Jump to content
blondy2061h

blondy2061h MSN, RN

Oncology RN
advertisement

Content by blondy2061h

  1. blondy2061h

    Nurse Gives Lethal Dose of Vecuronium Instead of Versed

    It's a good point. A nurse I work with made an extremely similar error, but the med they gave instead of the ordered med was not one with life threatening side effects so no viral news story there.
  2. blondy2061h

    Nurse Gives Lethal Dose of Vecuronium Instead of Versed

    They don't know how much was given. The CMS report makes that very clear. There were two syringes with different amounts of liquid. They weren't able to determine what was in each one. The nurse was very non-committal to what dose she gave. To me that means she really was totally clueless or she was being dodgy. I get that this happened a year ago, but I made a serious med error 7 years ago and remember everything about it.
  3. blondy2061h

    Nurse Gives Lethal Dose of Vecuronium Instead of Versed

    I was initially confused at how an ICU patient ended up off the unit without an ICU nurse or monitor, but it seems the patient was awaiting a floor bed. That then makes me confused why they jumped to IV versed for a PET scan. Seems like PO Xanax would have been a more appropriate starting point, but obviously I don't know the patient.
  4. blondy2061h

    Nurse Gives Lethal Dose of Vecuronium Instead of Versed

    Oh I do suspect she'll never be a nurse again
  5. blondy2061h

    Nurse Gives Lethal Dose of Vecuronium Instead of Versed

    But if the option is a nurse with no ER experience or no extra nurse at all, I'll take the one with no ER experience. I won't expect them to function independently, but they can be delegated to by other nurses. Hopefully there are some tasks they know how to safely do- drawing labs, starting IVs, taking vitals, hanging IV antibiotics, giving pills, helping transport people, etc.
  6. blondy2061h

    Nurse Gives Lethal Dose of Vecuronium Instead of Versed

    When you have such a big institution you're going to have more events than the average place even if your percentage is much better than average.
  7. blondy2061h

    Nurse Gives Lethal Dose of Vecuronium Instead of Versed

    I just got done reading the 56 page CMS report and I have a lot more questions than when I started. The nurse got the vecoronium out of the neuro ICU pyxis, where the patient was an inpatient. That explains how she had access to it. The bin was labelled as a paralytic that causes respiratory arrest. She's not sure how much she gave. Maybe 1ml or 1mg. She brought it down reconstituted in a baggie, gave it to the patient in a holding area. It was only when she gave the excess medication to the patient's primary nurse after the patient was brought back to ICU after the code that the primary nurse noticed it was vec. The patient was left with just the tech, unmonitored, in a room waiting to go into the scan. Never made it into the scan. This is a patient that came from an ICU and was step down status. These patients are always on monitor at my facility and are transported by an RN, not transport as described in the CMS report. Further in the report it says she was awaiting a floor bed, so that explains this. The RN was talking to the patient's family when she heard the code called in PET scan. She called PET scan not once but twice to see if it was her patient. She didn't get an answer. Calling an area during a code blue? How lacking in judgement is this person? She did indeed get fired.
  8. blondy2061h

    Nurse Gives Lethal Dose of Vecuronium Instead of Versed

    They clearly didn't know enough about vec of versed to know if it made sense
  9. blondy2061h

    Nurse Gives Lethal Dose of Vecuronium Instead of Versed

    The RN may be the last line of defense, but by overriding the med she went ahead and bypassed ever other line of defense and made herself the only live off defense.
  10. blondy2061h

    Nurse Gives Lethal Dose of Vecuronium Instead of Versed

    I don't understand that either. If she was sick enough to require an ICU or a SDU clearly she wasn't appropriate to have an outpatient test. Sometimes a PET scan is required to guide treatment plans. Working in oncology I have seen many an inpatient get a PET scan. And yes, outpatients get sedation but it's usually PO. Vecoronium doesn't come PO, but if the nurse got this far in this error, who is to say they wouldn't confuse the route also?
  11. blondy2061h

    Nurse Gives Lethal Dose of Vecuronium Instead of Versed

    This is what I don't understand about the timeline. 30 minutes since she got the vec when the code was called and they got her back with 2 rounds of acls? But she was so hypoxic she was declared brain dead within 24 hours? As far as job descriptions go she probably had a general RN job description but specific to the helper role.
  12. blondy2061h

    Pain Management & the Opioid Crisis - AACN-NTI

    I feel like "opiod epidemic" had just become such a trendy catch phrase with half the people using it having no idea what they're talking about our why they're using it in the context of patients who really are looking for pain relief. We used to talk about "pain is the 6th vital sign" and "pain is what the patient says." Now God help you if you have pain without a clear visible cause.
  13. blondy2061h

    Mandatory Vaccination

    That's punishment. A mask isn't. A mask is PPE.
  14. blondy2061h

    Pain control in pt. With hx of opiate abuse

    I have idiopathic intracranial hypertension also and an NSAID allergy, so yeah, that's my life.
  15. blondy2061h

    Tylenol for fever in a patient elevated LFTs

    Sounds like you probably had a lot of patients with very poorly managed pain. Yikes.
  16. blondy2061h

    What in hades.

    Nurses won't be waking them up to flush their lines
  17. blondy2061h

    Can You Prevent This Medical Error?

    Thank you so much for sharing this and taking steps to prevent it from happening again!
  18. blondy2061h

    Can You Prevent This Medical Error?

    It's good for a student to get good habits, too, I guess. Then become more efficient later.
  19. blondy2061h

    Can You Prevent This Medical Error?

    That checklist for the student nurses is almost hilarious when you think that it's not uncommon in my area for some nurses to have 16 patients on night shift and not unheard of for patients to have meds due every 2 hours. That just isn't happening. So short cuts happen. Yes, better staffing would help. But in the meantime it's better to make a more realistic algorithm that can actually be followed so short cuts aren't necessary.
  20. Sorry! It really is just nuts.
  21. blondy2061h

    Patient rights an privacy bathroom

    I struggle with this too. I tell people to do the same we do in every AMA situation- establish competence, educate and document. More so than the fall risk patients, I struggle with patients I suspect are doing drugs or self harming in the bathroom.
  22. It started on YouTube. There's a prominent cystic fibrous vlogger who vlogs daily- Mary Frey. She's quite popular among the "Spoonie" community. Then came Chronically Jaquie. She started the daily vlogging thing too and seemed to copy Mary routinely. Jaquie started pretty tame but quickly collected more diagnoses and more "tools:" a port, wheelchair, GJ tube, then separate g and j tube (before trying an NJ!) with the covetted Kate Farms formula, then AFOs and a whole exoskeleton worth of braces, IV ketamine on the regular, medical marijuana, Dilaudid, unlimited IV push Benadryl, etc. To tell you how ridiculous she is she now says she's getting an AV fistula. For IV access. For fluids. Now it's a trend. There are hundreds of people just like this on Instagram and Youtube all exactly like you describe. Feeding tube but clearly able to eat. Ports for no good reason. Only Kate Farms formula. Wheelchairs with power assist, pimped out and styled to their preference- but perfectly toned muscles. It's really bizarre.
  23. blondy2061h

    Sample voicemail greeting for an oncall runner for hospice

    That is a good point. If these are patients and family members calling in maybe something like "Have a peaceful day" would be better.
  24. blondy2061h

    Sample voicemail greeting for an oncall runner for hospice

    That sounds perfect to me
  25. blondy2061h

    Small hospital stopping services?

    I love working with nurses that have experience from critical access hospitals. They become very self reliant. They're not used to some of the luxaries buffet hospitals have, so they have to become good at things like IVs, drug calcs, and multitasking. They also need to learn excellent assessment skills, because you need to pick up on those subtle signs of deterioration early on. These skills all translate well to bigger hospitals.
×