Wow. Just wow

[BSNbeauty]

I'm really at a lost for words. A nurse deliberately made a med error. When she was notified by the nurse that caught the error that an incident report will be made, she had a resident write the order to cover her. Now a patient is retrieving a medication that is not indicated or needed. No harm done to patient, but it is just sad that some nurses are able to get away with this type of behavior.

[mhusen5]

Done..and done...whew!

[hppygr8ful, ASN, RN, EMT-I]

If I was vomiting in your ER, I would rather you played it safe and made me suffer for 20 minutes than pull a med without any type of order. 20 minutes of vomiting isn't a death sentence.

Do you know how many pregnant women were given Zofran in ER's who later had spontaneous abortions even though the medication had a black box warning that is was contraindicated in pregnancy since 2010. I have myself been in ER's with very severe N/V and Pain due to Ulcerative colitis/diverticulitis and had nurse be very apologetic about not being able to give me anything until they had orders. Did you know that giving a patient a cold washcloth for their head and giving them slices of lemon to smell stops nausea and vomiting in it's tracks. It was done for me and I in teun did it for a patient with success.

I have 15 years of experience including almost losing my license over a similar issues and let me tell you it's no fun to stand before the Board and try to defend your actions - oh and that "friendly" doctor threw me under the bus so fast my head spun (Even though he told me to "Use Your Judgement" The patient didn't even have a negative outcome but it came before the board as charting irregularities. I was lucky to get off with "Supervision" during which I went before the Board three times to explain how I had learned my lesson and would never do it again.

so totally not worth it.

Hppy

[mhusen5]

Hppty,

Agree totally! If there is an 'incident'..the nurse always becomes the target and ends up in front of the Board defending her actions...and btw...there are no 'friendly' doctors. They will never back you up!!

But you can't convince those who continue to go outside the scope of their license that they will face license revocation regardless of how many excuses they choose to offer!

Their know it all attitude is going to inflict serious harm on a patient..if not today...tomorrow!

They refuse to get it!

Their arrogance appalls me.

[edmia, BSN, RN]

Excellent advice to those nurses who are commenting, and trying to justify, that their 'personal' judgment supersedes the scope of their license, as well as the medication protocol in place wherever they practice.

They continue to attack, and try to discredit and belittle the vast majority of nurses who follow medication protocol. They will keep insisting that wrong is right until someone confiscates their license for malfeasance.

I'm amazed at the number of nurses who willfully put their license and patient outcome in jeopardy by assuming they know best. Whew!

Check your State Board of Nursing's on line public list of licenses rescinded,

and cause...it's an eye opener!

I've worked with nurses like you. By the book and only by the book. Most of the time, it's fine.

The problem is when critical thinking is needed. Example: nurse is watching his fresh post op patient's BP in ICU as it climbs. And climbs. And doesn't pull a dose of med (that we give routinely in this scenario) because the resident hasn't entered the post op orders yet and is not returning a call. We tell him to please just pull the med and give. Nope, there's no order.

We step in and give the med. attending walks in, we explain and he congratulates us for being vigilant nurses and chews the resident out for being late on routine med orders.

I think of the patients first and act accordingly.

Sent from my iPhone -- blame all errors on spellcheck

[klone, MSN, RN]

Do you know how many pregnant women were given Zofran in ER's who later had spontaneous abortions even though the medication had a black box warning that is was contraindicated in pregnancy since 2010.

Can you please cite this statement?

[mhusen5]

edmia

I totally agree with you that it is not a perfect world, nor is medicine a perfect profession.

The system fails, more often than not, due to human error, deviation from protocol, as your scenario proves.

It's a trickle down effect, always ending with nurses in jeopardy and the target/scapegoat when all is said and done....sigh.

I insist/harp on medication protocol, for everyone, MDs, residents as well as nurses, because more often than not, MD omission, not answering a page etc. starts and creates the nurse's dilemma whether to practice beyond the scope of his/her license. It's a catch 22 and the buck always stops with the nurse.

The resident didn't follow protocol!

The patient should never have been transferred from Recovery to ICU without orders.

The nurse should have checked she had the med. orders when she accepted the transfer. (I know, I know, I know..you are right out straight with a code in one corner and a bleed in another..I get it! **** happens...it's not a perfect world).

The resident should have answered his page..he didn't for whatever reason.

Nursing is a daily comedy of errors.

The attending "backed you up" in this particular emergency circumstance as he should have (you protected his patient, and his butt), but that is not always a given! What I am trying to convey is to tread very carefully. Going outside the scope of your license should never ever be considered in anything but an extreme emergency (not convenience as far too many do in a non-emergency).

Even the most rigid "by the book" nurse has to act on her experience, knowledge and "critical thinking" to act in the best interest of any patient in an emergency, but you'd best be right...but right or wrong your license is in jeopardy. Is it fair..of course not..but it is what it is.