Huganurse, thank for for the lecture on the sick role, I did attend that one
What I meant by nasty is, the first day the nurse ever went to see this woman, the dtr greeted the nurse at the door saying, "You should know up front I'm a bi##h, and I will not help her with this care, she will have to be able to take care of herself entirely." Well, at least she was honest. The pt also calls the dtr a Bi##h. But, if it was
a sweet loving family, I would have done the exact same thing. In my judgement, the purpose of getting blood cultutres is to see if IVAB are needed. So, if the pt does not even have a line in, I would hope that if a doc suspects sepsis, they get a culture and start a prophylactic IVAB, not a po AB which is not the appropriate Rx for sepsis. If it was a sweet lovong family, I would be the same aggressive pt advocate that I always am, and advise the pt of the consequences of not seeking appropriate Rx. If I thought the pt were incapacitated by a fever, I would tell the family member or call the emergency contact person and tell them I was sending pt 911. I do appreciate however, that not all pt's value my opinion, and if they choose not to seek treatment, than that is within their ethical right to do so, whether I like it or not. I don't loose any sleep, I always do my job so that I go to sleep with a clear conscious. It is not that I am uncomfortable at all w drawing blood cultures, I am an excellent phelbotomist. Our agency does not routinely do IVAB, so we rarely have a need to do blood cultures. Like I already said, if the pt had a line in and was already getting IVAB, we would probably have the blood culture tubes in our lab supply kit, which I do keep with me, and I frequently call the docs to recommened when labs be drawn. I think you missed the fact huganurse that 1) this is not my pt, 2) I am not the case manager, and 3) this is an acute change in status, and I felt the pt should be seen and evaluated in the ER, 4) our agency is not capable of supplying and initiating IVAB in the home. Not all agencies are alike, but it doesn't mean we do not provide outstanding care to our clients.
I think I did forget to mention that we already knew the wound is positive for MRSA.