So I was working a night shift last night and my post-op arrived at around 2100. When I accepted the new orders, the order for the nerve block and PCA were DC'd but that doesn't make any sense because those things are in place for post op pain. I paged the "service pager" which is a generic # that gets you in touch with the on call MD for that service. Didn't hear back right away. Then I found another patient on the verge of a Rapid Response and got the primary RN in to manage the situation and I began helping in that situation like any team player would :)
So a couple hours have gone by and I page the service pager again, no response. I talk to the Charge Nurse about it and she mentions calling the next in line for that service but then says something about them not being in house in the middle of the night and maybe its not worth calling a chief resident at 3AM. So at 5AM when the primary MDs come in, I page the service pager and get a response. MD states it was clearly a mistake for those orders to be DC'd and she'd be reinstating those orders. Okay, job done (I thought), I see new orders pop up on the screen but I'm busy passing 0600 meds, blood draws etc...
So as I'm giving report to the Day Shift RN she points out that there is no active order for the PCA. The MD had only reinstated the nerve block order but she clearly told me on the phone both would be reinstated. When I explained this to the Day Shift RN she seemed pretty upset that the PCA order wasn't active and went into the "In the future you should really call the Chief Resident for that order."
Now I know that its important to have the orders correct. I just feel that night shift differs from Day Shift in the availability of MDs and prioritizing calls. I feel I used judgement in knowing those orders being DC'd were a mistake.
On a scale of 1-10, how bad is this mistake? Thanks :)