Would you consider this a big deal?

  1. Got to work, and was told to float. I was to pass meds, do MAR/chart checks & anything I could to help for m/s wings 1&2, & tele. Fine...get to tele meds already passed except for one pt. Problem... meds in tele that were not due until 2300 were already done at 1900. These were not QD, BID but meds w/set times. The times were not changed to reflect the earlier time given but signed off as being given at scheduled time. One I remember was Lovenox...was not due until 2300, was signed off as 2300, checked pyxis & it was removed at 1700.
    I asked the nurse working & she said yes I already gave the meds....I said some of these are 4-6 hrs ahead of time. She replied oh its ok...I always do it this way. Uh no its not ok...they are scheduled for a reason...you did not already give the Lovenox did you? Yes its ok the ptt/inr is ok...won't hurt'em. Just give the rest of them...it does not matter. I said, these are scheduled for a reason, and we can't just give them all together at the same time because we want to... She got angry & said....WELL THAT'S HOW I DO IT!!! I said, well that does not make it right. Silence, & she slammed out of the med room. Now dang it I am new & she has been a nurse a lot longer...I am in a situation I do not want to be in. I passed the meds to the only pt that had not gotten his all at the same time. He has a room full of family, asked questions about all his meds...now I know why his were not given as the rest of them were.
    When the charge came around I told her the story. She said its ok I already know...nurse X, said she got mixed up on the times. No she did not...I told her the conversation...again the charge said, its ok she got mixed up on the times. Again I say no she did not, I asked her...repeated what nurse X had said. The charge was getting ill w/me & said it ok! So I said look...I was put into a place I did not want to be & am trying to do what I am suppsto & tell you....I do not want anyone hurt or loose my license for knowing this & not saying anything. The charge still says it ok she got mixed up on times. So is this a big deal? I was made to feel like I was the one in the wrong. I am not a trouble maker but I thought I was doing what I needed/was obligated to do.
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    About crb613

    Joined: Feb '04; Posts: 1,715; Likes: 542

    19 Comments

  3. by   gr8rnpjt
    I would go over the head of charge nurse and speak to supervisor in charge. You did right, that nurse was dead wrong!
  4. by   mom2michael
    It is the P&P at every facility I've ever been to - 1 hour before and 1 hour after the time listed on the MAR. Given earlier or later - it's a med error. It's also been my experience that you chart the time on the MAR you gave the med if it doesn't fall w/in that window and an IR has to be written up.
  5. by   teeituptom
    All I can say is Thank God I'm not a floor nurse.
    I just dont have that in me
    I love the all too different world of ER
  6. by   TazziRN
    Definitely NOT okay!
  7. by   santhony44
    You were not wrong.

    It sounds to me that the charge nurse was saying "I know Nurse X, she's going to do it the way she wants to, we don't want her to quit, so we don't call her on it." I agree with one of the previous posters, go over her head. You reported it and she didn't handle it.

    The way I was taught in school, back in the dark ages, we had 30 minutes before and 30 minutes after the time to give the meds. Granted, occasionally things will happen so that you fall outside that window, but it sounds like Nurse X is in the habit of giving meds when she thinks it suits her.

    You were not wrong, and these two nurses should not have put you in the wrong.

    If your manager is different than the one for the unit you were floated to, maybe talk to your own manager about how to deal with the situation.
  8. by   25(2)+2
    what she did was absolutely wrong. i am only a med aide and i know better. would she give her parents or grandparents their meds 6 hrs late. she needs to think about her license and how unfair that is to her patients.
  9. by   htrn
    That nurse was DEAD wrong - no pun intended. We have medication error forms that we have to fill out for EVERY medication error, near miss, wrong administration time, etc... (even if we know the MD won't care). If your facility has a form like that, fill it out ASAP and make a copy of it for yourself in case the original 'gets lost'. If you don't have that type of a form, write up some sort of incident report, send it up the chain and add a note that you want to know that this was addressed. Again, keep a copy for yourself.

    She may be able to get away with this a few times, but not for long. Pretty soon it will catch up to her. It is vital to patient safety that supervisors know - then they can go back and look at the PIXIS themselves and confront her. If she does it like this 'all the time' the PIXIS will show a trend of this behavior. In the mean time, CYB.
  10. by   crb613
    Thanks to you all. I do intend to fill out a IR...It will be just my luck that they went back & changed the admin times.....I did not see the MAR again after I talked to the charge. I also know the charge will probally try to get even :trout: ....makes my head hurt. It sure is a bunch of crap that you get put on the hotseat & you have done nothing wrong. A couple of weeks ago I gave antibiotic iv then saw it had been changed to po...and did an IR on myself.....I told the charge & then it was the right thing to do!
  11. by   cinderella6251
    ARE you right???? Uh..HECK YAH!!!! I shudder to think if I were one of those patients getting those meds and suffered OD from too much med in my system.
    You were standing up for your patients and what is good for them and TRYING to protect them from this insane nurse whom I assume has forsaken patient safety in order make things easier on herself because she is burned out! You were right to address the issue and call it what it was: A BIG DEAL! I am an older nurse now and no longer work in a hospital but I do remember the pressure and demands placed on nurses and the bickering and lack of espirit de corps that goes on. I hope if I am ever hospitalized that you are my nurse. You sound like a good one.
  12. by   crb613
    Quote from cinderella6251
    ARE you right???? Uh..HECK YAH!!!! I shudder to think if I were one of those patients getting those meds and suffered OD from too much med in my system.
    You were standing up for your patients and what is good for them and TRYING to protect them from this insane nurse whom I assume has forsaken patient safety in order make things easier on herself because she is burned out! You were right to address the issue and call it what it was: A BIG DEAL! I am an older nurse now and no longer work in a hospital but I do remember the pressure and demands placed on nurses and the bickering and lack of espirit de corps that goes on. I hope if I am ever hospitalized that you are my nurse. You sound like a good one.
    AAAAAAH thank you! I am pretty new (5mos) so I don't know how good I am but I do try. I just spoke to my director & she is going to look into this. I thought she was pretty good nurse (can't understand it). I don't mean her any ill will but this is just not right. I know I would not want her giving meds to my family so if its not good enough for them.......
  13. by   SmilingBluEyes
    It IS a big deal, for all the reasons you know and mentioned by other responders to the thread.
  14. by   Jerrica
    I used to work in a nursing home. Both medication aides and nurses were using that practice with the exception of sleeping pills. There excuse was "the patients take medications better with there meals". Although that is true (I have experienced it myself) you can get the doctor to change medication times due to noncompliance. Nurses need to remember medications are prescribed for the HEALTH of the client not for the CONVENIENCE of the nurse.
    You absolutely did the right thing. Good luck girl.

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