JCOAH Says Jump, We Ask How High

[Natkat, BSN, MSN, RN]

Recently our clinical coordinator told us that, according to new JCOAH guidelines we are not to give floor nurses advice or instructions on what medications to give and what medications to hold. Instead they should ask the doctor or pharmacist about this. So the next time I tell a nurse that I cannot tell her what meds to give or hold she is furious and says something snarky like "are you just a tech" or something to that effect.

In general I am okay saying it's okay to give insulin or hold antibiotics, but in this case the nurse was asking me about several cardiac and blood pressure meds. Unfortunately I am not well-versed on those meds, perhaps I should be, but I've always worked dialysis and have never given cardiac meds. In this case I was okay with tellng her to ask the doctor what she should do. I have a list of dialyzable meds and again, I'm okay saying to hold certain things because they'll wash out, but to tell a nurse what to do from a cardiac standpoint makes me uncomfortable.

I have been searching for this rule and I can't find it anywhere. Has anyone else heard of this or was my manager just pulling my leg?

[Biffbradford]

I've only just begun dialysis but have worked in cardiac and I don't think there were any cardiac drugs that were dialyzed out. In our ICU's med room, we had a large poster supplied by pharmacy that had every drug seen in that ICU and if it was dialyzed out or not. I agree that the patient's nurse should make a quick call to pharmacy and ask. THey don't bite.