Reporting Critical Value..

Here's the problem most likely...when our lab calls with critical labs they take our name and attach it the printed copy of the labs (to cover their butts and show they that notified us quickly of the result). I will assume your name is on the sheet as being notified of the lab and therefore there is really no proof that you told the real nurse.

Next time if the lab calls for a critical value on someone NOT a patient of yours, say "let me grab the nurse" and track down the actual nurse so his/ her name is on it.

The problem here is different types of responsibility.

The other nurse had a moral responsibility to call the doc,

unfortunately, you had the legal responsibility, because you accepted the report.

This has happened to me several times (i was the other nurse) and my

question always is, "why didn't you transfer the call"

i want to hear the report first hand and i may have some questions for

the lab

i believe the best way to handle this is tell the lab you will transfer

the call to the appropriate station

I'm really glad you brought this up. Our lab phones in critical values or reports of positive blood cultures, and takes the initials of the nurse receiving the results. I always passed this information on immediately to the nurse caring for the patient, or if the doctor is right next to me, I would let them know as well. Our unit has really excellent teamwork, so I had never considered that my colleague would ignore (or forget) to report a critical result to a physician. It never really occurred to me that I could be liable if the other nurse doesn't report the information to the physician, as my initial's are attached to the lab's phone call.

Good suggestion to grab the nurse caring for the patient directly to receive the results. Or if your colleague is really busy and you are able, take the result and phone the physician yourself.

All lab values are called to the charge nurse at our hospital, also a panic lab value sticker is placed on the chart with the value, time it was called from lab and time we informed the MD. The charge nurse notifies the nurse caring for the patient and obtains any pertinent information and then calls the MD.

We have a smart phrase we pull into the chart of the patient that says Critical Lab value of __ called to unit. ___notified and orders received/ not received.

If you take the value make sure you chart who you tell.

Our lab would take the name of whoever they reported it to, and that nurse (not necessarily the one caring for the patient) was required to document the value and the action taken in the computer.

Our lab would take the name of whoever they reported it to, and that nurse (not necessarily the one caring for the patient) was required to document the value and the action taken in the computer.

Same here.

If a coworker comes to me to tell me of a critical value, I ask "did you call the MD" and follow up accordingly--sometimes that means that I need to make another phone call to clarify orders--as the nurse taking the value knows little about the patient.

A number of facilities this is the charge nurse's responsibility. Otherwise, a hold on for nurse such and so to be able to take the value and follow up accordingly is the best case scenario.

It is always a good rule of thumb that if you are going to take the information, then you need to follow up on same to completion. And notify the RN of same.

I say to myself, "What do you mean? I told the nurse what the lab told me..." Is it my responsibility to call the doctor (even though I told the assigned nurse what the lab told me) because the charge nurse is making me feel like it was my responsibility...

=(

Yes, it was at least partially your responsibility.

There is a reason they ask for the nurse, and not the clerk. Once the info is in your hands you become responsible. Look up your P&P.

You are probably expected to do one of the following:

Call the MD, document & f/u

Relay info to charge nurse, and ask if he/she will f/u or if you should. Document.

Relay info to Assigned nurse, ask if he/she will f/u or if you should. Document

We don't carry phones in my ED (Hallelujah!!!!), so whichever nurse is closest to the phone at the nurses station takes the call, as the primary RN may be in with another patient, on the other line, on break, or what have you. As the RN who took the call, it is my responsibility to follow through by informing the MD, documenting the critical lab and my action in the chart, and by informing the primary RN that I have done so.