Would you have called?

[Art_Vandelay]

I had a really crappy day, but I'm going to try NOT to vent and ask for feedback.

I work evening shift and did not call the doc to clarify an order. The order was regarding IV ABT vs. PO/FT ABT. Morning shift had a hard time establishing an IV in said pt, so they received orders for "if no IV give x ABT PO/FT." When I received report, I was told, said pt had IV established that day. I gave IV ABT scheduled for my shift, but additional ABTs were ordered(not to be administered on my shift), and those were ordered PO/FT "if no IV". Third shift comes on asking about clarification of said order. I had not called the doctor. Honestly, I didn't realize the need to call. Thus, night shift calls doc at 1am to clarify order regarding IV vs. FT/PO as night shift had one PO/FT ABT to give. Doc was understandably ******. Then, night shift nurse says, "oh, I'm going to talk to manager about this because this should have been clarified on your shift." Actually, the initial order was taken on morning shift. Anyway, unfortunately, I was busy. Personally, I would have given said ABT per FT and clarified in the morning. The entire shift sucked. I was so busy, and then it is rather irritating when night shift comes on and wants an extended report. Seriously? It's right there on the Kardex. I still left several hours late. Feedback?

[xtxrn, ASN, RN]

If the order says "If no IV, give po- what is to clarify?"

What is there actual gripe?

I don't get it.... with the order as you have it, I would not have called.

[Art_Vandelay]

Well, at the time the initial order was taken, the pt did not have an IV established, so these ABT were ordered per PO/FT if no IV. Then, they were able to establish an IV, but the order was never updated to reflect that. Another IV ABT was d/c'd at the time because they thought the IV wasn't established. The pt was on several ABTs. I just wouldn't have called the doctor until the morning for one ABT. Sorry if the doc yelled at you, but it was your choice to call not mine. And then threatening to talk to the manager because I didn't get it clarified. Ugh.

[mediatix8]

I'm a charge nurse on night shift and I would NOT have called for that. It's obvious that "if no IV, give PO" means to give it IV if they have an IV. Let them tell the manager on you- they will only look stupid.

[xtxrn, ASN, RN]

Where I've worked, we've kept both orders, in case the IV poops out during the night- we can still get the dose in without waking the doc... The order for the route used is on the MAR, but there is a note with the "may give PO/FT" if no IV"....

Sounds like someone had sandpaper in their drawers....

[Art_Vandelay]

Well, there were multiple ABTs. Some IV, some not. I could see the need to want to get it clarified, but at 1am and for one ABT. Um, no. But, the order was written as, if no IV access, give ABT A and ABT B and d/c ABT C. So this nurse that called got ABT C re-ordered. But, that is NOT something I would have done at 1 am, and I am glad I am not the only one. I'm sorry, but I only call for critical things at 1am.

[mediatix8]

OK then I've seen orders like that with if no IV do A and B. I'd still assume to review the previous orders upon obtaining an IV access. I'd have called the pharmacy to explain the situation. I know our pharmacy would not have a problem in resuming the previous orders because they have done so in the past and I still don't think you need a clarification from an MD but I guess I'd have to actually see the orders in order to be sure. Where I work, we'd just resume the previous order but on the MAR we'd write "if no IV access, give ABT A and ABT B and d/c ABT C." I still don't think I'd call at 1am anyways as long as I could at least give PO.

[Double-Helix, BSN, RN]

Did you have an order for the IV antibiotics? It sounds like you're say the only order you had was to give po meds if there was no IV access. If that's the case then I would have called to get an order for the IV meds since dosages are often different IV. But if you had orders for both routes then I don't see an issue.

[Art_Vandelay]

There was an order for IV ABT as the pt had previously had an IV that infiltrated...and they were having trouble starting another one. I gave an IV ABT on my shift but there were orders for it. The night nurse called because she wanted to get all the ABT changed to IV and was upset because I hadn't clarified them. :-(

[DixieRedHead, ASN, RN]

Sounds to me like she either couldn't or wouldn't take the time to restart the IV and was embarrassed. Let her speak to the supervisor (I am the ADON and on the day shift that would be me) and see what a dunce she looks like. No I would not have called. If I couldn't get the IV started I still wouldn't have called, I would have followed the VERY CLEAR ORDERS.

[mindlor]

What is FT and what is ABT? I am a student so pardon my ignorance :)

[sapphire18]

I also don't see why the order needed to be clarified. Seems pretty clear to me.

What is "FT"?