Ordering antibiotics!?!

Nurses Medications

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So today I cared for a gentleman who became febrile at 38.7. I called the doc and pan cultured him as ordered, including a UA. The patient was not on antibiotics and was admitted for a lung AVM. The UA came back positive for Many bacteria, WBC, nitrates, etc. Since I work nights, I knew the doc wouldn't be looking for it. I called him (he's awake and in house) to let him know it was positive. However he never started the patient on antibiotics and acted like he didn't know why I was calling. I don't understand why the patient doesn't receive broad spectrum antibiotics. Any thoughts? I was just wanting to do what's best for the patient and get this UTI under control and reduce his length of stay. The only thing I can think of was it was a busy night on our ICU and they were admitting a gunshot wound down the hall. Any insight?!

Specializes in Hospice, LTC, Rehab, Home Health.

Sometimes how you phrase your "recommendation" depends on the particular doctor. Some docs are very open to our suggestions and others wouldn't give you what you asked for if the world was coming to an end.

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Specializes in PCU.

Chart the initial call, the response (new order received and noted), chart the 2nd call for the positive UA and the response for that (No new orders). CYA.

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Really? Wow. Why is it being presumptuous to know that a patient with a UTI needs antibiotics?

Suggesting a specific antibiotic might be sort of presumptuous, but....

I agree in this case since the patient was symptomatic with a positive urine analysis that we should give antibiotics. However, keep in mind that because someone has a UTI does NOT mean that they need to be treated with antibiotics. This is only true for pregnant women, infants, kidney transplant patients (data not entirely clear about this) and patients about to undergo urogenital surgery. But please do not propagate the idea that because someone tests positive for a UTI, which is very common, that they need to be treated. Also, it is super important not to treat someone based on the smell of the urine, which is commonly done with the elderly. Someone will see or smell their urine and assume they have a problem and need to be treated.

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Specializes in retired LTC.

#1 asparagus, #2 garlic #3 broccoli major offenders of funny urine smells.

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