Since when is it my responsibility to...

[nrsang97]

Reoprt labs for another nurses patient because I took the phone call from the lab? I got a nasty gram from my manager today telling me I didn't record that I reported a critical value. I did take the K of 7 from the lab, but reported it to the nurse taking care of the pt and the nurse she was reporting off to. It is their responsibility to report and record, NOT MINE. My manager didn't send the email to either one of them, just me. That shows she never looked to see I was not even assigned to that room. Guess I get the crap for being courteous and taking a result so the lab wouldn't have to call back.

[CrunchRN, ADN, RN]

I would thnk the MD would want to talk to the patients nurse and not the one that took the call and knows nothing more about the patient.....

[dudette10, MSN, RN]

This whole thread is a learning experience for me. I have taken critical lab calls, and I've just told the primary nurse, but I've always felt uncomfortable with the process for the reasons mentioned by other posters. From now on, I will document in the patient's computerized record that I took the call and reported it to the primary nurse.

[Esme12, ASN, BSN, RN]

No the lab can call the MD and report labs all the time. That's who calls the MD in the office ALL the time. When a patient signs HIPAA(not HIPPA, love ya Wooh but;) it 's one of those pet peeves...) release for medical treatment and "the need to know for the provision of care". The notification of critical labs is determined by each individual facility policy about how, who, when and how time limit the labs need to be reported. Their needs to be a quality indicator as well. It is also a new key note quality initiative with The Joint Commission this year....(:cool:I know another JC rule)

http://www.jointcommission.org/assets/1/6/NPSG_Chapter_Jan2012_LAB.pdf

[Kittypower123, BSN, RN]

I work in a LTC/SNF facility. Our 2-10 nurse team works together very well. If I take a critical lab for another nurse, I page the MD, note in the chart and let the patient's nurse know what the lab was and that I paged the MD. That way, when the MD calls back he can talk to the patient's nurse without her being caught off guard. All the MD's are reached through their answering service, so there is always a delay between when we page and he/she calls back. We don't worry too much about whose patient it is, we help each other out. In addition, we rotate halls, so we are at least somewhat familiar with all the patients in the facility.

[nrsang97, BSN, RN]

I got an email back from my mgr today and she asked me which nurse I reported the result to. I knew nothing about this pt and he was an off service pt so I had no idea which service to call.

[Kunzieo]

Yep, but what's rule Número Uno for nursing?CYA.If you didn't document it, you didn't do it. It may not be your responsibilty to call the MD, but definitly your responsibilty to document 2 lines in the chart about what the lab value was, what time you received it, who you got it from, who you reported it to, and when you reported it. Good luck with your NM.

[CrunchRN, ADN, RN]

Yep, but what's rule Número Uno for nursing?CYA.If you didn't document it, you didn't do it. It may not be your responsibilty to call the MD, but definitly your responsibilty to document 2 lines in the chart about what the lab value was, what time you received it, who you got it from, who you reported it to, and when you reported it. Good luck with your NM.

That is a good point.

[NicuGal, MSN, RN]

We have to document who we give the result to...if it is the nurse caring for the patient or the doc. It is one of your jobs to make sure that value gets where it needs to go. You took the result, you are responsible for getting to someone and documenting it.

[merlee]

What an interesting topic! What a gray area, too. Depends on the situation, and the facility's policy. I like the idea of the lab calling the doc - and why not? Removes a layer of possible micommunication.

I always wondered why the pharmacy called the nurse with a questionable order, when they needed to talk to the doc directly.

Finally,some facilities started telling the pharmacy to call the doc!

Bottom line - if you took the call, it appears you are the responsible party.

[caliotter3]

I would definitely revisit the facility policy on this. You may have brought to light a systemic problem waiting to be solved.

[wooh, BSN, RN]

(not HIPPA, love ya Wooh but;) it 's one of those pet peeves...)

Thought my sarcasm was apparent, also said JACO, and my pet peeve is people that don't realize that they've been "Joint Commission" for YEARS now.

It's all about passing the buck. And hospitals are perfectly happy to throw nurses under the bus. So if they can make a policy that puts nurses in the hot seat the majority of the time, that's what they'll do. So either the nurses answers the phone and takes the critical result on other patients and the blame if it doesn't get passed along, or we're not "team players" answering the phone for our coworkers.

[imintrouble, BSN, RN]

I've taken the lab call when my fellow nurse was busy. Have honestly never had another nurse throw me under the bus by saying I didn't tell them. Can't remember a time when the nurse I reported to, didn't take care of the problem.

If the OP reported to two nurses, and neither one of them addressed the issue, I think there's a problem with staff. How could anyone ignore a K+ level of 7?