LPN47331

I had a pt admitted with CP and hypertensive urgency who was also on telemetry. His/her admit BP 200s/100s. C/o headaches. I look @ admit orders and no meds ordered for BP. Just vicodin, tylenol, and anti-emetic. This pt was not on the floor 5 minutes and I called the ER doc who wrote the admit orders and explained the pt's BP was 225/117 and asked if (s)he could order something for his/her BP. ER doc would not give me anything and suggested I call the admitting doc for orders, which I did without any luck. I paged, left messages and called the doc @ home and still no answer. When the pt was in ER, (s)he was given: 3 NTG SL, morphine, vicodin and zofran before his/her BP came down to 190s/60s. I called ER again and finally got an order for some NTG ointment. I'm just wanting some opinions or thoughts on this. Thank You!

Our medsurg manager and DON suspended a nurse for practicing medicine without a license due to a med error. She gave the wrong med and realized what she did and immediately notified the doctor and wrote herself up w/ incident report. Our nursing leaders decided to ignore the non-punitive error reporting policy that is in place. To top it off, these nurse "Leaders" are on the safety committee from which this policy came to be. The patient did not suffer any adverse reactions. The nurse in question filed a grievance w/ HR and luckily HR overturned the DON & medsurg mgr and stated they were wrong and gave the nurse her pay she lost. It was a one day suspension but the MS mgr go enjoy the day w/ your kids. I would like to say that he...MS mgr... is the ONLY department head who does not help their own unit. The moral is at an all time low and mgt are oblivious to it. Just had to vent.....thanks!

it was an anterior.....

Just recieved news yesterday that the pt on arrival went into v-tach. Coded her and found out she had 100% blockage of her RAC. They placed 2 stents and she is now doing fine.

I had 2 DWIs but were misdemeanors because of time frame of arrests. But, I took a chance and went to LPN school without knowing if I would be allowed to sit for the boards. My stupidities took place in my 20s. I have been a nurse for 4yrs now. My teachers signed a letter of recommendation in which I presented to the Indiana BON. I sat before the board in a public meeting and had to answer their questions and answer for my past mistakes. All but one voted that I be allowed to sit for the boards, which I did. I sometimes tell stories about my past behaviors to hopefully educate those that don't realize mistakes can and do follow you for years to come. Of course I don't drink now. Been sober for 6 years. Have a good job, wife and kids. Don't give up! Always be persistant. Use your experiences to hopefully teach others. Good Luck!

We have a new ER doc who is very respected as a Family Physician for which this is all he has done for many, many years. We had a 74 yo F with c/o bilat arm pain and burning between shoulder blades. BP was 180/110, rest of vs wnl. Doc ordered NTG SLx3 and pt had no relief. 4mg MSO4 IV given and BP dropped to 59/40. BP came back up even though Doc ordered NS@100/hr. Pt still had chest pain & rated 9/10. EKG showed anferior MI, ck-mb 64, Trop I = 9.6. I asked the Doc if he wanted to start a NTG drip. He said no due to previous drop in BP. Pt then c/o nausea and I asked for some phenergan, zofran, etc. Doc said no....because of BP, which she was SBP 110-130. This pt was extremely symptomatic and we did nothing for. She was transferred to a cardiac facility and had 2 stents placed that night. I discussed this with the ER director and he stated a NTG drip was the appropriate treatment regardless of episode of low BP. I felt completely useless for this pt. I have been working ER for 4 yrs and am an LPN. I just did not know how to respond to this situation. I asked my ER director if it would be appropriate to make suggestions to this Doc because he is not an ER MD. He said yes it would. I've witnessed some odd situations but this takes the cake. If anybody has any comments or suggestions, I would really like to hear from you. Thanks!

Regardless of code status, a pt has the right to be treated and is our obligation to treat the pt and not the 'status'. I should've worded the description differently. I'm sorry. As it turns out, the pt came back to our facility as skilled for pt/ot. The Heart Hospital's surgeons did not do any prcedures. I wonder how many other health professionals instinctively imply DNR=Do Not Treat??

Our ER supervisor watches over an elderly couple because they are old friends of the supervisor's family. The patient is 94 and is a DNR. Well, the ER supervisor decided to have the patient transferred for a pacemaker placement. She is NOT POA and has no legal connection to this patient other than being a friend. She is also the back-up DON. When asked why she did this, her response was: "At least they can't say I didn't try everything." This certainly seems like not only a legal issue but also an ethical one. Did she have a right to do this?