Wow. Just wow

mhusen5 · Mar 5, 2015

VANurse,

You are rationalizing illegal activity! Can't you see that?

The "override" covers many things...not one of which gives you permission to not follow protocol!

It's purpose is not to excuse improper protocol and behavior.

The law states you document the verbal order etc etc etc

Good luck, when the pharmacy calls you back after you've given the medication to inform you the patient can not take that medication..for whatever reason! It happens all the time!!!!

They are your safety net!

I'm not out of touch with reality...

You are.... if you don't follow protocol, thereby possibly creating an adverse reaction

that harms a patient... rather than alleviate pain!

"The Devil is in the details".

VANurse2010 · Mar 5, 2015

During my last few years of "inexperience" I've been taught by my SENIOR staff what is appropriate and what isn't. If a doctor gives me a verbal order then yes I will go get the medication before putting the order in the computer if a patient is in distress but I would never take it upon myself to order something for the patient and then inform the doctor later. Again, it doesn't matter what kind of relationships you have with the doctor, I would love to hear you defend that in court if something happened to the patient based off of you taking it upon yourself to play doctor.

And yet you give APAP without an order because its "OTC" ? Seriously, get a grip.

VANurse2010 · Mar 5, 2015

VANurse,
You are rationalizing illegal activity! Can't you see that?
The "override" covers many things...not one of which gives you permission to not follow protocol!
It's purpose is not to excuse improper protocol and behavior.
The law states you document the verbal order etc etc etc
Good luck, when the pharmacy calls you back after you've given the medication to inform you the patient can not take that medication..for whatever reason! It happens all the time!!!!
They are your safety net!
I'm not out of touch with reality...
You are.... if you don't follow protocol, thereby possibly creating an adverse reaction
that harms a patient... rather than alleviate pain!
"The Devil is in the details".

Frankly, the ignorance you've shown here and the fact that you're probably not even a nurse makes me very dubious of your qualifications to comment. I've managed just fine the past 5 years without following your deranged conception of mediation management.

dinah77, ADN · Mar 5, 2015

VANurse,
You are rationalizing illegal activity! Can't you see that?
The "override" covers many things...not one of which gives you permission to not follow protocol!
It's purpose is not to excuse improper protocol and behavior.
The law states you document the verbal order etc etc etc
Good luck, when the pharmacy calls you back after you've given the medication to inform you the patient can not take that medication..for whatever reason! It happens all the time!!!!
They are your safety net!
I'm not out of touch with reality...
You are.... if you don't follow protocol, thereby possibly creating an adverse reaction
that harms a patient... rather than alleviate pain!
"The Devil is in the details".

It does not appear you are a nurse with any real experience: thus, it's pretty hard for any of us to take you seriously

mhusen5 · Mar 5, 2015

macawake,

Standing orders are not the topic under discussion.

As we all know, a Standing order means you already have an order and/suggests/allows/permits you to legally give a medication.

We are discussing those who choose to "play doctor", prescribe and administer medication without a standing, verbal or written order....and then later getting an MD to cover the medication he/she did NOT order....by writing an order after the fact.

Apples and oranges... ;-)

BSNbeauty, BSN, RN · Mar 5, 2015

Never mind! I'm done with this thread. You all look like you're having a great time with it. So please carry on. Once again, I'm sorry for posting this I really just needed to vent but couldn't give details for the obvious reason .Thanks for everyone that cared to respond. The nurse was found to be in the wrong and appropriate actions was taken. I feel better now.

macawake, MSN · Mar 5, 2015

macawake,
Standing orders are not the topic under discussion.
As we all know, a Standing order means you already have an order and/suggests/allows/permits you to legally give a medication.
We are discussing those who choose to "play doctor", prescribe and administer medication without a standing, verbal or written order....and then later getting an MD to cover the medication he/she did NOT order....by writing an order after the fact.
Apples and oranges... ;-)

I was responding to the post I quoted :)

Since that post mentioned implementing verbal orders before transcribing them and standing orders I think I managed to keep it within the apple family

BrandonLPN, LPN · Mar 5, 2015

Brandon I'm a bsn RN with six years of experience. Sorry to disappoint you, BrandonLPN !

I wasn't talking about you.... Go back and look again at who I quoted.

I hope you're not still taking the "I have to assume its possible you're overreacting" comment personally. I didn't mean it as in "I assume you, prnqday, are overreacting because you are prnqday", I meant it as in: "without knowing any details, I would assume any nurse might be overreacting". I thought that was clear, but maybe not.

To be honest, this thread shifted away from your OP quite a while back, as many threads often do.

Lev, MSN, RN, NP · Mar 5, 2015

Are you familiar with the range of pain mgmt for knees? (That's not meant to sound snarky, I'm trying to understand your rationale)
You would send a healthy knee patient to the ER? By car 3 days post op with 9/10 pain or by ambulance?

Knees are painful but with a proper pain management discharge plan their pain should not be a 9/10. I've discharge patients post op day 2-3 with 4 or 5/10 knee pain and they were only on orals. That patient needs to see/call doctor for uncontrolled pain as discharge instructions generally advise. In this situation I would assess the knee for signs of infection and tell them to take extra strength Tylenol and percocet 1 hour early this time only and take the next percocet on schedule.

BrandonLPN, LPN · Mar 5, 2015

mhusen, I hope you realize that when we write the occasional "after the fact" order, we are not doing so for staff convenience. We are doing so to more quickly give a patient a medication they urgently need.

If it were all about ME, I would have no issue with seizing an opportunity to stop my med pass and put my tired feet up at the nurses station while waiting for the MD to answer his page. But it's really about the patient in bed who is in pain or nauseated or whatever.

mhusen5 · Mar 5, 2015

Newsboy,

Sorry, you lose. I am not a brand new nurse. Your supposition skills are as faulty, as your

illegal medication protocol.

No medication is SAFE all the time...surely you know that!

The purpose of medication protocol is in place to protect the patient.

It is not there for you to bend as you see fit in whatever situation you decide you know best.

Medication protocol is textbook...for a very good reason!

One of the few things in nursing that still is...in order to protect the patient from nurses who want to play doctor..... or.... because of lack of ethics, longevity or arrogance believe they are qualified to supersede the scope of their license.

If you choose to circumvent it, engage in illegal, criminal activity, order and administer medication

.. so be it. Your deliberate decision could cost you your license.... or worse still, harm or death to a patient.

But please don't accuse those of us who won't practice out of the scope of our license, as out of touch with the real world.

The real world I live in..... will soon catch up to your illegal activity, if not today...tomorrow!

VANurse2010 · Mar 5, 2015

Newsboy,
Sorry, you lose. I am not a brand new nurse. Your supposition skills are as faulty, as your
illegal medication protocol.
No medication is SAFE all the time...surely you know that!
The purpose of medication protocol is in place to protect the patient.
It is not there for you to bend as you see fit in whatever situation you decide you know best.
Medication protocol is textbook...for a very good reason!
One of the few things in nursing that still is...in order to protect the patient from nurses who want to play doctor..... or.... because of lack of ethics, longevity or arrogance believe they are qualified to supersede the scope of their license.
If you choose to circumvent it, engage in illegal, criminal activity, order and administer medication
.. so be it. Your deliberate decision could cost you your license.... or worse still, harm or death to a patient.
But please don't accuse those of us who won't practice out of the scope of our license, as out of touch with the real world.
The real world I live in..... will soon catch up to your illegal activity, if not today...tomorrow!

trollin' trollin' trollin'....