Pt not getting procedure because of med

Specialties Med-Surg

Published

Night shift here. Pt scheduled for a stress test the next day. Day shift reported NPO after MN, no meds held. All 2100 meds given as ordered. Pt NPO as ordered. No meds held per cardio MD. 

Pt was given 3.25 mg of Coreg at 2100. Cardio comes unglued that the Coreg was given, then cancels study due to an unrelated (really, it was a "We don't have the ability to do this procedure due to his size" and "We didn't know he was actually this sick, its not safe") reason. Another nurse is acting like I should loose my license, but there was no order to hold ANYTHING. Nothing. Just NPO. 

How wrong was I? Yes, I'm beating myself up with the should've, could've, would've thoughts. In the end, the cancelation had nothing to do with the med, but still... I should've caught it.

Specializes in Peds med surg/ heme onc.

Huh?  I don’t even understand what happened.  I’m thinking a stress test is looking at cardiac conditions and Coreg is a cardiac med, so I guess it could have affected the stress test.  But I work peds and I don’t deal with stress tests.  On my unit if it’s OK to give meds, the order will say NPO except meds.  Rather than just guess, why isn’t OK to call md and ask if OK to give coreg at 2100?  That’s what I would have done.  No big deal and no reason to beat self up about it.  ?

Specializes in oncology.
2 minutes ago, Ellepile said:

.  On my unit if it’s OK to give meds, the order will say NPO except meds.

Midnight is midnight, not 2100 meds. 

 

3 minutes ago, Ellepile said:

Rather than just guess, why isn’t OK to call md and ask if OK to give coreg at 2100?  That’s what I would have done.  

The RN was not guessing. The patient's care is given into our hands as we are professionals. It was a physician fail. We cannot keep asking "do you really  want to do this?" 

We are professionals we don't need someone saying "that's what I would have done" after the fact.

 

 

6 Votes
Specializes in oncology.
On 3/9/2022 at 10:07 AM, PaddedCellLPN said:

In the end, the cancelation had nothing to do with the med, but still... I should've caught it.

There was nothing for you to catch....The physician missed/fumbled a bunt and blamed you. 

5 Votes
Specializes in NICU, PICU, Transport, L&D, Hospice.
On 3/9/2022 at 7:07 AM, PaddedCellLPN said:

Night shift here. Pt scheduled for a stress test the next day. Day shift reported NPO after MN, no meds held. All 2100 meds given as ordered. Pt NPO as ordered. No meds held per cardio MD. 

Pt was given 3.25 mg of Coreg at 2100. Cardio comes unglued that the Coreg was given, then cancels study due to an unrelated (really, it was a "We don't have the ability to do this procedure due to his size" and "We didn't know he was actually this sick, its not safe") reason. Another nurse is acting like I should loose my license, but there was no order to hold ANYTHING. Nothing. Just NPO. 

How wrong was I? Yes, I'm beating myself up with the should've, could've, would've thoughts. In the end, the cancelation had nothing to do with the med, but still... I should've caught it.

2100 is not 2400. What is it that you believed you should have caught? If there was an error related to evening meds it is owned by the ordering provider who, apparently, is a dishonest coward who thought his best option was to ignore his error, misrepresent his own assessment of why the procedure needed to be canceled and then tried to make a nurse accountable for his malfeasance.  

Yikes.

 

2 Votes
Specializes in Peds med surg/ heme onc.

OK, I will keep my “what I would have done” and all my comments to myself.  Thanks for telling me what is needed, London flo.  I will be quiet.

toomuchbaloney said:

2100 is not 2400. What is it that you believed you should have caught? If there was an error related to evening meds it is owned by the ordering provider who, apparently, is a dishonest coward who thought his best option was to ignore his error, misrepresent his own assessment of why the procedure needed to be canceled and then tried to make a nurse accountable for his malfeasance.  

Yikes.

Agree.

If they did not want pt to have b-blocker due to its possible effect on stress testing, they should have written an order to hold it.

*********

[Yay for another bumped thread. ?]

 

1 Votes
Specializes in oncology.
Ellepile said:

OK, I will keep my “what I would have done” and all my comments to myself.  Thanks for telling me what is needed, London flo.  I will be quiet.

The point of this forum is to discuss what we encounter daily in our practice and what obstacles come up. Congenial (not I would have done better by doing this)  discussion suits us best. But Monday morning quarterbacking (or what I would have done) just makes the OP feel bad. I hope you continue to post.   

2 Votes

NPO at HS (midnight), is exactly that! Meds given at 2100 are fine. Most orders now will state the expection "NPO can take meds with sips of water." The provider should have simply held the med for 2100 if they didn't want it given. 

1 Votes
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