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?
Specializes in Gerontology, Med surg, Home Health.
I think FT is feeding tube, but I've never seen that abbreviation used. The original order was a simple If...Then...sentence.
Another example: discontinue foley catheter. Due to. Void in 8 hours. IF no void, THEN reinsert foley. No need to call the doctor since there was a clear directive. IF no IV access, may give PO. There WAS IV access so give the med IV.
That is ridiculous. It's obvious that the either/or orders were written due to the fact that someone had mentioned or already knows the patient might fail IV therapy. The MD was made aware and wrote orders to facilitate the patient getting meds one way or the other. Also, the MD figured that orders were clear and covered which ever way the wind was going to "blow" for that patient for future situations. I could give a rat's behind if some nurse previous couldn't get the IV, and now there is an IV.
It is up to nursing to chart and keep up on the current situation with each other. If there is now good IV access then great. You got to give that in report and also give a heads up about past situation, so everybody knows they might be going PO at some point because of a potential IV problem AND that orders have been written to cover that scenario.
Why do people fight the simple act of helping the situation out. Just give report and give any and all "heads-up" info. Why can't people just try to be professionals. This is what professionals do. Sheesh. Stop going to tell "mommy" people.
OP, I sympathize with you. Go ahead and vent away!
from my perspective as a student, the crazy amount of alphabet soup floating around in healthcare seems like it would be dangerous...what do you guys think?
When I am charting, I take the few extra moments to just go ahead and type out the full words.....
from my perspective as a student, the crazy amount of alphabet soup floating around in healthcare seems like it would be dangerous...what do you guys think?
When I am charting, I take the few extra moments to just go ahead and type out the full words.....
It's not the nurses, often times. The doctors write in alphabet soup, and we have to decipher it, so it's something you need to learn.
As for the OP, no I would not have called. Unless the patient is in a dire situation that needs to be addressed right then and there, I call docs for issues discovered on my shift at 6 a.m. A route clarification when the patient will get the necessary abx by another route per order...no way. I would have called pharmacy first, then made a decision based on pharm's feedback.
from my perspective as a student, the crazy amount of alphabet soup floating around in healthcare seems like it would be dangerous...what do you guys think?
When I am charting, I take the few extra moments to just go ahead and type out the full words.....
Point....which is why there are fewer and fewer being used.....Yes, ABT is AntiBiotic Therapy, FT would be Feeding Tube....I think the problem that the noc nurse was getting at that is one of the ABT's was D/C d/t only being IV, then it was NOT resumed when IV was reestablished. Was something else substituted? was it as effective as the one D/C?
Was the D/C ABT a once a day? such as Rocephin?.... good luck
Seems pretty clear cut to me, too. We often see orders for PO if unable to obtain IV w/our difficult sticks. We keep both to ensure meds are administered regardless. Have had too many where we finally just call for PICC placement, but then you have the frequent clotters that have had PICCs go bad and throw clots which then means remove PICC/don't touch arm:uhoh3:
If the main problem was that NOC nurse needed clarification why one ABT was still being given PO, it could easily have waited till 6 am or even passed on to AM shift (that is what some noc nurses do and I never have a problem w/calling on my shift), since it was still going to be administered, so no loss there.
The only issue I see in all this is the one of bioavailability of the med between IV and PO, but AGAIN...not as important as ensuring patient gets med and drive on.
Feedback?
CapeCodMermaid, RN
6,092 Posts
I think FT is feeding tube, but I've never seen that abbreviation used. The original order was a simple If...Then...sentence.
Another example: discontinue foley catheter. Due to. Void in 8 hours. IF no void, THEN reinsert foley. No need to call the doctor since there was a clear directive. IF no IV access, may give PO. There WAS IV access so give the med IV.