders. I see less than yrs ago but Dr will ask them to order antibiotics per protecol depending on labs. They also order labs when the Dr misses it.
  9. by   leslie :-D
    Quote from angel4gramma
    Pharmacist can and do write orders. I see less than yrs ago but Dr will ask them to order antibiotics per protecol depending on labs. They also order labs when the Dr misses it.
    wow, never knew that, angel.
    never, ever saw or heard of it.

    do you know why a pt would be on 1x/wk vanco?
    (thought i'd go 2 for 2.)

  10. by   angel4gramma
    LOL, no except maybe he had renal issues. I have seen 3 times a week after dialysis but, can't recall once a week.
  11. by   belgarion
    I'm kinda curious about the dosage schedule myself.

    Don't sweat your license unless the guy is related to the governor or something.:chuckle (Just kidding) Yeah, you have to take part of the blame. Just make sure you learn from it.

    IMO, you might get to spend a little quality time with the clinical manager , DON, or whoever handles this stuff. Of course, few others will probably get to pay a visit to the same person. This sounds like an opportunity to close some gaps in the system. I hope everyone learns from it.
  12. by   Sirapples
    And the next time a medication is not charted off, but you got in report that it as given, (or even if you didnt get it in report that it was given) inform your supervisor. Protects you as well.

    And I have never heard of a once a week vanco dose. I cant imagine that doing anything for anyone.