Vertical Violence on the floor

Right on. Fight it if you can. 'Course, it was THEIR machine that malfunctioned! Jeezus! Honey, I understand... as I too have learned the painful lesson about documenting until you're blue - HA, and that doesn't even save your orifice entirely!

Wonder if you could call the BON? They do have to investigate these things, don't they? Hang in there..

SHEESH!

What I do when this kind of situation arises, is :

- Do my best to get another pump and restart the infusion ASAP

or .....

- Document this task passed on to oncoming nurse . State reason for interruption of infusion and time delay obtaining a replacement and name of nurse you passed this on to.

As some oncoming nurses seem to readily forget to do this kind of stuff ( as some think it's your responsibility and liability), this kind of documentation is necessary.

These situations do arise and not a reason for why you should have to stay overtime to wait for a replacement pump to arrive.[/quote

]

Nurses know what nurses face, and nurses know what nurses do. What in the past would have been a shrug of a shoulder, and an "I'll retime it" is now an abysmal waste of resources and phone calls between RN's, pharms and occassionaly doctors as we ALL try to cover our butts to the management demigods who understand NOTHING

except what the computer says. I spent 1 hour today doing exceptional charting on meds that were given ON time but the computer failed to acknowledge. Who or what is running the show here?

Why didn't you run the piggyback by gravity after the pump malfunctioned? Seems like that should have been the first step.

Why didn't you run the piggyback by gravity after the pump malfunctioned? Seems like that should have been the first step.

only if that is allowed at that hospital....it may be P+P to use a pump on everything......but your comment isn't exactly germaine to the point any way.....she was cited for "falsifying" doc. because she signed it off.....i am wondering if the emar/or mar, doesn't have spaces to sign off the hanging of and the flushes after? this is what i have seen in LTC recently. This would have proved helpful to you, i think.

Yes I was told I falsified docmentation because the antibiotic was scanned as being given but was found not given and hanging on the pole with no IV pump. The truth is what I already wrote here. I checked out that website...it looks very helpful. I wish I had done more research then, however now it would only look like I was retaliating because they have reported me. I kept thinking it would not last.....

To me...this is pure BS (on their part, not yours) and I will tell you why.

You scan the medication BEFORE administration...to match it with the patient.

It is silly because if they follow that logic...then God forbid if an IV is left continuing to run through a shift change...b/c if they are going to be that strict, then all IV's should probably be taken down at shift change and new ones hung by the new nurses coming on...after all, they didn't scan the IV meds and they are left to be hung on their shift.

to me...this is pure bs (on their part, not yours) and i will tell you why.

you scan the medication before administration...to match it with the patient.

it is silly because if they follow that logic...then god forbid if an iv is left continuing to run through a shift change...b/c if they are going to be that strict, then all iv's should probably be taken down at shift change and new ones hung by the new nurses coming on...after all, they didn't scan the iv meds and they are left to be hung

good point! seriously everyone, if we tried to second guess every situation that happened during the course of the day, we'd still miss something plus we'd never be done with documentation....how would you know what you should cover? when i graduated nursing school, that is what round the clock nursing meant--if i did not get it done--would you do it. a yes, meant yes i will. period. if they accepted the responsibility, it was now on their shoulders. just like when u trade shifts, if the other nurse says ok, she can't decide not to go in on the day in question. so when would you stop? ex: pt didn't eat full meal, chart or not to chart, pt watched tv more, pt had argument with spouse, friend, had visitors, no vistors, did not like previous shift, liked you, iv alarmed air in line a little more than normal, pt states iv burned when u flushed it but then it was ok, looks just fine too, scd machine alarming, ordered new one and had it on within 15 min turn around time...ya know? the list goes on and on. its frustrating....hind sight is 20/20

Sorry if this is a bit off topic, but I am a new grad who is currently pouring over books on documenation to cover my butt (although it's a shame that every time we document, we have to write as if every note will end up as part of a lawsuit). Anyway, what guidance can you seasoned nurses give should this situation of a nonfunctioning pump at shift change (or something similar) happen to me?

I think it was suggested to document that the pump was not working, that you went through the proper channels of seeking a replacement and was waiting for it, passed the task onto the reporting nurse at shift change. I've read that we should never document that "such and such job for such and such patient was passed onto Nurse Jones" because we should never put a specific nurse's name in the record. But, if we don't in this situation, can't that nurse completely deny or just plain forget that we relayed the problem and transferred the task?

How would one document this kind of situation properly and CYA?

That is a great question...and obviously one I had! Every seasoned nurse I asked told me they do not normally document such things. Perhaps I would have CYA better if I had told the oncoming nurse ALONG with the charge nurse. I was always taught such comments do not belong in the legal document...I am still contemplating this one....

Anyway, what guidance can you seasoned nurses give should this situation of a nonfunctioning pump at shift change (or something similar) happen to me?

How would one document this kind of situation properly and CYA?

Grab a working pump and get the meds in your pt before you leave or at least have those meds infusing while giving report to the relief nurse with documentation to back it.

Not possible...for reasons stated. Pump needs to be ordered from central, there are not extras kept on floor, and it did not arrive before shift ended. Otherwise there would have been no problem ;-)

Sorry if this is a bit off topic, but I am a new grad who is currently pouring over books on documenation to cover my butt (although it's a shame that every time we document, we have to write as if every note will end up as part of a lawsuit). Anyway, what guidance can you seasoned nurses give should this situation of a nonfunctioning pump at shift change (or something similar) happen to me?

I think it was suggested to document that the pump was not working, that you went through the proper channels of seeking a replacement and was waiting for it, passed the task onto the reporting nurse at shift change. I've read that we should never document that "such and such job for such and such patient was passed onto Nurse Jones" because we should never put a specific nurse's name in the record. But, if we don't in this situation, can't that nurse completely deny or just plain forget that we relayed the problem and transferred the task?

How would one document this kind of situation properly and CYA?

We put nurses names in the patient record all the time...if someone assists me with a procedure, or if I pass along information to the next shift, you can bet your bottom dollar I am going to document who...otherwise, that nurse can deny you ever told anyone or that they ever touched the patient.

That is a great question...and obviously one I had! Every seasoned nurse I asked told me they do not normally document such things. Perhaps I would have CYA better if I had told the oncoming nurse ALONG with the charge nurse. I was always taught such comments do not belong in the legal document...I am still contemplating this one....

This is how I would have charted it:

1845: Infusion pump found to malfunction. No replacement is available at this time. Spoke to John Doe with central equipment who is currently locating one to be cleaned and brought up to room 1000 stat. Informed Jane Doe, RN in report that patient has LR infusing at ___ ml/hr to be restarted as soon as equipment is available. Communicated event to Susie Smith, RN, charge for AM shift.....Babylady, RN.