I feel if I write on here and share my story I’ll be able to help someone else as well as feel a little better. I just started working in the ICU in April (was on med surg for about 10 months before).
I’ve always wanted to be a critical care nurse and my dream came true! I just got off orientation last week, needless to say I’m inexperienced to say the least in this specialty. Still getting used to drips and medications I’m not used to and becoming familiar with doses, etc. Yesterday at work the census and acuity were so low we sent a nurse home leaving me and two other nurses which of one was the most experienced.
A rapid response (of course) was called at almost change of shift. I went upstairs and it appeared to be a patient in SVT or a fib RVR sustaining in the 180s. There were already many people in the room. I was trying to figure out what happened to the patient and if they were a potential candidate for the unit. Finally, the supervisor said, "no", and they were all set. I went back downstairs and the phone rang.
That patient was immediately coming down to the unit as they were now unstable and there ICD had gone off multiple times. We set up the room and it was a MESS. This patient was at least in SVT for now an hour with no cardiac medications. One nurse was drawing up and preparing meds the other nurse (the charge) was recording and helping with other things and that’s all we had for help. So it was either I stepped up to the plate and took on the role of administration of meds as a novice nurse or this patient was in trouble . To the best of my ability, I tried my best.
The doc wanted an “amio bolts drip“ he did NOT say IV push 150 mg amio. The nurse preparing the medications handed me a bag of amio, line already primed. I saw the name but failed to look at the dose and programmed the pump after repeating to the doctor the dose of 150 mg bolus. The bag was more than half full when the charge nurse suddenly said this is all wrong who prepared this medication? I asked what was wrong with it, she said the concentration was wrong and the way it was set up. I was sweating. I had no idea what I did. I said the other nurse handed me the bag. I had programmed the pump to administer the whole bag, just like a bolus, but it was the wrong concentration up. I felt terrible the nurse was yelling in my face not helping any of the situation I stepped out of the way and said someone else should be taking over the medications.
Overall there were many things wrong with this situation.
A) the experienced nurse giving me the medication gave me the wrong bag ,
B) I failed to double check the dose, and
C) I should have stepped back knowing I was the novice nurse & volunteered to help with something else. Lesson learned.
Luckily it was caught early no harm was done. But I can’t help but shake this anxiety. At the end of the day I know I just need to move on and take it as a huge learning experience.
Beats me. I was the only one of out 3 who wasn’t in a room . Understaffed on days. But one ICU nurse has to go to a rapid response. But either way this happened when they came down to us .
The patient did survive . Many other medical problems we ended up finding out that led to the HR in the first place. He was already a sick sick person with a significant cardiac hx.
I don't think any phrase that includes "150mg" and "Amiodarone" can be interpreted as anything other than an amiodarone bolus during a code. If a physician uttered this phrase and then failed to undue their order, whether it was intentional or unintentional, it's clearly not the nurse's fault if it ends up getting administered.
This is why we no longer allow Physicians to run codes. Only Physicians can call a code, but they do not "run" a code and are frequently reminded to keep their conversations quiet if they insist on talking during a code.
I am really curious about this statement. Around my neck of the wood (CA), a MD usually runs the codes; we run it until she/he arrives to the room. I've never seen it the other way around, as you are suggesting; however, I've been working at the same facility for a few years now. Is this a new practice out here??
To the OP, live and learn. Jumping in during an emergency situation is what we do as ICU nurses; just wish the senior nurse was more professional in correcting you during that situation (there is no need to humiliate). As others had mentioned, you need to own the fact that you didn't verified the right dose of the medication ordered. I know you are a new ICU nurse, but at the end of the day, you are deemed competent and it is your license on the line.
Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
On 7/11/2021 at 10:58 PM, 2BS Nurse said:
Also, why can't physicians run codes?? Aren't they supposed to be calling the shots during a code?
This varies by facility. In my hospital the RRT RNs run the codes, unless its in the ER.
On 7/6/2021 at 11:23 PM, MunoRN said:
This is why we no longer allow Physicians to run codes. Only Physicians can call a code, but they do not "run" a code and are frequently reminded to keep their conversations quiet if they insist on talking during a code.
Same in our hospital. Codes are run by the RRT RNs. I don't understand what you mean when you say only physicians can call a code? Do you mean stop the code?
PMFB-RN, RN
5,351 Posts
I don't understand why you, a new ICU nurse, went up stairs to the RRT?