Misreading doctor order

jadelpn, LPN, EMT-B · May 30, 2013

Because you had the best of intentions, and got some stern talking to. And as adults, it really is tough when another adult seems to speak to us like we are misbehaving toddlers.

You did what you did because it seemed like a logical thing to do at the time. Going forward, you can only remember to look at your orders carefully and mindfully. Critical thinking tells us that how are you supposed to assess a wound you can't see? And unless there's a bunch of co-morbidities, what is the purpose of the visit if not to change and assess the wound?

If you get called out on this, I would perhaps offer to become wound care certified. It will present that you are willing to "improve" your practice. But I know I would have done the same thing. I like to see what I am dealing with before I can assess it well.

Anonymous25 · May 30, 2013

Thanks for your response. I had a horrible night beating myself up over this and thinking how horrible I feel if I impeded this PTs wound healing. It's very hard when someone makes you feel two inches tall. I prayed all night for my patients speedy recover which hopefully wasn't harmed by my stupidity.

PMFB-RN, RN · May 30, 2013

I had my first mistake as a nurse recently. I misread the doctor order and removed a wound bandage the wound doctor did not want removed! Which was plainly written in chart. I noticed my error within two hours and fessed up. The doctor was upset (understandably) although my feelings were hurt by some comments. Although I've tried to look at the bright side and think that at least this doctor cares about his patient. I fixed the problem to the best of my ability (im a hh nurse and even went and bought non stick bandages i needed). I notified my boss and I fixed the dressing the best I could. My patient is safe. I apologized to patient and family. But why do I still feel so crappy?

*** I have no idea why you feel so crappy. You made a simple, honest mistake that did not harm your patient and immediately took responsibility for it, admitted your mistake and did your best to rectify the problem.

Sounds to me like you are a good person and a good nurse. Relax and pat yourself on the back.

Anonymous25 · May 30, 2013

Thanks I guess the drs comments made me feel like this guy would lose his leg because I removed the dressing. The last thing I would want to do is cause my pt harm

PMFB-RN, RN · May 30, 2013

Thanks I guess the drs comments made me feel like this guy would lose his leg because I removed the dressing. The last thing I would want to do is cause my pt harm

*** No of course you don't want harm to come to your patient. You don't have to say that, it's assumed. Your are a nurse and get the benefit of the doubt in that regard.

You really have to never allow a doctors opinions or comments affect you. Whenever I hear a doctor make a comment about a nurse's care I have a couple hundred ready true stories about physicians neglecting or harming their patient, or only being prevented from harming their patients by the timely intervention of a nurse. That usually shuts them up.

carolinapooh, BSN, RN · May 30, 2013

HAHAHAHAHAHA that's classic!! What's the word? Oh, yeah - BAZINGA!

classicdame, MSN, EdD · May 30, 2013

the MD's reaction could have been more positive and I am sorry it upset you, but no doubt you beat yourself up worse. We all make mistakes. I firmly believe that MD's WRITING in charts makes them more than partly guilty. Will be so glad when all orders are computerized.

jadelpn, LPN, EMT-B · May 31, 2013

Thanks for your response. I had a horrible night beating myself up over this and thinking how horrible I feel if I impeded this PTs wound healing. It's very hard when someone makes you feel two inches tall. I prayed all night for my patients speedy recover which hopefully wasn't harmed by my stupidity.

And to play devil's advocate----the wound could be equally as impeded if you did not look at it. You can't see it if it is covered. And then the MD could have went on an on about how you "didn't look at the wound".....

As I am sure you know, you can not document on that you assessed a wound you did not see. And "dressing C/D/I doesn't talk about the wound, just the dressing.

Additionally, if the dressing was soiled and the wound draining, what would the MD have you do with that? Leave it?

Working with such nasty MD's, I would be 100% sure that you have malpractice insurance. For your own protection.

OCNRN63, RN · May 31, 2013

Thanks for your response. I had a horrible night beating myself up over this and thinking how horrible I feel if I impeded this PTs wound healing. It's very hard when someone makes you feel two inches tall. I prayed all night for my patients speedy recover which hopefully wasn't harmed by my stupidity.

I can guarantee you that doctor did not get through his internship and residency without making mistakes and getting dressed down on more than one occasion. You made the mistake, you've learned, the patient was not harmed. Stop beating yourself up or it will be very difficult for you to move on and work with this doctor in the future.

If you ever have to have another conversation with him regarding an error and he speaks down to you, tell him you understand the need to discuss the error, but you would appreciate discussing it as colleagues.

allnurses Guide · May 31, 2013

Just wanted to reinforce that you made a mistake (everyone makes them), you recognized it, reported it, and took action to rectify it immediately. There is nothing else you could have done.

As far as the mad MD, this is a reaction of a provider that cares about their patients, but he/she should not have been rude. You both made mistakes in this instance.

You did the best you could to fix an honest mistake.

brownbook · May 31, 2013

I used to really hate to tell people bad news.....as in I made a mistake.....and would beat myself up over the mistake for days! I finally learned to give myself a stern talking to...."pull up your big girl panties....tell the Dr. what happened......if he/she can't handle the truth (as in gets overly mad, annoyed, yells, gripes, complains, etc.)....then **** him/her."

Mature adults are people who can handle the truth regardless of what it is, without overreacting, yelling, berating, the culprit. Sure some annoyance is okay, you (I) deserve it, but then it we all get over it, fix what we can, and let the "poor me I'm a terrible nurse/ person blah blah blah feelings" go.