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iPatch
9 Posts
no one else used the words "the system," but they are discussing it. the pharmacists, the doctors, the nurses...are the system. if we are not, define it for me, please. what does your system consist of?
basically the same. when i mentioned "health professional," i was actually referring to the same examples you listed.
actually, it's the opposite of saying "the planet earth is the universe." that would be saying that the responibility falls on to one, and i'm saying it does not.
and i said all along it can fall on a combination of things, as opposed to just the nurse, doctor, or pharmacist.
pharmacy is a part of it, nurses are a part of it, physicians are another part of it. so are hucs, so is the computer system we use to enter orders. however, it responsibility falls most heavily on those that prescribe, prepare, and administer. i'll ask again, what other specific people/units/variables are involved?
i don't think i need to elaborate more on this.
you are narrowing my definition of "we," not me.
i didn't. you mentioned "we" as your specific definition. you insinuated that only living, breathing individual providers comprise a system.
there are many different types of med errors. you should see the list to choose from, when filling out an incident report about a medication variation. errors from transcription, to preparation, to dispensing, there are a couple dozen choices. multiple checks are in place already. it's not something that you're going to fully comprehend when you're not doing it day in and day out, and have never seen it even. i am not sure what you mean by, "we are blaming everyone." not at all. but somewhere, despite the checks, things fail. who did depends on the specific error. if a medication that is prescribed, for example, that is not a proper dosage: the md who wrote is first at fault. s/he may have written the wrong dose. the huc entering the order may not question it, although if they have to type in an amount of 10 tablets to equate the written dose, that would be a red flag. if it's not questioned at that point, the pharmacy then gets the order. the pharmacist should question the dose. if they do not, they send up the med. lastly, the nurse receives the med, to give to the patient. s/he is pretty much that last stop on this trail, and at this point could (should) question the dosage. if s/he does not, the patient might even question it, when it's given to them. they may say, "i take 2 pills of this at a time at home, why am i getting 10?" however, most patients don't have a good understanding of their meds, so it may not happen then, either. for this type of med error to happen, every one of these checks has failed if the patient takes that med. but the checks are in place. this example is a totally different type of error than mentioned in the op, though. i think you get the idea.
i am not sure what you're trying to argue here. all i am saying is not all medical error is attributable to individual negligence or misconduct. i am merely focusing on the improvement of a system and not blaming individuals.
if they decided not to go after the "little people," i am not understanding your comparison to a witch hunt. wouldn't that mean that they do go after "the little people?"
witch hunt is an analogy that refers to the lynching of "perceived" wrong-doers. again, i am implying that there might be a chance, no matter how slim, that the doctor, nurse, or pharmacist is not at fault here.
"claimed?" that implies that you think i'm lying about that.
claim means to assert. i don't see, in any shape or form, how i am implying you're lying.
believe it or not, there are meds that i give literally every day at work, some multiple times, so yes, i am very familiar with them and no, i do not need to look them up each and every time. (for example, toradol...i know that our guideline states to push it over at least 15 seconds. i know that i need to check their creatinine level prior to giving it, and that we shouldn't give it in patients with a history of renal problems, stomach ulcers, allergy to aspirin. i know that i may not give it if they are having low urine outputs post op, since we may not know if the cause of that is dehydration or renal insufficiency). although you imply otherwise, there is nothing wrong with that. to say that i "use a little discretion" when administering meds does not contradict that at all. discretion meaning, that if a physician has ordered iv ativan, morphine, and benadryl all prn, just because they're ordered doesn't mean they can or should all be given at the same time, it depends on a lot of factors. in fact, it's from having a knowledge of these medications that prompts knowing to use them with discretion. all of these meds have the potential to sedate the patient, and i know this. if i give them a dose of morphine, i am going to see how they react before giving another one. "discretion" when administering also means that, if a physician orders ativan 1-2mg iv every 2 hours as needed, i'm going to look at many factors: the other meds the patient receives, their vital signs, respiratory rate and quality, size/weight, and medication history when deciding if i should give 1 or 2 milligrams. that's my nursing judgement.
i can respect your point here, although i have to admit, this is beyond my comprehension.
you assume complacency. knowing something doesn't mean complacency in any sense of the word. when you've looked up and given a med literally hundreds of times, you can know something. i know that iv ativan needs to be diluted at least equally with normal saline and pushed over at least 1 minute. i know that we give iv metoprolol at a rate no faster than 1mg/minute, and that we check a heartrate and blood pressure both before and 15 minutes after administration. i know that benadryl is pushed over at least 5 minutes. i know that on the floor, we can't give more than 5mg of morphine, 0.75mg of dilaudid, or 35mg of demerol in a single dose on a prn schedule. what i do always do is look up compatibililty with another med. if i am giving a med to someone with a pca, i always check to make sure the med i'm giving is compatible with the pca med. you seem to assume that my saying having knowledge of some med means i'm saying that i have knowledge of all meds, and that because i say there are things i don't have to check, that i don't check anything. that's both untrue, and unfair to assume. some meds, i can literally recite our guidelines word for word from the manual (see above). do i sometimes still check them anyway? you bet. that doesn't make me complacent.
i wasn't assuming. i just elaborated on your exact choice of words.
until you know what the job entails and actually do it, please don't make assumptions about those who do.
let me get this straight. are you saying i don't have the right to talk about nursing until i get a degree, pass the nclex and actually do the job?
i think you're arrogant. this is a message board. it's a place to share opinion, not facts. it's a virtual place where making assumptions is the general rule.
just who are you to curtail my right to speak?
respond if you will, but i am done here with you.