Friday, April 17, 2009

Oh what a day!

Well today is gorgeous! The weather couldn't be better, although they are saying a better day tomorrow. I am back on track with ww...I just needed to get myself through that little slump I had. Looking forward to cousin Greg offered to walk the dogs with me at the bike path...I will do my best to get pics of this adventure tomorrow. I am also going to walk the dogs today to get that back on track, but that will have to wait until later as I must head down to my grandparents house to see if Nana needs to go to the store.
On a different note, I am going to go on a soapbox. As a nurse, and to any nurses who read this I must question the following actions that happened to me yesterday...
I remember in nursing school when we started learning how to hang IVs that the teacher taught these simple steps
1- Spike the bag
2- Prime the tubing
3- Put the tubing in the pump
4- Check to make sure the IV works
5- Connect the tubing to the patient...
5 SIMPLE STEPS....that is it 5. Please tell me how on earth something so simple as this can not be done. At work on Wed I followed a nurse who has won the Nightingale award for Nursing (I found this out after my shift was over, but keep that in mind). This award is named after Florence Nightingale. I went in at 745 to assess my patient and the IV bag was completely empty. While as a general rule I like to program the pump to alarm before the bag is completely empty, I know that not everyone does that. Apparently this nurse is one of those people. I also make sure that if the bag that is running is a medication...A VITAL part of the patient's treatment that I also make sure to order a back up bag from pharmacy. After all that is what they are there for right? Anyway, I asked the nurse that I was following if she ordered an extra bag of Octreotide, since the bag that was hanging was empty. She asked me what I meant. OK what does it sound like...THE BAG IS EMPTY!!! I again told her that the bag was empty and she said, "no, I didn't order a new bag, I didn't even hang it." That statement right there should have been my clue that I was in for a long night. Whatever, I ordered the bag myself and had to order it stat. Anyway, I continued with my patient assessment, and my patient asked to go to the bathroom. That is easy enough, I am not use to patients asking that question anymore since working in the unit our patients are primarily vented so they have no way of walking to the bathroom. Anyway..I put my hand on the iv pump and my hand got wet. Why on earth is there water near electrical equipment?!?! I checked the tubing to make sure that nothing was leaking, and viola what did I find?!? The Octreotide was NEVER connected to the patient. The pump was running, the medication was leaving the bag, yet the patient wasn't getting any of it. I have no idea how long it has been not connected to the patient. I check the electronic medical record, which is just the way we chart, and it says the medication was started at 1246. At this point that was 7 Hours ago!! So I quickly connect the patient to the medication, and scan the next bag of Octreotide. Help the patient to the bathroom and leave the room. Now, since I found the incident, I have to call the doctor to let him know that the medication that he ordered for his patient umm like half the day ago has not been going to the patient for I don't know how long. My exact words to the doc was "the Octreotide that you ordered for the patient has made sure that the IV pump does not currently develop a GI bleed." The doc didn't understand my little attempt to joke, so I explained to him what I found and how I was going to rectify the situation. Let me remind you that the nurse I followed received the Nightingale Award. When the next shift came on I had to explain to them why the Octreotide was running longer than it was supposed to, and that is when I found out other information about this nurse. That is right then and there that I asked myself ;what do I wrong when I make sure that my work is done, I ask appropriate questions when I am not sure why we are doing something and I strive to do my patients no harm; and yet I don't get any recognition for anything, but a nurse that makes critical (could lead to patient harm) mistakes and gets the Florence Nightingale Award. I don't think Florence would approve.

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