2 Nurses needed???

jadednurse · Apr 22, 2003

I guess my question to those of you who have to double check so many meds is do you guys document this somewhere? I think alot of places started requiring doublechecks on certain "high-risk" medications after some serious "boo boos" occured with patients. Certainly one reason is to protect the patients (no better reason than that I think!) but I'm sure another is to protect themselves from litigation. I think the catch here though is that if the institution doesn't require a co-signature to be documented they could open themselves up to alot of legal headaches should a major error occur. I worked at one place that made a huge deal about double checking heparin drips (after years of never having any such policy) but then never had a place to document a signature from the verifying nurse. Good system, but kind of incomplete in my mind.

debmsn01 · Apr 30, 2003

As a 24 year veteran of nursing and now as a nursing instructor, I don't think this is about "old school". It is as many have stated, "good nursing care". By double checking your meds such as insulin & heparin, you ensure safe & efficacious care to a patient. I carry my PDA with me at all times & still look up many of my drugs to make sure of any interactions, concerns, etc.. If a mistake is made, you probably didn't mean it, but will have to live with the outcome forever and it isn't easy. I have many friends who suffer with "what ifs" because they failed to have someone check something & a sentinel event occurred. Another thing is narcs-have someone check them also, it will also cover you if someone is diverting-you won't be suspect.-Debb, MSN, RN, OCN

tonchitoRN · Apr 30, 2003

this is an interesting thread. although double checking is a great idea i think most people are so busy to go find someone to double check every med. now if you think 2 signatures are going to get you away from litigation, think again. if a mistake is still made then the 2 signatures get pulled into deposition so be careful when you check. remember, everything is about accountability. if you ask me to double check your work be prepared to show me the original order (no kardex), the bottle you pulled the med from, the syringe and the patient. then and only then can i verify that the 5 r's are being done. if you can't do that then find someone else to help you. i am protecting myself too, you know. :cool:

debmsn01 · Apr 30, 2003

You are absolutely right, I would never sign or even verbally verify unless I see everything. Usually at the times of these meds, there are more than 1 nurse at a med station. I made a fellow staff member throw insulin away that was mixed & do it again so I could check each dose/type.

mother/babyRN, RN · May 5, 2003

I have never worked anywhere where insulin had to be verified, although with anything like heparin, I always did so...

CougRN · May 5, 2003

Originally posted by southernbelle36
I don't know if you are trying to say that LPN's are incompentent to give medication without verification, but she was just saying that was their hospital policy. I don't care what your title is you still have to follow policy. In my 12 years of nursing I have seen ALOT of incompentent RN's and LPN's. I am an LPN and I am not ashamed of it. I would go up against your nursing skills anyday. People get their degrees according to life style, finances and many more things that can inhibit spending more time in college. Most of you RN's would not be able to function without us LPN's because then you would have to get up and do a little work.

Ok, I'm not sure what I did to you in a past life but this wasn't addressed to you. I wasn't even thinking about RN vs LPN because we don't have LPNs in my unit. Sorry if you took this personally.

It has become apparent to me that I have offended a few people with my comments. Sorry, it was just my opinion but I guess that is not what this board is for. I will fall in line and regurgitate everything you all believe and not think for myself from now on. jk

Anyway, I stated earlier that we as nurses should be able to read and order and know when an order is not "regular". what i was trying to say is that when an order appears out of the ordinary then i would double check or even triple check the order for verification. I'm not against checking orders because I do this all the time. I check my dosages and math every night. I just thought it was odd to have a policy in place for insulin verification. You will have to excuse me for being surprised by this.

So in answer to the question originally posted, No we don't have a policy in place to double check medications in our intensive care units. Yes, we check gtts and medications with each other all of the time because we are safe and compitent nurses.

jschut, BSN, RN · May 8, 2003

Oh my goodness....we have never had anyone double check (although I think it woud be a wise idea).

Heck! I can't even get the nurse going off duty to count narcs with me!!!!

healingtouchRN · May 21, 2003

safety first, I know how tired I get & it keeps me safe!

Texagain · May 21, 2003

We verify too. Not just the syringe, but the order in the chart, the MAR and the bottle(s) for insulin with the syringe in it. It's better than making a mistake.

celestlyn · May 24, 2003

In my small hospital, we had that policy until about 6-8 months ago. The rest of the floors in the hospital had changed and were no longer requiring 2 nurses to verify doses on insulin. Our floor was the last to change.

canada · Jul 25, 2003

At my facility, a LTC with 300 beds. We do not check any drug with another nurse unless its a narcotic. We use insulin pens for all insulin doses. RPNs give the majority of insulins and heparin is given by RNs. If you can find another RN to verify a dose you would be indeed lucky.

ucavalpn · Jul 26, 2003

I work in HH . I often pre-fill insulin syringes for my pt's. 1-2 weeks at a time. When I was working on the units I did often ask another nurse to double check .