Wow. Just wow

Nurses General Nursing

Published

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.

Specializes in Mental Health Nursing.
Newsboy,

Sorry, you lose. I am not a brand new nurse.

You're right. You're not a nurse at all.

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mhusen, none of this is as exciting or scandalous as you seem to think it is. None of us are running fraud operations out of our place of employment where we impersonate MDs.

If you want the truth, most of my "practicing medicine" involves routine bowel care interventions we don't have standing orders for. I'll take my chances.

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Specializes in Acute Care Pediatrics.
That sounds very nice, but not always practical. At my previous job I received a pt from the PACU. After just a few minutes on the unit she was having severe vomiting. The resident was in the middle of a procedure and he said to me "give her 4 mg Zofran IV." I read it back to him, went to the Pyxis, got the Zofran, gave it to the pt., and the put the VO in. If I went 100% according to what you have above I would: 1. take the VO, 2. write the VO, 3. fax the VO to the pharmacy, 4. wait for pharmacy to "verify" the med and put it in the patient's eMAR. That could take a half hour or more. If I have a post op pt. vomiting (or in severe pain, or having a hypertensive crisis, etc.), I am not going to go through all those steps before administering the med.

I don't know what happened in the OP's scenario and I understand why she can't give all the details. However, I can understand how someone would not follow the protocol to the letter of the law.

Exactly... patient care comes before everything else.

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Specializes in ICU.

I won't grab anything without at least a verbal. I know patient care comes first, but our charts get audited all of the time, and if someone were to notice that I charted that I gave something before the order was put in, well... it's indefensible. If the order's not in yet but I've at least HEARD a physician mention it, I'll do it. If I haven't heard anything, I won't. The only exceptions are if it's a life and death situation. I have given ACLS drugs, D50, sedation for a newly intubated (and struggling) patient, and boluses for hypotension without orders. Anything else can wait.

Yeah, it sucks to have a patient with heartburn and not have anything on the MAR to give them. It would suck even more if I lost my license and couldn't work as a nurse again over something as dumb as an OTC antacid. That is a lot of money and schooling to throw away over a pill probably not even worth a dime.

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Specializes in Emergency & Trauma/Adult ICU.
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!

As you wish.

When you're vomiting in my ER, I will not medicate you until I get an order from the doc. What's that - he's with a critical patient? No matter - I'll get the order 20 minutes from now. You'll wait.

If you want, I'll even wait for orders for your Epi when you're coding.

I'm flexible.

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Specializes in hospice.
Newsboy,

Sorry, you lose. I am not a brand new nurse.

Then you should update your profile.

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Specializes in Emergency, Telemetry, Transplant.
trollin' trollin' trollin'....

I sure hope you are right! No responsible nurse is going to wait for all "protocols" to go through before he/she gives a medication for severe pain, an antiemetic for projectile vomiting, or an antihypertensive for hypertensive emergency. I am not breaking the law if I don't wait for pharmacy to verify a med in a critical situation. In fact, I can find myself in a legal proceeding if my patient suffers a negative outcome while I wait for the pharmacy to check the verbal order.

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I sure hope you are right! No responsible nurse is going to wait for all "protocols" to go through before he/she gives a medication for severe pain, an antiemetic for projectile vomiting, or an antihypertensive for hypertensive emergency. I am not breaking the law if I don't wait for pharmacy to verify a med in a critical situation. In fact, I can find myself in a legal proceeding if my patient suffers a negative outcome while I wait for the pharmacy to check the verbal order.

We can all debate what's an emergency and what's not. I wouldn't per se consider severe surgical pain an emergency. However, your point is correct and this person doesn't know what she's talking about, full stop.

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Brandon,

You know you are breaking the law...I reminded you...you're offended...so be it!

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mac

;-)...touche!

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Wow. Just wow

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I have NEVER had the time or inclination to put my feet up while on duty.

My patients deserve better..and so do yours.

There are a dozen things you can do for your patient's comfort while you are waiting for legal protocol to work, and........IF you hang on to your nursing license long enough, you will develop those skills ......or maybe not.

As a Supervisor I've encountered many like you who 'forget' to document and have to call you back in to clean up your mess...while I write you up for "failure to follow medication protocol" and report your medication error to the state, as required by law! An error is an error is an error.

You choice is to break and/or bend the law and rationalize your illegal and criminal behavior....

My choice is to honor the scope of my license and report it....so be it.

I'm done..have a nice day.

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