What do you consider 'am'

SICU Queen · Nov 25, 2007

I've found that, in most ICUs, they're usually scheduled for 4 am but we can do them when we want, pretty much... especially if a patient is a new admit. The nice thing is that WE draw the blood, not lab... so they don't have as much control over what gets done. It DOES make sense to combine labs, but it's not appropriate for every patient.

That being said, it sounds like your facility needs to revamp its policies somewhat. It makes no sense to do labs 4 hours after they've been done, unless you're looking for something specific like an H/H or cardiac enzymes.

In your particular scenario I'd have said "Fine, I'll notify the doctor that you've done a lipid profile on a non-fasting patient and I'll get an order for another one to be done at an appropriate time. Thank you!!" Then I'd hang up the phone and move on... ... and notify the doc in the AM about what occurred.

TazziRN, RN · Nov 25, 2007

What Queenie said. About the response, I mean. I would have told the lab, "In that case I'll get an order for another draw and I'll notify you when I get it. I will also inform the physician that the lipid levels are not accurate and that you refused to correct the situation."

I would also write up an incident report. Regardless of what the hospital policy is, because the lipid panel was not done appropriately the lab should have redone it at the proper time and voided the first result so the pt doesn't get charged for it. This is not getting anyone in trouble, this is notifying the powers that be that things are not being done properly and that either policy needs to be changed or the lab needs to have an inservice.

defeatedcreek · Nov 25, 2007

I agree, 0330 to 0400 is the optimal time for labs unless (like sicu said) it's an H/H or CE. But like him/her we also draw our own labs on the floor. This sounds like a typical clash with lab techs, we have them in the military too. AM does not mean after midnight as your techie erroneously stated. UAs are sometimes sent up earlier than 0400 but other than that your tech was ***.

gina gina · Nov 25, 2007

am is considered morning.usually labs are around 5am.if labs r to b ordered at a specicific time.it should state what time very specific becuz there is a most likely a reason.seem like there was a failure in direct communication.

EmmaG, RN · Nov 25, 2007

Our lab always asked. Yours was wrong to do this without consulting with you first.

caliotter3 · Nov 25, 2007

Always have seen labs being done from 4 am on. A definite miscommunication. If you speak to the doctor in the future you might bring this up and ask him about it. He might not be aware that the lab is doing this. Or maybe it is just the mistake of that one particular tech. At any rate, speak to someone about this so that it can be avoided in the future.

crysobrn · Nov 25, 2007

We usually have them done between 5 and 6... Our lab would ask if they could be combined if there was a time other than that.

pagandeva2000, LPN · Nov 26, 2007

This is interesting because we don't communicate with our lab at all. They only seem to call when they have abnormal results or to let us know that a sample was not sufficient. Otherwise, most times, am for us seems to be at 6:00am.

Now, am for me, PERSONALLY is whenever I wake up...(on my days off, usually around 12 noon...lol)

allnurses Guide · Nov 26, 2007

Small rural hospital - lab comes in at 0630 so labs on the floor get drawn after that and are ready for the docs when they round - between 0730 and 0830.

Stat labs on the floor and/or ER can be done by the pm supervisor (we've been trained to run them).

steph