Wow. Just wow

Nurses General Nursing

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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.

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.

Again, you don't know what you're talking about - and it's so egregious that one must wonder if you're lying about your qualifications.

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Specializes in ICU.
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.

I know you weren't addressing me, but I just had to point out that Epi is covered under ACLS and most places consider that a protocol a nurse can run without a physician, so you actually do have rights to pull Epi before a physician arrives. To compare that to vomiting (unless there is an Advanced Vomiting Life Support protocol I know nothing about) is a touch histrionic.

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.

I am assuming you all really, really trust the physicians are going to cover your butt when you overreach and order a med. I had a physician freak out on me once because I gave a liter saline bolus for a patient and once he called me back he wanted Hespan instead. I just about lost my job over that saline bolus. The systolic was in the 60s, if anyone was curious.

It's awesome if you want to be a cowboy nurse and just do things, but you're just risking that one day the physician you ordered that med under is going to be in a bad mood and might just say, "I didn't tell you to give this." IMO, that's just an unacceptable level of risk for me personally. I have a mortgage to pay.

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calivianya,

If the patient goes sour...you can count on that MD throwing you under the bus,

if you decide to 'play doctor'...sometimes even if you didn't.., in order to cover their own backsides!

They don't all have integrity...far from it...they cross the line all the time!

1.Document, document, document!

2.Don't exceed the scope of your license, ever.

Directly above are the only weapons nurses have to protect their licenses!

Between your coworker's sabotage by not following protocol, MD's mistakes passed on to nurses, and patients and litigious families, it's a wonder any nurse manages to hang on to her license!

The best money I spend is for private ...the hospital takes care of the hospital and you are expendable. Carry your OWN insurance.

Nurses are always the primary target! You don't have to do anything wrong to become a target!

True story..I had an epileptic patient who had an MD order and a signed waiver that he was NOT to be required to use a safety belt in his wheel chair... and the patient assumed responsibility for any incidents related to that request! Of course he had a seizure , flipped out of the wheel chair and broke his nose!

When ER asked what happened, the jokester said "Nurse Mary punched me..she packs a real wallop"! ER documented in quotes and reported, as required, and the "investigation " went on for a year, despite the fact that the patient said a hundred times that he was joking and was laughing when he said it! The documentation was in his chart that I was giving shift change report to the staff when the entire staff heard him fall..no one was present or witnessed the fall! They were determined to target someone and create a very public cause celebre for something that never happened...to justify their salary? The patient and his family were so distressed, they kept trying to "pay expenses" I didn't have! I carry my own malpractice insurance!

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VanNurse

It's common practice to attack the messenger when you can't refute the message :-)

Ask yourself, "Why does the truth offend me and make me angry"?

The answer may give you some insight...or maybe not!

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VanNurse

It's common practice to attack the messenger when you can't refute the message :-)

Ask yourself, "Why does the truth offend me and make me angry"?

The answer may give you some insight...or maybe not!

It's been explained to you ad nauseum why you are incorrect in reference to verbal orders. Your indignance, ignorance, and attempts to turn it around don't change that. As you know, it's also common practice to accuse someone of being aggressive or rude when you don't like what they're saying.

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Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.

Know your facility's policy on verbal orders. Many do not allow them except in code situations. Nurses can and have gotten fired for doing a verbal, as well as giving a med and asking for the order later. As others have said, if something goes wrong, the doc is not going to come to your rescue. The doc will save his/her own hide first.

I'm not saying that I don't know that there is sometimes a difference between the letter of the law and what happens in the real world. But as long as you do so knowing that your license and your job is on the line every time you step out of your scope.

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Know your facility's policy on verbal orders. Many do not allow them except in code situations. Nurses can and have gotten fired for doing a verbal, as well as giving a med and asking for the order later. As others have said, if something goes wrong, the doc is not going to come to your rescue. The doc will save his/her own hide first.

I'm not saying that I don't know that there is sometimes a difference between the letter of the law and what happens in the real world. But as long as you do so knowing that your license and your job is on the line every time you step out of your scope.

*Ding ding ding* We have a winner. You have to know what's acceptable in your facilities. Although I personally would never work for a facility that wouldn't allow you to override pull say, Lasix, for someone in flash pulmonary edema (an emergency, not a code) with a verbal; knowing your policies is key to survival.

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klone,

Thank you for your common sense post!

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!

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VanNurse,

Good grief ...give it a rest..you serve no purpose by attacking me.

Your opinion does not supersede my knowledge because you engage in character assassination.

Different types of facilities, States etc have differing medication protocols.......

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Specializes in Oncology.
What about this scenario..

You're on call in home health. You have a knee patient, that you admitted and know that they're a high functioning healthy middle aged adult with bad knees from sports. They're 3 days post op and the spouse calls at 3 am reporting patient up for the last hr with pain 9/10, they've iced, repositioned, no s/s of complications and have taken the max dose of Percocet 5/325 2 tabs every 6 hrs and their next dose isn't due for another hr. The rx bottle is of course in their possession. What actions would you take?

Sudden, severe pain three days post op not controlled by the pain medication he was using prior should definitely be an ER visit. No way would I advise them to just cover the pain up with more meds, if that's what you're asking.

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VanNurse,

Good grief ...give it a rest..you serve no purpose by attacking me.

Your opinion does not supersede my knowledge because you engage in character assassination.

Different types of facilities, States etc have differing medication protocols.......

You should take your own advice.

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Specializes in Psych, Addictions, SOL (Student of Life).

I have been a nurse since 2002 and I am a bit appalled about how many nurses think it's ok to play fast and loose with the Nurse Practice act which very clearly tells us what our scope of practice is. No nurse except one who has prescribing privileges such as an NP is permitted to write medication orders. I was fired last November for refusing to write orders under a physician's license. The poster who has stated that this will ultimately cost some their license are write and Dr's no matter how friendly they may be will alwya choose their license over your.

If a patient is in pain and the Doctor can't be reached the appropriate protocol in hospitals where I worked was to call the ED and have a resident/PA or NP all of which have prescribing ability to evaluate the situation. In the meantime there are several ways to help the patient be more comfortable while you are waiting.

Hppy

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