please commiserate with me -very frustrated

[rnto?]

So, I was 3-11 shift supervisor tonight at my SubAcute/LTC facility. Got report from unit manager that Mr. X was "allowed to self administer his own meds" and was told it was all taken care of. OK. Fast forward to 930pm, floor nurse attempts to administer his cardizem as stated in the MAR, and patient refuses, showing her a bottle of his own pills he had in his dresser. Floor nurse knows nothing about him being allowed to take his own meds, so comes to me. Further investigation into the chart reveals that there is NO ORDER about the patient being allowed to self-administer, and no nurses' note documenting any kind of conversation that the unit manager had with the MD. I go talk with the patient-he has a bottle of cardizem and states he spoke with the unit manager earlier and she said him taking his own cardizem was fine with the physician (the patient did not think our cardizem was working). BUT the order we have here for cardizem is cardizem 150mg BID, and the prescription bottle he has is Cardizem CD 180mg BID. The prescription expired in May 2009. Now I'm the bad guy explaining that it's against DOH regulations, etc., and the patient is disagreeing with everything I say. "the rules are stupid" "You don't have to have everything written in the chart". Whatever.

I'm frustrated because I feel like every time I walk in, I'm fixing something the unit manager did.

[Platypus]

RNTO -

I can see you are frustrated with the turn of events. I am a new supervisor myself on the night shift and I have received conflicting information on a number of items. To make matters worse, I am also a new nurse so my "ivory tower" ideals are being tested to the limit, in addition to the conflicting information. It is hard keeping it all straight.

I think asking a lot of questions and clarify and vague information could help us both. Good luck with your new job.

L

[classicdame, MSN, EdD]

write it up as med error and see what happens. :)