Last night, while reconcilating MARs, I noted that an 8 y/o Patient had been prescribed Depakote 250 mg am/500mg pm. The PharmD had transcribed it as 250mg and 500mg am. The med had been administered for two days as a single dose. The MN Nurse who had reconciled the previous two nights MARs had allowed the order to stand as transcribed.
I contacted Pharmacy in order to gain a consensual perspective, thinking that I could have missed something, which I do sometimes. No, I hadn't and the MAR was corrected. I contacted the MD, informed him of the original order, the actual administration, and the rectification. He said, "That's fine." I let the House Suprvisor know what was going on and she reinforced that I should also fill out a Med Variance form.
Tonight, I'm working with the MN Nurse who allowed the order to stand as transcribed. I informed her in private of the variance at the beginning of the shift. She said, "I don't do that, but you gotta do what you gotta do."
I sensed she was upset with the occurence. After things had settled down, I approached her with my my observation. Basically, what transpired during the conversation was: She accused me of selectively following protocol, attempted to bring heresay into the conversation, accused me of acting due to personal reasons, and interrupted twice while I was speaking. I told her that no good was coming from this conversation and ended it.
I'm O.K. with my actions in this situation. Had I acted totally out of emotions, I might have been able to just shine this situation on. However, I am a Nurse first and believe I acted according to my beliefs and principles.
Too bad we can't be Peers and friendly acquaitances.
Oh well. What are you gonna do, but live and let live?
Thanks for allowing me to process this emotionally-charged situation.
Dave