RNDarling
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RVs error was definitely egregious, and it goes past just being on some form of autopilot. Just yesterday, I was on autopilot and at the Pyxis to retrieve phenergan for my patient. We give it IM for patients coming out of surgery and complaining of nausea. Typically it comes in ampule form. This time, I looked at the drawer and saw blue vials. I figured I typed the wrong med, closed the drawer and started over only to find the Pyxis opened the same drawer with blue vials. Confused, I grabbed one and it said Phenergan. My idiot self thought long and hard and I doubted myself enough to close the Pyxis, walk back to the EMR and confirm I really wanted Phenergan and wasn’t having some sort of brain melt that had me thinking of giving the wrong drug. Obviously they had just loaded vials into the drawer instead of ampules and I wasn’t aware of the change. My point is that I was on autopilot (yes, I know I shouldn’t be at the Pyxis, but I was), but coming across something unexpected gave me enough pause to double check what I was doing. RV saw something that had to be reconstituted and still didn’t stop and double check. The error is absolutely her fault and in my opinion, her nursing license should be affected in some way. I just don’t know about criminal charges though.
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Thanks for the great recommendation!
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Thank you!
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I'm an ACNP student and was just wondering if anyone has recommendations on good podcasts? I would really love to use my commute to expand my knowledge base. Thanks!
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Great article, thank you!
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I'm new to PACU and was just wondering why a preOp evaluation inquires specifically about beta blockers? Also, why do or don't you want a patient to have taken their routine beta blocker preoperatively? I'm just trying to better understand the significance of beta blockers in this specific setting. Thanks!
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Thank you for the feedback! This really makes me feel so better. To answer the two previous posts, I have 1.5 years of ICU experience and do not have yet have my preceptors lined up as I don't start clinicals for over a year. I will be looking to line those up in about January per the school's suggestion. Thank you again for taking the time to reply!
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I currently work nights in an ICU and am in school to become an ACNP. I'm burned on nights but can't work 12 hour days because of child care. I'm considering a change to 8 hour days in a PACU but am worried that leaving the ICU won't look good for my ACNP program (I.e. finding clinical placement will be more difficult and then finding a job after graduation will be more difficult). I don't graduate for another 2 years. Any thoughts/experience with this? Thanks!
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I think you're well within your right to apply to any and all positions to find the right fit for you. Due to personal circumstances, I had about a 2 year gap between the time I graduated and started applying for jobs. It took about 2-3 months but I was hired on a med surg floor at a great hospital and I had no issues at all learning the floor. I did refresh my book knowledge prior to starting and looked up everything as I worked, but it comes back quickly. Just have confidence in yourself.
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We do not and the justification I've been provided is that you want to use the patient's dry weight (for consistency and accuracy), instead of a weight that may be higher due to fluid volume, for example. Also, if the titration is based on labs, such as would be with heparin, then you risk changing the dose based not on the lab measurement but on the weight.
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Agreed, people now get trophies for showing up and we wonder why the newest generations grow up so entitled. To hppy, I am impressed by you and your response to the idiot at the nurses station you referenced. No one deserves to be disrespected at work and we can all do our part to instill a positive culture at work.
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Congratulations, you must be very excited!