What should I do- med dose?

[perfectbluebuildings, BSN, RN]

OK I just now realized something. On night shift on Monday, I had to call a doctor for a pt drug order... there was one crucial drug he needed (phenergan), and then another that was not so crucial at that point (zantac). At the other nurses' suggestion, I had the drug dosage book in front of me for when she called back, to give her the dose per weight numbers (I am in peds). On the phenergan, I got it right, and then for some reason on the zantac I looked at the wrong thing and gave her the dosage for someone with decreased renal clearance. I did not want to call her right back about that at four-something AM, especially since by the time the meds got up from pharmacy, I was not going to be able to give that drug on my shift anyway since all his meds were IV, and I had to give the phenergan at that point, and an already scheduled antibiotic. And then I got really busy (no excuse, I know) and forgot to tell the nurse coming on or leave a note about my mistake. Now I know the nurse I reported off to is a really good nurse and checks all her dosages so hopefully she will have caught it. But if not then he will be getting subtherapeutic doses of Zantac and maybe it won't help him, and they will not realize he is getting subtherapeutic doses and do other tests or something, or else he will just not be getting relief and it will be all my fault. I don't know why it took me so long to realize all this. So, should I call work and tell them I realized this and to tell his doc? If I was going back in like tonight it would not be as big a deal, but I will not be back at work till Friday night and of course, there's no guarantee that I'll have him. Thanks for reading this long ramble post... What would you do? Thanks in advance... :)

[Daytonite, BSN, RN]

I'm sure the patient's doctor came in to see the patient during the day on Tuesday. The doctor should have reviewed the physician order sheet to sign the order you wrote and realized the dose was too low and corrected it by now. Go back to bed and get some sleep.

[babynurselsa, RN]

I would call up whoever is there and aske them to double check the dose for you. Sometimes things come back to me after I get home.

I have the little "brain farts" once in a while. I try to fix em when I realize em.

[babynursewannab]

Better it was a subtherapeutic level for something like Zantac than a toxic level of anything. Like another poster said, the doc should catch that on chart sign-off.

[babynurselsa, RN]

I personally feel that keeping quiet and hoping someone else finds my error is wrong. It is much more responsible, and trustworthy to say oops I mis- calculated that lets refigure it than not saying anything. This is a good way to develop a reputation of someone that needs to always be checked behind.

Granted it would be better to be sub-therapeutic than toxic, but it still is not the ORDERED dose. Plus this is less beneficial to the patient. Obviously there are some GI issues going on here.

Just my opinion.

[fergus51]

I always call if I forget to tell the RN something in report, just so that I can get some sleep. If I don't, I'll obsess about it.

[perfectbluebuildings, BSN, RN]

thanks for the input everyone.