wrong nursing assessment. help!

Nurses General Nursing

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like 2 weeks ago, i saw my patient's chest for the first time when i was gonna give him his heparin shot on the abdomen. i noticed red dots that looked like petechiae to me. i asked the patient if he always had those red things and he said no. then i asked my nursing supervisor to check it out and she said it definitely looks like petechiae. so i called the doctor and relayed info and he ordered to d/c heparin, so i did. then last week i came in and checked on him and asked him if he still had them. this time he saw exactly what i was pertaining to and he said those are his moles!!! i was like, omg. i dont know what to do. i asked a coworker if i should call the doctor and ask for it to be ordered again and he said just to wait on his next monthly labs. aaahhhhh idk what to do. i need some good advice please. im so scared to call the doctor cuz he might yell at me for making a big mistake! help please

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I think you did the right thing..you asked another person for help and acted in the patients best interest with the knowledge you had. I would contact the physician and explain the situation and have him evaluate it, after all this is something they should be following up with anyways.

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Specializes in LTC, SNF, PSYCH, MEDSURG, MR/DD.

just explain that the pt has stated these are moles. everybody makes mistakes.

so what if he gets mad?

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Specializes in Cardiac Telemetry, ED.

What was his platelet count?

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Specializes in ..

The doctor shouldn't yell at you for making a mistake. Whether he does or not might be another story. It's my opinion that this negative responsive attitude to "mistakes" only encourages the secrecy and shame that leads to more mistakes being made and jeopardizing patient care. Speak up and do what is in the best interest of your pt.

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Specializes in ED, ICU, MS/MT, PCU, CM, House Sup, Frontline mgr.

call the doc and get yelled at... you will survive.... this is not about you and your ego... this is about taking care of your patient which means being an advocate!!! and yes, i have taken my own advice... been there done that....!!! :D by the way, are you a new grad (less then two years of nursing work experience)? if so please join us on the first year after nursing licensure forum. https://allnurses.com/first-year-after/

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Specializes in Hospital Education Coordinator.

this shows why it is important for the MD to assess the patient as well. I think you did the best thing with what you knew.

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Specializes in School Nursing.

Not to be critical, but moles and petechia look nothing alike.

Praiser :heartbeat

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I agree, they look nothing alike. Were there not labs that coincided with the diagnosis?

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Specializes in Med-Surg.

You reported a symptom. It was the doc's responsibility to follow through with his or her own eyes and order labs. And, you are certainly not the only nurse to have seen them.

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I don't think the patient has any idea what he is talking about either if he goes from not having them before to calling them his 'moles'. Maybe the patient uses 'moles' to describe all skin problems?

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I will soon be starting my first year as newbie and this stuff scares me too. But you had your supervisor check it out also and she agreed with you. Also does this person have any memory problems or confusion? I would have thought the doc would have assessed him by now also but like I said I am not out there yet.

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