nursindaz

2200 is 10 pm. for some reason there is a policy on our floor that for our ortho patients, they want the coumadin given at that time. I have talked to one of the docs and he says that it is when it is best absorbed in relation to meals, and the timing of the PT/INR at 0500. They dose acording to that days blood draw for coumadin. so if the patient recieved it six hours earlier than they know, they could be dosing the coumadin at higher levels than they would if it was given at the ordered time. I don't know, but to me a fresh one or two day post op total joint should have their meds followed to a T, according to what is ordered. Especially if it involves a high risk drug like coumadin. Calgon, take me away!

theses meds were things like Cipro, which the patient recieved at 10am, then she gave it at 1600. also coumadin, which is specifically ordered for 2200 (for ortho pateints) , which she gave at 1600. I checked the accudose and it showed that she pulled the meds at 1553,but she left the times on the MAR at 2200. so unless she forgot to change the times (on three MARS) she knows that the meds should be given at specifically designated time. I think I will talk to my manager, the pharmacy should be able to audit her charts for pulling medications and falsely documenting the administration times. All of our meds are stored and dispensed from a computerized system. I think I should write it up as a med error. Then it is out of my hands as to what disciplinary action our manager takes. (And how many offenses the pharmacy finds.)

Yes our unit is busy, but she is a relatively newer RN Yes, we are a fairly busy floor, although small. We are an acute care/ orthopedic specialty unit. on any given night (3-11pm) we will recieve 5-6 post-op total joints. We generally have three RN's, 2 CNA's and a unit clerk. Thanks everyone for your input.

I have recently been named as the full time charge nurse on my unit and I have come to soe unpleasant discoveries. I am not sure exactly what to do. I found out that another RN on my unit has been giving her patients their bedtime meds at 4,5,or 6 pm, instead of 2200 as ordered. Apparently the previous charge was very aware but tired of the BS (retired now after 50 years of experience) and never really addressed the issue. I asked the nurse why she was giving meds so early and she bold faced lied to me, told me "because the daughter asked me to give her her meds now" SO I couldn't really call her a liar but I audited her other patients med sheets and several of them were the same...now the thing is, she didn't change the tmes to accurately reflect when she gave the meds, so I KNOW she knows what she is doing is wrong. the issue I have is that she wanted the charge position BAD and thay gave it to me, I don't want her to think I am singling her out. I also don't want to make too many big wave my first week on the job but this is really bothering me. How would you handle this situation? Any input would be helpful.

Hello, My family is thinking of relocating from Dover, DE to Columbus, OH (actually Dublin) and I was wondering if anyone can give me an idea of the salary an RN (ADN) makes in this area. I currently work in orthopaedics/ med-surg. Any info would be helpful! Thanks!