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medteleER

medteleER

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  1. medteleER

    Written Up

    this is what bothers me. my rationale was "it's ONLY 1 mg". i've been in similar situations with schedule acetaminophen and prn norco, antibiotics being scheduled incorrectly by pharmacy (receiving a q8, q12, or qday dose too early because patient was a direct admission and received whatever it may be already at other facility), and meds that are synergists of each other, ie; the "seeker" type patients. and i was able intervene. can anybody else answer below? i need to keep myself out of trouble. any assistance is appreciate it. please and thanks.
  2. medteleER

    Written Up

    i'm not sure if there were adverse effects, but according to allnurses.com there might have been or was. believe it or not, the patient dropped off a daisy award nomination for me.
  3. medteleER

    Written Up

    and i'd add some dilaudid for pain and benadryl for the itch. lol. believe it or not we have patients here that receive all of that. maybe it's just where i'm working. anyway. thanks everybody for the posts.
  4. medteleER

    Written Up

    how exactly would you approach this? i am asking, not being contentious. we care of patients like these frequently, with "patient advocates" who somehow manipulate (maybe that isn't the correct word) the MDs into prescribing meds like dilaudid, benedryl, trazodone, xanax, ativan, librium, phenergan, seroquel, gabapentin, amitriptyline, restoril in 1 sitting. most are scheduled and cleverly labeled PRN. i once questioned some orders being "not safe" and was grilled by the an MD and charge nurse. roughly, "if the vitals are stable, you have no reason to deny a patient their medication." even if i spread medication out an hour apart, some do not metabolize out in an 1 hour. and i'll get terminated for time management issues. any ideas?
  5. medteleER

    Written Up

    all i wanted to do was help my patient sleep and not wig out. the patient told me "the MD ordered 1mg of xanax for me", but the orders didn't reflect this. so i took their word for it and got creative. i figured 0.5mg+0.5mg = 1mg, so let's try that. since 1 was for sleep, and 1 was for anxiety, it would be OK, i thought. i did take into consideration 1mg of xanax isn't going to kill the person. but now i'm not so sure. i actually feel bad about this.
  6. medteleER

    Written Up

    The oncoming shift charge nurse got on me about "double dosing" a patient. MD had (2) specific orders PRN: 1) xanax 0.5 mg for sleep 2) xanax 0.5 mg q8h for anxiety I gave BOTH of them because the patient claimed being anxious and wanted something to sleep. My charge nurse pulled me to the side afterward and stated she was going to write it up. The patient was VSS in the morning. I'm not sure how I should be feeling about this.
  7. medteleER

    need advice, telemetry and ER

    it IS NOT the policy to spend time on the tele unit, prior to transferring to the ER. though it IS POLICY that I have to spend 6 months there if I do transfer... meaning I will be stuck there for 6 months. I am going to make contact with the managers as soon as I can. I would definitely want to shadow somebody in the ED, if I can.
  8. medteleER

    need advice, telemetry and ER

    Thanks in advance for reading. Just wondering if this is a good idea. I’ve made some posts regarding transferring to the emergency room, but my educator said it is necessary I spend some time on the telemetry unit prior. I am a med/surg nurse with 5 years under my belt. The nursing supervisor said I DO NOT have to do this and recommend I request to be floated there (telemetry) while I stay in med/surg. And I believe she also said, I could even request to be floated to the emergency overflow, occasionally (if I had all the certifications) So…. Should I transfer to the telemetry unit and stay for 6 months (policy) before going into the ER? If there isn't a position, it might take longer than 6 months. Or... do what my supervisor says about this floating to telemetry and ED overflow? I only feel like I can jump straight into the ER because they do hire new graduates. But I also want to be completely prepared (tele experience) before I do.
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