Don't you just love it when the docs compliment you for a job well done? The example I have happened this evening. I worked just a few hours at the end of a 12 hour shift. An admit had come in earlier during the day and I was figuring out what meds she still needed. Coumadin was a home med for her, and she had not had today's dose. I looked at her labs. The INR was 3.73 and the PT was like 38.5. I held the Coumadin. I had the on-call doc paged. I told him the labs results and what the patient's Coumadin dosage schedule was. I also informed him that I had not given today's dose because I wanted to see what he advised. When I told him I had not given today's dose his comment was: "That was smooth thinking." He ordered the Coumadin held for the weekend and to recheck her INR/PT on Monday. To me, holding the Coumadin in light of the labs was just common nursing sense. But it still made me feel good that the doctor noticed I was paying attention.
Now, if the stupid ER doc would have looked at the pt's labs before he wrote the admission orders, he would have seen the elevated PT/INR and ordered the Coumadin held.
But that is whole other thread.
Jun 15, '02
Had a pt. who was in resp. distress, but satting at 92% on 3L. I called the PCP who got right on the line, and as soon's I told him the patient's name, he then said, "OK, what do you want to do?" like he trusted my judgment....
(Maybe it was 'cause I sent the same guy out about a month previous for +4 dependent edema at 3 am and the on-call swore at me and wanted to know how come I hadn't called sooner
, to which I told him that, as house RN, I had just been notified myself.... since the pt. was on BR, the CNA's didn't get it when they saw his privates and hands all swollen. )
So I 9-1-1'd him out over the objections of the other, more experienced RN (of course, the pt was a full code
) . Poor gent died late that evening from CHF.
So it was a mixed feeling in the end....
Last edit by Sleepyeyes on Jun 15, '02
Jun 15, '02
I like it when I get compliments--strokes are great from anyone!! I really like "coup'ing" the docs. One day I started my assessment on a premie who was under bili lights in an incubator. She very sweetly opened her mouth as wide as she could right under the bili "spot" light--and showed me her soft palate cleft!!! I could hardly wait for rounds!!! I listened carefully to rounds--no mention of this cleft. I said, "let me know when you all are through and it's my turn." Then I got to tell them, "This baby has a soft palate cleft!" The attending was all over it!! That was fun--esp since I didn't much care for that particular intern.
OK, a bit evil I know, but fun.
Last edit by prmenrs on Jun 15, '02