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Discussion

interventions

This is relating to a charge nurse that I was working with that had received lab results on a patient and decided to call the doctor to change the patients amount of Coumadin that he was to receive later in the evening. The charge nurse did not ask for the MAR so that she could see what the order was originally, so when I got the chart and saw that the amound the patient was going to receive was going to be twice the amound, I did not think that was correct. I took the chart along with the MAR to the charge nurse and told her to call the doctor back and fix the order because I was not going to transcribe the order and cause a life threatening incident to take place. Now if the charge nurse had come and asked to see the MAR before calling the doctor then she would not have had more work to do. I feel that this was a result of deductive reasoning. If I am wrong please let me know. I think that my reaction to the situation was the correct one and I do not believe that I would have done anything differently in the future. what do you think?

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I don't understand how any nurse could call a doc and NOT know the coumadin amount? This is not something to play around with! Poor judgement on her part.

I would be exactly like you, have HER call the doc and get a clarification!

She was the one that took it upon herself to get the orders changed and leave it to her to straighten it out and SHE will have to explain to doc why she is getting a clarification!

Just my thoughts!

that's why there are med checks and we go to school. it's called critical thinking. the important thing is that the mistake was caught before it got to the patient. you did a good job and the charge should thank you for picking it up. she too learned a valuable lesson....knowing the coumadin dose, the lab value and the goal of therapy before talking to the doc is the best course of action......always :smokin:

I don't understand why the doctor didn't ask for the original order on the MAR.We would get chewed out for not knowing it!

I dont understand how the doc came up with a dose without knowing the original dose, did they just pull a number out of their buttocks?

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