Neuro Floor Nightmare!

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background: i worked on a neuro floor that should have a 4:1 pt to nurse ratio, because it is considered a critical care floor. our shifts are 0600-18:30. i received my 6th patient at about 15:30. problem: for some reason we didn't have a decent pct/secretary. a variety of people were putting in orders. some orders got missed including mine. this was a serious problem since my pt. was admitted with a k+ level of 7.2! the doctor came in an hour later and the orders still weren't put in. he was ****** and looked at me like it was my fault. i dont know how to put in orders and wasn't trained to do so. besides that, the orders were missing. when i finally found them they were tucked behind the front desk computer. by the time they were put in and results were received, night shift was there and got the results. the pt. k+ level was 8.0.:eek: the pt. could have coded. so obviously the night shift nurse looked at me like it was my fault, and potrayed it to the physician that way. i'm so upset and depressed i don't know what to do. in the midst of all this i had other patients and physicians pulling me in different directions. i never want to go back. what should i do??:crying2:

Well with your reply, it obviously sounds that you take things in a concrete manner. So you're actually implying that you don't like to learn how to put in orders because you don't want them to rely on you for that-----afterall, maybe you're thinking, it's more work for you right? And besides, it's the job of the secretary.

I work in the am, and we have more than one secretary.....and guess what, if I find something erroneous, I correct it personally before I co-sign something.....instead of waiting and waiting and waiting for a secretary to correct it......before that order gets missed and late! Years ago, one RN co-signed what a secretary put in without double checking.....turns out, Miss Secretary, actually didn't. And it was a critical testing for one patient. So Miss Secretary gets sacked and Miss RN gets written-up!

Those who fail to learn from their past are doomed to repeat it. I hope this thing doesn't happen to you again. The patient might just be that not lucky.....and you and your license may not be as lucky too!

And... the other patients and their problems and their orders? I guess they'll get ignored since I'm putting in my own orders for other patients. "Learn from it" learn from what???:confused:
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Specializes in Pediatric/Adolescent, Med-Surg.
I am irked when the first suggestion I see to a question is "QUIT".Why should we quit first before finding out if a situation is salvageable?

If you never ask,the answer is always no. OP, speak to your nurse manager and with your pregnant state, you might even have a leverage.

And next time,next shift nurse gives you feaces when it is not your fault,try standing up for yourself.Be assertive and correct her in non-aggresive tones.

I'm sorry if you find my answer to be the easy way out, but the idea of being a nurse of 6 step-down pts would scare me to death. I float to step-down (neuro and cards) all the time and typically have 3-4pts. Even with 3-4 I find myself very busy, often running around busy with new orders, sudden changes in pt statuses, etc. As a nurse, I know I could not accept an assignment of 6pts on a step-down unit. IMO this nurse was set up for there to be a mistake somewhere in the system that day.

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Specializes in M/S, ICU, ICP.
background: i worked on a neuro floor that should have a 4:1 pt to nurse ratio, because it is considered a critical care floor. our shifts are 0600-18:30. i received my 6th patient at about 15:30. problem: for some reason we didn't have a decent pct/secretary. a variety of people were putting in orders. some orders got missed including mine. this was a serious problem since my pt. was admitted with a k+ level of 7.2! the doctor came in an hour later and the orders still weren't put in. he was ****** and looked at me like it was my fault. i dont know how to put in orders and wasn't trained to do so. besides that, the orders were missing. when i finally found them they were tucked behind the front desk computer. by the time they were put in and results were received, night shift was there and got the results. the pt. k+ level was 8.0.:eek: the pt. could have coded. so obviously the night shift nurse looked at me like it was my fault, and potrayed it to the physician that way. i'm so upset and depressed i don't know what to do. in the midst of all this i had other patients and physicians pulling me in different directions. i never want to go back. what should i do??:crying2:

wow, i am sorry that you were caught in such a dire situation and sorry that the patient is the one who would have suffered the most. it is a good idea to ask for orientation with a unit secretary in order to learn how to take off orders. it is so priceless in a rush or until a secretary can come help. after all is said and done, it is always the nurse's license that is on the line and that is frightening to say the least. in the meantime...

i would always grab the md order sheet and send a copy to pharmacy, call the supervisor for help on the floor, and make myself a copy of the orders.

as i went down the list carrying out the orders i would write out beside it what i did or what size foley or cc's returned etc. then i would worry later about how to enter the orders or get some help to do it. at least grabbing the orders and faxing them to pharmacy and doing them got the patient the right care as soon as possible.

it has helped me more times than one to at least have the orders being done even if they have not been entered into the system yet. i wish you the best of luck and i wish i could tell you this same situation wil never happen again. i think that is why we nurses get so burned out, frustrated, and leave the bedisde.

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Specializes in Telemetry/Cardiac Floor.
Well with your reply, it obviously sounds that you take things in a concrete manner. So you're actually implying that you don't like to learn how to put in orders because you don't want them to rely on you for that-----afterall, maybe you're thinking, it's more work for you right? And besides, it's the job of the secretary.

I work in the am, and we have more than one secretary.....and guess what, if I find something erroneous, I correct it personally before I co-sign something.....instead of waiting and waiting and waiting for a secretary to correct it......before that order gets missed and late! Years ago, one RN co-signed what a secretary put in without double checking.....turns out, Miss Secretary, actually didn't. And it was a critical testing for one patient. So Miss Secretary gets sacked and Miss RN gets written-up!

Those who fail to learn from their past are doomed to repeat it. I hope this thing doesn't happen to you again. The patient might just be that not lucky.....and you and your license may not be as lucky too!

Well I guess we should all be like you.

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