Not My Fault, But Worried Anyway

[AngelfireRN, MSN, RN, APRN]

I have an issue that I would like some advice on. I have been at my job for about 5 months now, and I absolutely love it. But there is an occurrence that has happened twice in the last 2 weeks that has me concerned.

Last week, my head doc asked me to fax some papers on a lady to another doc, who she was supposed to have an appointment with the next week. The lady was not doing well, but was insistent that she be allowed to go home before seeing this doc, rather than being transferred. Her admitting doc was against this, and said that my doc would have to do the d/c AMA. My doc was not too happy, but they worked it out, and I was told to write those orders. I arrived on the floor, only to find the admitting doc writing them, and telling me not to worry about it, but in a way that (to me) seemed like he was miffed.

Then, the doc she was supposed to follow with was out of town, and my doc was in clinic, so I left a message to ask if another doc in the same group would be OK, since she needed to be seen pretty quick. (Sure as I had made an appt with another doc, my luck, doc would have not wanted to do that) He said fine, and by the time I got to the floor to write for it, the floor nurse, who had already talked to my doc, had written the orders. So, by none of my own doing, what should have been simple was a train wreck, and here I was looking like the conductor that was texting instead of driving.

Flash forward to today. Same doc asks me to set up a test on a patient. I call the test center and set it up, then head to the floor to write the order, only to find that the patient is upset, as he knew nothing about it, he had eaten breakfast (need to be NPO for the test), and he is refusing the test.

Here we go again.

I call doc, explain what happened, verify that no, there was no NPO order written, and tell him that the patient has refused the test. He says he'll take care of it, which makes me hear an unspoken "Because you can't."

Now, I know I'm being paranoid. I know that there was nothing that I did to cause these events to occur. I was just following my orders. However, I am afraid that my head doc will see it as incompetence on my part, that I can't complete the simplest task without mucking it up. I'm afraid I'll lose my job.

Anyone dealt with anything like? Any tips, other than Valium? Thanks for reading the dissertation if you made it this far.

[mom4josh]

What I would do is keep a journal of events as they occurred. I'm not sure if it's just a lack of communication or what, but keeping a record will help you if it comes back to bite you.

[SuesquatchRN, BSN, RN]

I'm discovering, now that I am management, that no one owns their errors or incompetencies. It's rare that someone is stand-up enough to just acknowledge xyz was his fault. That's all that's happening here.

The first, forget it. The seocnd had nothing to do with you. Did you know about the test the night before? Is it your responsibility to write his orders? No. So forget what you think you herd implied.

[Virgo_RN, BSN, RN]

Next time, call the floor nurse. In the first scenario, the floor nurse had already called the doctor and was writing the order by the time you got there. The nurse probably had no clue you were on it. A quick call to the floor nurse to let them know that you were on it and would be there to write orders might have averted that situation.

In the second scenario, without a written order or any communication from the physician about the planned procedure, there is no way for the floor nurse to know. A quick phone call the second you knew about it, to give the nurse a heads up, might have made a difference. Depending on how long the patient needed to be NPO for the test, you may have been able to schedule it for a different time, or give the doctor a more prompt heads up that the patient had eaten breakfast.

I'm not finding fault with you at all. Hiccups like this happen all the time, and are not anyone's fault, really.

[Iris Santana]

You are doing fine. Relax and enjoy the ride. These occurrences are very normal . In the medical field we have to understand that it is a practice and as we practice we do get better. I am sure that the next time these situations arise you will be a pro but be prepared my sister others will arise.