stat xrays

[calliesue]

Took report from nurse who told me pt A has xray ordered. The doctor ordered it stat, but nurse manager told her not to order stat xrays because they cost the facility to much money. So she did not order it stat.

I advised her to follow the doctors orders to protect her license and the patient. She did call xray and change xray to stat.

I just hate knowing that a manager would be so blatant about disregarding dr s orders , and that an inexperienced nurse would follow those directions not understanding her liability if the pt goes south.

Makes me sad.

Also, I now have a serious trust issue with this nurse manager.

[santhony44, MSN, RN, NP]

If the facility has a risk management department, then they need to be aware. If not, then whoever the manager reports to needs to know.

For a certainty, if the patient had an adverse outcome, the inexperienced nurse would have been left flapping in the wind. I am sure any manager who said "it costs too much to do it stat" would have no problem denying those words."

Good for you for standing up for the patient and the inexperienced nurse.

Oh, the doctor needs to know about it, too.

[Wendy_RN]

I would definitely report the incident. This really irritates me. The nurse manager has absolutely NO right to hold the patient's life in her hands. I have no idea why the test was ordered STAT, but I am sure there was a reason. Regardless, the physician ordered STAT and there should have been no comments or debate. Maybe the nurse manager can go back to school, become a physician, and then be held liable for her bad judgement.

[RNperdiem, RN]

The nurse was caught in an awkward position.

In such a situation I would offer to page the doctor so the nurse manager could talk to the doctor about changing the order.

There are guidelines about when it is appropriate to order Stat orders. Where I work there are Stat, Expedite and Routine Xrays. Stat is reserved for emergencies.

Some doctors do abuse Stat xrays and labs, but the nurse would be held liable if the orders were not followed.

[TigerGalLE, BSN, RN]

Why would it cost more for it to be STAT? It is still the same procedure?

[CritterLover, BSN, RN]

why would it cost more for it to be stat? it is still the same procedure?

it doesn't for inpatients, though many people erroneously think it does.

(i guess some facilities may try to bill more for higher-priority diagnositics, but insurances don't pay more)

[sharlynn]

In small hospitals where the Radiology department closes at night, a stat x-ray costs more because the staff has to be called in. This cost however, is usually passed on to the patient.

[suanna]

I guess it depends on the situation, if the CXR was ordered STAT because the patient was unstable and needed immidiate evaluation- STAT means STAT. If it was ordered STAT because the doc had a T-time in an hour and didn't want to be late-ASAP seems adequate.

[BittyBabyGrower, MSN, RN]

Where I work stat does mean an extra charge, no matter if it is in or outpatient. If the order reads stat, and the doc has a very good reason to order it stat, then the order should be as stands.