reasonable,prudent and no parameters? - page 2
I held a lasix 20mg for a older gentleman whose bp was 82/50,I also noticed the bp was low 3 times that month, we are taking bps cause he has a low dose cardiac med which has bp parameters when to... Read More
Apr 2, '03Ohbet
I got another reply for future reference........
The patient has been admitted into hospital care for monitoring therefore as a professional I will continue to monitor my patient as I was trained [as a professional nurse] who by the way cares.
Apr 2, '03Originally posted by ohbet
and because the pt. load is so great on the floor and because taking the bp is time consuming and that the unit will be trying to eliminate orders to take bps and hence parameters on meds like lasix, and based on this information ,she instructed me in the future not to get bp parameters for meds like lasix.
You got the order for parameters. That was the right thing to do.
Apr 2, '03Um...what state are you in? I just don't want to worry that my family my end up in your "hospital".
Keep doing what you know is right....your HN is a nutcase.
Apr 2, '03You did the right thing.....
Let the HN go sit before the nursing board by not checking a BP before giving a cardiac med or Lasix......and an elderly patient goes KER-PLUNK on him.
Apr 3, '03I agree that patient safety comes first. The other night I checked blood glucose without an order (the MD ordered HS Lantus but only am blood sugar checks). Big deal, right? But to my surprise, a coworker questioned why I would do this. Well, sorry folks, but I don't ever give insulin without knowing a person's blood sugar!
;-( I don't need a policy to be safe and prudent! Policy isn't the final word. We are patient advocates, not robots running off hospital policy.
A few years ago, I refused to give an oral cardiac drug on the telemetry unit despite MD order because the drug book said it had a substantial risk of causing Torsades....not to give it without MD present (IN BOLD PRINT). I spoke with the pharmacist who hemmed and hawed over it,"Uh, he's a highly respected cardiologist, I don't know what to tell you."
I called the cardiologist and questioned the order.The MD said, "It's okay to give it without me." I told him it was not "okay" with me, and I wanted an MD there & the code team, etc! I did not give the drug. And the MD finally dc'd the order.
It's our job to question & make such decisions.
Remember, "First, do no harm."
You did the right thing!!!!!! Your HN needs a reality check.
Apr 3, '03you did the right thing! patient safety is utmost! does everyone find the same thing happening with digoxin these days, no pulse check because it doesn't get done at home! isn't it amazing though how much a nurse can pick up if he/she does the job properly.
Apr 3, '03emily writes: "While they don't check it at home and that may very well be normal for them, it doesn't save your license if he dies.
Did you call the doc?"
Exactly. And whatever the doc says, write it in the chart.
The "irritation" your HN seems to experience will pale next to the irritation your license review board will demonstrate at your hearing.
This incident is but one more example of the sig line:Last edit by sjoe on Apr 3, '03
Apr 3, '03I agree with your decision too...
Like, duh, that's what they're in the hospital for - for medical and nursing care.
"Gee...this pt has CHF...but I don't really need to listen to their breath sounds, because they don't do it at home!"
Or how about, "Dang, this pt is in cardiac arrest, but if he was at home by himself, he wouldn't be able to do CPR...so I guess I won't either!"
(edited to correct sleep deprivation induced error)
Apr 4, '03You definately did the right thing. My question to your HN is, "If his bp is already low, why would I want to make it lower?" and "When he passes out and his head hits the floor, are you going to back me up in court?" Chances are that he will NOT! Remember, pt safety first because second is too late...