OMGosh...she wrote me up! Update about the Narcan!

Nurses General Nursing

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For those that didn't see my post, I had a patient come in after surgery who was very sedated, however...didn't meet the criteria for using narcan. He had serious sleep apnea so his pulse ox went from the 70-90's dependant on what part of the snore he was on, had good color, breathing about 18-20. I had called the MD, I did everything correctly...I even came on here and discussed my actions which no one said I was incorrect for holding narcan for a pt with hx of being overly sensitive to IV medications, post large back surgery, and it being near 11pm! I was of the mindset to let him sleep it off, and I will monitor closely instead of stripping his opiate receptors and leaving him in uncontrolled pain!

The nurse after me used the narcan X3!!!!!!!!! (did she wait to tritrate to effect long enough???!!!) And since she used narcan it needs to be investigated (protocol). She pointed the finger at me being at fault (just like I thought she would!). She said I didn't tell her about the pulse ox ...OMG yes I did, ad nauseum infact...and told her about the differences between breaths and I put him on 4L of O2, and that if she uses the pulse ox to wait a while and watch the trend. Guess she didn't. Also she said she couldn't wake the pt...I could...so I wonder what is up with that?

SO again...I was called into the managers office to discuss this. My boss seemed very perplexed about the pointing of fingers...and I said I was not suprised at this at all...and told her my side of the story...quoting my own documentation, people that were with me for reference..and my clincial opinion of the situation. Needless to say that my documentation was beyond efficient (two pages of details), and the managers were all on my side! The poor pt had to go through 2 days of uncontrolled pain because of the narcan...and we will start up incident reports on that soon!

Anywhooooooo they are going to talk to the nurse and get her side of the story...but in her documentation in the chart she actually wrote that I was at fault! That is not cool and I believe since it wasn't my fault...that is false documentation and proably more!

I was very professional and to the point and stood behind my choice! Everyone was so proud of me! Including me!!!!!!!!

Specializes in OB, M/S, HH, Medical Imaging RN.
In her documentation in the chart she actually wrote that I was at fault!...that is false documentation and proably more!

I was very professional and to the point and stood behind my choice! Everyone was so proud of me! Including me!!!!!!!!

I'm proud of you too triageRN_34! That nurse is in trouble charting that it was your fault. First it's legally WRONG! Second it's ethically wrong. Sounds like she was trying to CHA and the expense of yours. WRONG, WRONG, WRONG, I hope administration writes her up for this misjustice. Let us know what happens. You did great!

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Anywhooooooo they are going to talk to the nurse and get her side of the story...but in her documentation in the chart she actually wrote that I was at fault! That is not cool and I believe since it wasn't my fault...that is false documentation and proably more!

I was very professional and to the point and stood behind my choice! Everyone was so proud of me! Including me!!!!!!!!

I may not be a nurse (yet) but I think it's unprofessional, immature, and even unethical to chart who is at fault. You chart what you see at the time, not what the nurse before you saw - that should already be charted.

Also, I was led to believe that narcan was to be given only in emergencies, respirations low or nonexistant, seizures, codes, etc. You don't mention any of that. It sounds like the pt just did need to sleep it off. Even though he was experiencing apnea (heck, my dad experiences that when he snores), his sat did not stay in the 70's for an extended period of time. This may not mean much coming from an aide, but it sounds like you did the right thing and you remained professional throughout this ordeal. I think you should be commended for what you did.

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Also, this noc shift group you work with could learn alot from you if they paid attention and treated you with the respect that you deserve. IMO, they treat you like crap! Are you going to stay on noc? Don't let them get you down for you are a great nurse.

Can I work for you??

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Specializes in Tele, Infectious Disease, OHN.

Sounds like either 1) she overreacted and now has to justify her practice or2) she IS really messing with you and took advantage of this opportunity to try to make you look bad. Either way it got in the way of her treating the patient appropriately. Either one is her bad :madface: If you are half as professional in real life as you are on this board ( no doubt here!) there is no way she has a leg to stand on. I am proud of you because you DID the right thing, above and beyond, and documented it! :smiley_aa I hope this blows over soon.

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Sounds like either 1) she overreacted and now has to justify her practice or2) she IS really messing with you and took advantage of this opportunity to try to make you look bad. Either way it got in the way of her treating the patient appropriately. Either one is her bad :madface: If you are half as professional in real life as you are on this board ( no doubt here!) there is no way she has a leg to stand on. I am proud of you because you DID the right thing, above and beyond, and documented it! :smiley_aa I hope this blows over soon.

What she said.!!!!!!!!!!!!!!!

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Wow... writing opinion in the notes... just wow.

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I absolutely hate this kind of shift to shift BS. This gal sounds immature, childish, and immature. I cannot believe anyone would trash the previous shift in writing! Good Lord!!!:trout:

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Specializes in Med-Surg, Tele, DOU.

Wow!!!!!

We have a very specific protocol for using Narcan and it appears your facility has one likewise. It is very unfortunate that the patient had to suffer for such a long time due to that impulsive decision.

Triage, your decision was phenomenal. The "cutie" unfortunately is not going to fare well in nursing and neither are her patients. Impulsivity alone is not a good thing in nursing. However when one combines impulsivity with pride and removes thought and understanding . . . OMGoodness, this is reallly bad.

Please keep us updated with how things turn out for you. I wish you the best.

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Wow! I can't believe she actually put such a thing in her notes..Unbelievable! I sure wouldn't let something like that slide by without being addressed. By your first post about this particular pt, and previous posts about the night nurses attitudes with you, I was afraid you'd come back and say she wrote you up.

As I said before, you did right by your pt, I wouldn't have given the Narcan either in that particular situation. It's a shame the pt had to suffer in such pain afterwards. She obviously wasn't too concerned with his comfort, sad, very sad indeed. She should not have made it her priority to undermine you, at the pts expense.

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thanks, P_RN

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Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac.

By "written up" are you talking about what she documented in her nurses notes?

Or did management give you a written warning that is in your personnel file?

I'm sorry this happened.

(What about Bipap for the apnea? Was the MD aware?)

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