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Discussion

PCA pump error

Question: Our charge nurse set up a PCA pump with morphine for a new grad. Our policy states she has to set it up with another RN, but this manager just did it herself then had another nurse go in and check it. So, what happened was, she set it up so the patient got 25 mg of morphine in one hour (he survived with no obvious suffering). The charge nurse was not reprimanded, the floor manager decided to use it as an educational experience for the difficulty of the PCA pump. The MD wanted both nurses fired. So my question is, was this just a med error open to education? Or should something more have happened? Should the nurses have been fired?

Thanks for your input.

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I'm a new grad & uncomfortable with PCAs. I was recently advised by an "experienced" nurse to request doctor's orders for a PCA pump when my patient's pain wasn't well-controlled by hourly PRN IV morphine orders. I just wasn't able to keep up due to high pt load/acuity assignment. I went through a few nurses, starting with the charge nurse, before finding one who knew how to set up the pump & repeated the scenario a couple of days later when it was time to d/c it.

We had a brief PCA lesson during orientation. I plan to let the manager know (without naming names) that the need for training beyond orientation exists.

The doctor, I think, feels that if a nurse is suggesting a treatment method she must be knowledgeable...

This is a good thread. Thanks to all previous posters for sharing your experiences.

]Where do you normally set up your PCA's if you are in an open unit like PACU?

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