JMK04

Feeling very ashamed today. I need to vent to my fellow nurses and please do not judge. I'm an RN working in home health and forgot to follow up with my Clients PCP regarding a urine specimen which is where this story begins. My client has a Foley catheter and a history of frequent UTIs. The Patient was complaining of UTI signs and symptoms and I attempted to collect a specimen but didn't have enough urine for a culture. i notified the PCP's nurse and my DON. The nurse stated she would call in a script and still wanted a urine culture. She requested I follow up with her once the specimen was collected. I informed her that the caregiver would attempt to collect a specimen as I was already gone and would not be returning to the clients home that day ( Friday). I also informed her the lab was not open on weekends and the likelihood of submitting a specimen on Friday was slim and that we could try again next week. Another nurse visited with the Pt on Wednesday and contacted The PCP, again regarding the UTI signs and symptoms and informed them she was unable to collect the specimen as well, she also asked about the Abx Rx as the patient never received it. Another 9 days goes by, I'm visiting the Pt and notice no Rx was filled for antibiotics and called and reported this and the signs and symptoms to the PCP's nurse. She was hostile on the phone and stated she was waiting on the culture before sending the Abx and that I failed to follow orders, delaying treatment. She faxed new Med orders to my agency and wrote directly on the order that I had failed to notify the doctor. Thankully the client is doing ok. But I'm worried about being reported to the board by the PCP. I take responsibility for failing to follow up and clarify the orders. I've spent most of the day agonizing over the situation and thinking of what I could have done differently.

Tip #1: use a straight needle for the collection if possible. Tip #2: if using a butterfly needle for the draw, ensure you draw 2 tubes of blood as the 1st tube will not completely fill d/t excess air.