Was I in the wrong here?

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Specializes in Ortho, Neuro, Detox, Tele.

Hey, all....I've got a question. Tech....soon to be RN(may 16th, WOOT!) here.

Patient came up with a broken ankle. ER orders clearly state that she is NPO....and she has a box lunch on her lap(sandwich, applesauce, cookies, juice, milk). As the ER transporter drops off the order, I look at them and note (oh, she's NPO). I take the box lunch off the lap, explain to patient and daughter that "well, you're NPO, so we need to take your box off here". patient states "oh, my sugar was low downstairs, and they told me I wouldn't go to sx for a day or two" AFTER the ER orders clearly mark NPO on the sheet! (sugar was 62...so not crashing out) I explained that I would be happy to bring her a 1/2 cup of juice once we moved her to her bed...and did. Also, patient has D5.45NS running at 86 ml/hr. (so she wasn't going to crash).

The daughter filed a complaint against me about my attitude as I took away the lunch because I didn't know the whole situation.....My thought is "Ummm...she's NPO, we're erring on the side of caution, and they should have given her juice downstairs....not an entire box lunch!" And she just got d/c'd on the 7th...from tele floor...and when we call the doc? Oh, we have to admit her and THEN transfer her to a monitored tele bed.....all 1 hour before shift change.

So, was I in the wrong for taking away the box lunch? should I have had that complaint monitored against me? Or am I just figuring that the daughter thought I was "just" a tech...and I didn't know what I was talking about?

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Specializes in CMSRN.

You are not wrong. They may have gotten upset in the way it was handled. What was said seemed fine but a little "extra" may have avoided upsetting a very sensitive person. Don't get me wrong I am not siding with them but in order to avoid possible repercussion for something innocent walking on eggshells may be required till a rapport is met. Empathy, understanding yadayadayada

Not always easy to do though.

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You weren't wrong but I would have handled it differently. 62 isn't crashing but it is pretty low. I would have tried to find out when she was going to surgery, and if it wasn't for another day I would have clarified when the NPO status was to start. Docs write orders sometimes without thinking, and it could have been an error.

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Specializes in cardiac/critical care/ informatics.

you weren't wrong, did you talk to the nurse and did you tell the patient and family that you were going to d/w nurse the bs, npo etc.

My guess is they think you might have been acting out of your scope of practice as a tech. Yes you should have taken the box away and told them I will let your nurse now of the situation and maybe we can get this back to you. Thats just my 2cents.

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Specializes in Med/Surg.

Congratulations on making it through NS. I agree you should have let her nurse handle it. Telling her to hold off on eating for a couple of minutes while it was checked out would have been appropriate :nurse:

If I'm correct a full liter of even D5W has only like 20 calories. Not enough glucose to make any difference. A doctor told me that when I once suggested switching fluids from NS to D5W.

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Specializes in LTC, Psych, Hospice.

You weren't wrong, but I would have let the nurse handle it. The patient and her daughter were probably seeing you as a tech and they had no way of knowing you were in nursing school. If I had no medical knowledge, I would probably have been upset also if someone other than my nurse was telling me that I couldn't have lunch. Just my 2cents.

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Specializes in Behavioral Health, Show Biz.
You weren't wrong but I would have handled it differently. 62 isn't crashing but it is pretty low. I would have tried to find out when she was going to surgery, and if it wasn't for another day I would have clarified when the NPO status was to start. Docs write orders sometimes without thinking, and it could have been an error.

**************************

Ditto. (As usual---thanks, Tazzi)

I would have informed the RN assigned to the patient also.

As Tazzi stated, a blood sugar of 62 is not crashing,

BUT IT IS LOW.

Sometimes, the patient and their family memebers don't realize when we're acting on their behalf in this case patient safety.

Also, Congrats to you for completeing Nursing school. :yeah:

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62 can feel way too low if someone is used to higher sugars. I know of some patients who are used to being over 200 and they feel low (hungry, shaky, dizzy, vision changes, hard to focus/concentrate) if they drop to even mid or low 100's. If they wake up low, they're ok. But if they get to around 150 during the day (after being awake for a while), they feel hypoglycemic.

I don't know how you approached the people, I don't know what they thought, therefore cannot comment on what would have made the situation smoother. Next time, try just telling the nurse or try to approach the people in a different way, if you choose to approach them at all. Some people can't be pleased, no matter how personable one is toward them. Also, the damage was already done, so you could have just let her finish eating, I guess.

How serious is your boss' response to their complaint? I hope things are ok for you. And congrats about your RN graduation!

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You weren't wrong, but I would have let the nurse handle it. The patient and her daughter were probably seeing you as a tech and they had no way of knowing you were in nursing school. If I had no medical knowledge, I would probably have been upset also if someone other than my nurse was telling me that I couldn't have lunch. Just my 2cents.

Of course, these days it's hard to know who's a nurse and who isn't. :nuke:

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Specializes in ICU/CCU, Home Health, Maxim Security Men.

I have found it helpful if i always try to tell the patient what i am going to do and why. Congratulations on your soon coming promotion. Yeah! Ya did it! knew you could!:yeah:

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Specializes in Community Health, Med-Surg, Home Health.

I don't think you were wrong at all. You saw that the patient was NPO (very observant), you took the food away and if you told the nurse what was happening, that was the best you can do as a tech.

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Specializes in Ortho, Neuro, Detox, Tele.

Thanks all for the differing viewpoints...I believe in both sides. Oh, well...when I go back, it won't matter anyways, so big whoop. Thanks again!

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