Policy/Procedures or DON rules?

[Trubie]

Had my first med error today When I looked at the front page on the chart, it listed NKDA for the patient. Dr. ordered Bactrim. After giving first dose, I noticed the pt was allergic to sulfa. This was within 1 hour of the dose. Patient had no adverse reactions, normal vital signs. Notified Dr and Family, they were unconcerned, but Dr changed order to cipro.

I went to tell my DON about the mistake, and she told me that the nursing staff needed to follow up for the next 24 hours by assessing and charting every 30 MINUTES!! Are you kidding me!?!?! I checked the policy/procedure book and it said to do initial assessment, then follow up q shift for 3 days. This seems much more realistic.

However, does the DON's rule override the policy/procedure book?? This DON is famous for piling on tons of unnecessary work that is not in the procedure guide.

What should I do? I dont want to get in trouble with the DON, but I really feel she is being excessive

Advice??

eta: discovered allergy because allergy list in chart did not match allergy list in MAR.

[SuesquatchRN, BSN, RN]

The DON hired you, she can fire you. The DON decides what is policy, that is one of her basic roles within the facility. It would be prudent to follow what she says.

BESIDES.

You always follow safest practice. Checking your patient every 30minutes is not a HUGE request. If you were before the Board or a Jury would you really whine that you did not want to check your patient every 30 minutes? I would be very surprised your DON ment a full head-to-toe assessment and a full paragraph in the chart every 30 minutes.

A flow sheet checked off every 30 minutes or charting stating res continues on q30 minute wellness checks should suffice.

It's huge when you have 29 others.

[opensesame]

It's huge when you have 29 others.

I was thinking that too. Too high a level of care for long term.

[inshallamiami]

This is why I hate nursing.