RN's barking unsafe orders at me

[newtress, LPN]

Hello to all. I am wondering if other LPN's have had experiences like mine. I have had three different RN's on three different floors "requesting" (more like yelling or barking because they are hype frenzied themselves) that I do somthing or pull up certain meds for agitation PRN STAT. One which cost me a med error. How do I tactfully tell her/him I am the med nurse tonight and need to make sure this med is OK for me to give right now. More to the story, but trying to keep it short.

[netglow, ASN, RN]

Tell them... "I am the med nurse tonight and need to make sure this med is OK for me to give right now." :)

[nueve]

they shouldn't be barking at you in the first place...but yeah, i agree with the first response

[fungez]

I doubt any of those situations were life and death. If it were me, I would pull up the meds quickly but without compromising safety. If that's not fast enough for the crazy people you work with, well then, they can do it themselves.

[belgarion]

Ask them if they are going to sign them out and write in the chart so it will be THEIR license on the line.

[kcochrane]

Just what you told us. I will be more than happy to do that, but first I need to make sure x can get this and get it at this time. You will have no leg to stand on if you give a med that is not ordered - RNs cannot give verbal orders to LPNs.

You need to protect your license and your patients/residents.

[socks341968]

Do exactly what you said. It is on you to do the right thing, even when you are being rushed. Once they see that you are going to check things and be thorough, they'll drop it and just let you do it the way you need to. Sometimes it just takes a little standing up for what you know is safe, whether others like it or not. Hang in there :)

[soulofme]

:smokin:Sometimes I bark..but I'll never bite*

[rn4ever?]

Just say that you're uncomfortable giving it and they can give it if they want to. They might roll their eyes.....but who cares.....always ensure patient safety and protect your license. Or maybe, you can administer the PRN STAT medication for agitation to the barking RN!joking.....

"Hello to all. I am wondering if other LPN's have had experiences like mine. I have had three different RN's on three different floors "requesting" (more like yelling or barking because they are hype frenzied themselves) that I do somthing or pull up certain meds for agitation PRN STAT. One which cost me a med error. How do I tactfully tell her/him I am the med nurse tonight and need to make sure this med is OK for me to give right now. More to the story, but trying to keep it short."

[rn/writer, RN]

They shouldn't be barking safe orders at you, much less unsafe ones.

Chances are the nurses are freaked by the agitated patients, and they're just sharing the wealth. Handling patients in melt-down mode is a skill that comes with time. You can set a good example by not taking the nurses' wigging out personally. You can tell them (in a calm and soothing voice) that you'll take care of whatever they want as soon as you can safely pull it off. Let them fuss and fume. You can only do what you can do.

What these nurses need to learn is that they can't control the universe and that getting just as agitated as the patient helps no one. You are in a good position to demonstrate this knowledge by keeping your cool under pressure. Really, what choice do you have?

To practice this Zen demeanor, arrange for family members or friends to come at you with URGENT MESSAGES while you're making dinner or doing some other task that requires a fair amount of your attention. Desensitize yourself to their commotion until you're able to continue with the task at hand while they're still bombarding you. If you can keep your breathing and your pulse normal and still proceed, you will set a good example for the nervous nellies at work.

You can also try to defuse the situation by asking if the crazed nurse would like a dose of what she's ordering for the patient. Only do this in a sense of gentle ribbing, not real anger.

Do NOT jeopardize your license because others are in a tizzy.

[shiccy]

Some people don't realize it but unless a patient is swinging fists, attacking with a dangerous object, or actively seizing, having something "STAT" isn't really all that important.

People sometimes need an attitude check, which is your job as a human being to not put up with their abuse. ... Also some people need a bit of education on the difference between "ASAP" and "STAT". STAT is a cardiovascular, pulmonary, or airway failure emergency or impending emergency. Anything else is ASAP.

Sometimes asking politely for a coworker to chill the eff out helps wonders. And, as always, double triple quadruple check the meds you're pulling!

[newtress, LPN]

Awsome advice and support. I did end up NOT drawing up the ativan for an 8 yo who had 0700 routine meds anyway. I walked over to her and the child she was holding down on the floor because he was cranky, frustrated and crying (work at a psych hosp) and told the youngster I wouldn't give him anything (did not use the word "shot" like she did, and really got him crying) if he would come over to the station and be a good boy and I'll talk to you. I descalated him and in less than 60 secs he was completely compliant and calm. I think that's what made her give me stink eye muttering in a corner "pffff, should have gave him the **** shot." I see these nurses taking little youngsters down like they are on an African safari shooting tranquilizer dart guns just to quiet a scared insecure child, regardless of the heavy narcs they are already getting at that time. He was in no way a threat to harm himself or others. Turns out when I went in last night, my charge nurse did mention the scene to me and she agreed with me that it was inappropriate for that nurse (who I didn't even know her name because she just showed up and jumped right in on the boy) and that I did the right thing.