Written Up

[medteleER]

The oncoming shift charge nurse got on me about "double dosing" a patient. MD had (2) specific orders PRN:

1) xanax 0.5 mg for sleep

2) xanax 0.5 mg q8h for anxiety

I gave BOTH of them because the patient claimed being anxious and wanted something to sleep. My charge nurse pulled me to the side afterward and stated she was going to write it up. The patient was VSS in the morning. I'm not sure how I should be feeling about this.

[Emergent, RN]

I also try to be humble and modest about my 145 IQ.

[guest974915]

I'm out-hijacking this thread to offer self aggrandizement and your inflated sense of purpose is nauseating. Going to go throw up now!

[Persephone Paige, ADN]

21 hours ago, morelostthanfound said:

Agree with Sour Lemon on this-not technically a med error, just maybe a lapse in judgment, but let's face it-1.0 Mg of Xanax is not a whopping dose by any stretch of the imagination!

Word...

Patient probably had a decent night's sleep too. Patients all up and down the hallways on enough Dilaudid to fell a draft horse, but let's get our knickers in a knot over a PRN order that can overlap at HS for a moderate dose of Xanax. Sounds like nursing to me...

I'm not arguing that it's best practice to double dose, because it's not.

Meanwhile pt's deliberately wait an try and time Benzos and Opiates together. And the way the order is written, it falls within the realm of possibility.

OH LAWDY!

[Emergent, RN]

27 minutes ago, morelostthanfound said:

I'm out-hijacking this thread to offer self aggrandizement and your inflated sense of purpose is nauseating. Going to go throw up now!

Was my humor too subtle for your average IQ ?

[KatieMI, BSN, MSN, RN]

47 minutes ago, Emergent said:

Was my humor too subtle for your average IQ ?

That was likely about me. As I said, there are lots of people who just cannot stand anyone who is smart and openly proud of it.

[guest974915]

1 hour ago, Emergent said:

Was my humor too subtle for your average IQ ?

You don't anything about me or my IQ, however, your pomposity and arrogance are quite evident in your posts

[Emergent, RN]

5 minutes ago, morelostthanfound said:

You don't anything about me or my IQ, however, your pomposity and arrogance are quite evident in your posts

Well , your lack of a sense of humor is clearly evident, since my posts were entirely tongue in cheek...

[Emergent, RN]

41 minutes ago, KatieMI said:

That was likely about me. As I said, there are lots of people who just cannot stand anyone who is smart and openly proud of it.

Your pride is quite obvious

[Ruby Vee, BSN]

While the orders were not written optimally, you did actually give the patient twice the ordered dose of Xanax in one dose. Double dosed him. It was a med error, and demonstrate poor judgement.

[Ruby Vee, BSN]

23 hours ago, medteleER said:

all i wanted to do was help my patient sleep and not wig out. the patient told me "the MD ordered 1mg of xanax for me", but the orders didn't reflect this. so i took their word for it and got creative. i figured 0.5mg+0.5mg = 1mg, so let's try that. since 1 was for sleep, and 1 was for anxiety, it would be OK, i thought. i did take into consideration 1mg of xanax isn't going to kill the person. but now i'm not so sure. i actually feel bad about this.

I hope you've learned something about taking the patient's word for what the MD ordered.

[Emergent, RN]

5 minutes ago, Ruby Vee said:

I hope you've learned something about taking the patient's word for what the MD ordered.

Ain't that the truth.

An experienced patient is good at manipulating less experienced staff.

[Ruby Vee, BSN]

56 minutes ago, KatieMI said:

That was likely about me. As I said, there are lots of people who just cannot stand anyone who is smart and openly proud of it.

Dunning-Kruger Effect