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Thought number 1: Why are we in nursing??? To help people (tis much more than a job, it is an adventure:). Thought number 2: I hope when I need a nurse someday you are it! and not the day shift, and Good Heaven Above not the new trainee! Thought number 3: Can you look at yourself in the morning mirror and know you did your best for your pts?? That is what it comes down to and that is what life is all about.
Yes. The nurse objecting needs to lie in bed in pain for an hour or so......readjust the thinking.......I've been a patient in pain....waiting for pain relief....5 min is 5 hours. That being said, it is also a big issure with JCAHO..... and perhaps with good reason?
Geeze... I don't usually get myself too worked up in most of these threads, but ....... LEGAL RAMIFICATIONS????????? For what? doing their job???? My red hair is showing thru the blonde dye............
ah, geez.... I know some First shift nurses who would...not medicate...and would have been the one screaming "legal ramifications" if you did medicate before recieving report......bottom line..if you assess, do it and document it..then you have taken care of the patient per expected nursing standards today.( conciderering PAIN being the 5th vital sign) Would you go to report or ignore the patient with a 170/112 bp for the next hour????? No... so there's your "ramification". always er in CARING for the patient....and document! document! document!.....whats the worse could happen ? Report time would be delayed and she could not go home (yet). oh well like THAT is a sentinel event (more like a commanality)... Just my revved up thoughts thanks!
originally posted by CNERN:
"bottom line..if you assess, do it and document it..then you have taken care of the patient per expected nursing standards today.( conciderering PAIN being the 5th vital sign) Would you go to report or ignore the patient with a 170/112 bp for the next hour????? No... so there's your "ramification". always er in CARING for the patient....and document! document! document!.....whats the worse could happen ? Report time would be delayed and she could not go home (yet). oh well like THAT is a sentinel event (more like a commanality)... Just my revved up thoughts thanks!"
I know! I tell you my hair is ON FIRE!!!! I know JCAHO is a pain...but maybe we should stop giving them reasons to be!!!!!
Originally posted by YoudaI probably wouldn't have, either, IF I didn't know the patient and IF I didn't know the off-going nurse. But, when you've worked somewhere awhile, it's different. I probably would've said, "Hey, Day-Nurse! ____ wants a pain pill. Do ya want me to give it before we go into report?"
I agree I would have done the same thing and given him the pain meds. You still are acting immediately and not letting him suffer, but covering your butt too.
Personally, I would have done the same thing that you did (give the pt. the pain med, document, and then go to report). I also think it's important to remember though that the orientee is new, and operates off of "text book" guidelines. New nurses often learn by watching experienced nurses, so maybe he/she saw how you handled the situation and learned from it. You served as a role model in this situation, which is why orietees have preceptors. Don't discount the impact that you have on the orientees, they notice more than we give them credit for. Hopefully, they learned from it.
Linda
Tweety, BSN, RN
36,321 Posts
I was orienting a new nurse the other day. (We have three new nurses on night shift!!!!!! Plus I don't do charge when I orient!!!!)
Anyway, I happened by the call light on the way into report, a patient in my assignment was asking for pain medicine. The day nurse was busy with another patient. I've known this nurse many years, she was not going to medicate this patient, she was going to finish up, come into report and go home. Period.
I said the the new nurse, "why don't we make things easier and medicate this patient now, instead of making him wait until we are finished, which could be about 30 minutes". I'm real big on making people comfortable, and I fussy about prioritizing pt's in pain and not making them wait. It just makes life easier for all concerned.
I explained I would check the narc record, and check with the day nurse and do a pain assessment on the patient before we medicated him. She said she wasn't comfortable with this at all. It wasn't our patient until we accepted the assignment from the day nurse. She was worried about the "legal ramifications".
I was more concerned about the patient and not getting *****ed at for him waiting so long. So I medicated him.
I know I could have gotten ugly and insisted the day nurse do it, but I'm not ugly and she was very frazzled, and I have a good rapport with the day shift I would like to keep.
Any thoughts?