Would you consider this a big deal?

[crb613]

Got to work, and was told to float. I was to pass meds, do MAR/chart checks & anything I could to help for m/s wings 1&2, & tele. Fine...get to tele meds already passed except for one pt. Problem... meds in tele that were not due until 2300 were already done at 1900. These were not QD, BID but meds w/set times. The times were not changed to reflect the earlier time given but signed off as being given at scheduled time. One I remember was Lovenox...was not due until 2300, was signed off as 2300, checked pyxis & it was removed at 1700.

I asked the nurse working & she said yes I already gave the meds....I said some of these are 4-6 hrs ahead of time. She replied oh its ok...I always do it this way. Uh no its not ok...they are scheduled for a reason...you did not already give the Lovenox did you? Yes its ok the ptt/inr is ok...won't hurt'em. Just give the rest of them...it does not matter. I said, these are scheduled for a reason, and we can't just give them all together at the same time because we want to... She got angry & said....WELL THAT'S HOW I DO IT!!! I said, well that does not make it right. Silence, & she slammed out of the med room. Now dang it I am new & she has been a nurse a lot longer...I am in a situation I do not want to be in. I passed the meds to the only pt that had not gotten his all at the same time. He has a room full of family, asked questions about all his meds...now I know why his were not given as the rest of them were.

When the charge came around I told her the story. She said its ok I already know...nurse X, said she got mixed up on the times. No she did not...I told her the conversation...again the charge said, its ok she got mixed up on the times. Again I say no she did not, I asked her...repeated what nurse X had said. The charge was getting ill w/me & said it ok! So I said look...I was put into a place I did not want to be & am trying to do what I am suppsto & tell you....I do not want anyone hurt or loose my license for knowing this & not saying anything. The charge still says it ok she got mixed up on times. So is this a big deal? I was made to feel like I was the one in the wrong. I am not a trouble maker but I thought I was doing what I needed/was obligated to do.

[Jerrica]

I used to work in a nursing home. Both medication aides and nurses were using that practice with the exception of sleeping pills. There excuse was "the patients take medications better with there meals". Although that is true (I have experienced it myself) you can get the doctor to change medication times due to noncompliance. Nurses need to remember medications are prescribed for the HEALTH of the client not for the CONVENIENCE of the nurse.

You absolutely did the right thing. Good luck girl.

[Marie_LPN, RN, LPN, RN]

Got to work, and was told to float. I was to pass meds, do MAR/chart checks & anything I could to help for m/s wings 1&2, & tele. Fine...get to tele meds already passed except for one pt. Problem... meds in tele that were not due until 2300 were already done at 1900. These were not QD, BID but meds w/set times. The times were not changed to reflect the earlier time given but signed off as being given at scheduled time. One I remember was Lovenox...was not due until 2300, was signed off as 2300, checked pyxis & it was removed at 1700.

I asked the nurse working & she said yes I already gave the meds....I said some of these are 4-6 hrs ahead of time. She replied oh its ok...I always do it this way. Uh no its not ok...they are scheduled for a reason...you did not already give the Lovenox did you? Yes its ok the ptt/inr is ok...won't hurt'em. Just give the rest of them...it does not matter. I said, these are scheduled for a reason, and we can't just give them all together at the same time because we want to... She got angry & said....WELL THAT'S HOW I DO IT!!! I said, well that does not make it right. Silence, & she slammed out of the med room. Now dang it I am new & she has been a nurse a lot longer...I am in a situation I do not want to be in. I passed the meds to the only pt that had not gotten his all at the same time. He has a room full of family, asked questions about all his meds...now I know why his were not given as the rest of them were.

When the charge came around I told her the story. She said its ok I already know...nurse X, said she got mixed up on the times. No she did not...I told her the conversation...again the charge said, its ok she got mixed up on the times. Again I say no she did not, I asked her...repeated what nurse X had said. The charge was getting ill w/me & said it ok! So I said look...I was put into a place I did not want to be & am trying to do what I am suppsto & tell you....I do not want anyone hurt or loose my license for knowing this & not saying anything. The charge still says it ok she got mixed up on times. So is this a big deal? I was made to feel like I was the one in the wrong. I am not a trouble maker but I thought I was doing what I needed/was obligated to do.

Years ago our surgeons had an increased issues with PT PTT INR results coming back way out of range, rsulting in cancelled cases in large numbers. Since there was such a surge of those results, an investigation was done, and it led back to two nurses giving meds way earlier than scheduled.

[kate1114]

I asked the nurse working & she said yes I already gave the meds....I said some of these are 4-6 hrs ahead of time. She replied oh its ok...I always do it this way. Uh no its not ok...they are scheduled for a reason...you did not already give the Lovenox did you?

When the charge came around I told her the story. She said its ok I already know...nurse X, said she got mixed up on the times. No she did not...I told her the conversation...again the charge said, its ok she got mixed up on the times. Again I say no she did not, I asked her...repeated what nurse X had said. The charge was getting ill w/me & said it ok!

So is this a big deal? I was made to feel like I was the one in the wrong. I am not a trouble maker but I thought I was doing what I needed/was obligated to do.

Yes, it is a big deal, and yes, you did the right thing. I agree with other posters who say that you should follow up the chain of command and write an incident report.

Please don't allow someone to make you feel like you are wrong. You did a great job. This sounds like a very dysfunctional unit, if the charge nurse is defending someone who is doing something wrong. :angryfire The patients needed an advocate, and it's good that you were there! The person with more experience is NOT necessarily right. It sounds like it was done just for the benefit of that nurse's schedule. Interesting insight with the fact that the meds weren't given that way with the family who questioned meds. That just shows that she knew what she was doing was wrong.

[RN BSN 2009]

You did the right thing! Just document document document so it doesnt come back and bite you!

[GeminiTwinRN, BSN]

Wonder what the story would have been had a patient died at 2100, had a med given by the nurse you're posting about 6 hours early, but charted that she gave it at 2300.. ??

perfect example of how something that she "always" does could come back and bite her in the butt. worst case, yes, but definitely a possibility.

you done good, girl. :)

[crb613, BSN, RN]

Thanks to all of you for your support! My director said exactly what all of you have. She was very supportive as well. She said there would be an audit done on the pyxis....must have already been done because I met this nurse in the hall, & she would not look at or even speak to me. Its just really sad that these people were put in danger at the very place that they trusted to take care of them. Thanks again to all of you!

[NurseCard, ADN]

All I want to say is that I am IMMM-pressed, girl!! Wow! :) I mean, you certainly did the right thing!

[jo272wv]

Write an incident report and send a copy to risk management of the hospital you work in. The MAR can be compaired to the pixus by them and prove you are telling the truth.