I had a situation the other night while working a NOC shift, I had a client c/o CP. After evaluating her situation I administered a SL Nitro per prn orders, performed proper monitoring for BP and pulse at 5 minute intervals. CP was relieved with 1 nitro, O/C MD notified.
The O/C was so furious that I had woken him up to notify of CP relieved with one nitro that I could have envisioned steam coming out of his ears. I was referred to as incompetent for not knowing the difference between an emergency and routine care, and I was questioned as to whether I was even old enough to practice nursing (I'm 33). He told me he was not speaking to me anymore because he could not consider me a professional.
This MD is generally quite abusive, however I just wanted to get a second opinion on what you would do in the same situation. I had worked with this client previously, she did not have any nitro signed out in the MAR, so I felt this was a somewhat unusual situation for her.
Do you normally call the MD if someone has a prn Nitro order?
Specializes in Gerontology, Med surg, Home Health.
I don't think I would have called for chest pain which was relieved with one dose of nitro. I wouldn't call for knee pain that was relieved with a prn dose of vicodin.
He was wrong to speak to you in that tone of voice and if you worked in my building, I would have personally called him the next day. We had a doc screaming at the nurse for calling in an abnormal lab (this was during regular business hours so we didn't wake him up.) He said the lab wasn't 'abnormal enough' to be bothered with. I told him that since the DPH had seen fit to tag us not notifying docs of abnormal labs, we would be calling on EVERY abnormal. I gave him 2 choices: Stop ordering labs, or write patient specific parameters of when you need to be notified. He was *****, but he did it.
I told him that since the DPH had seen fit to tag us not notifying docs of abnormal labs, we would be calling on EVERY abnormal. I gave him 2 choices: Stop ordering labs, or write patient specific parameters of when you need to be notified.
CapeCodMermaid, RN
6,092 Posts
I don't think I would have called for chest pain which was relieved with one dose of nitro. I wouldn't call for knee pain that was relieved with a prn dose of vicodin.
He was wrong to speak to you in that tone of voice and if you worked in my building, I would have personally called him the next day. We had a doc screaming at the nurse for calling in an abnormal lab (this was during regular business hours so we didn't wake him up.) He said the lab wasn't 'abnormal enough' to be bothered with. I told him that since the DPH had seen fit to tag us not notifying docs of abnormal labs, we would be calling on EVERY abnormal. I gave him 2 choices: Stop ordering labs, or write patient specific parameters of when you need to be notified. He was *****, but he did it.
Always err on the side of calling.