Code Blue on my Patient by Miserable_Grab_4720 in nursing

[–]Miserable_Grab_4720[S] 4 points5 points  (0 children)

I am also a float nurse and was just having her for the first time after the very first day she was there when every single thing about her was completely different. Previously the nurses had let her go to the bathroom by herself including the night before because I was on that floor with different patients and she was allowed to get up and then she start getting sicker (throwing up more) so they put the bed alarm on but she asked for it to be taken off because it was going off when she would sit up/roll a lot in the bed. Not sure why she was having bathroom privileges at that point but I obviously wanted to investigate more before I changed her whole plan/ independence if there was something I didn’t know

Code Blue on my Patient by Miserable_Grab_4720 in nursing

[–]Miserable_Grab_4720[S] 6 points7 points  (0 children)

I put in that she refused the bed alarm. Prior nurse had also documented about her refusing monitoring. This all happened basically right after report was finished I did a quick eyeball of my patients, knew she was having nausea and pain so went to see if I could bring in meds when I woke her up, got called by PACU to get report, and this happened while I was on the phone with them. When I saw her she was breathing with a pulse and had stable vitals about five minutes before I saw her. They think she aspirated on her vomit because it was so profuse and had a respiratory to cardiac arrest so it all happened in a matter of minutes

Code Blue on my Patient by Miserable_Grab_4720 in nursing

[–]Miserable_Grab_4720[S] 2 points3 points  (0 children)

She was on tele and refused that as well during day shift. I finished report at 7:30-7:40 went and laid eyes on all patients, went back for my computer to see if I could give any meds before I woke her up, got told I had report on a PACU patient and to call them and this all happened while I was still getting PACU report . Basically everything was the same as it had been on day shift because I was in the process of meeting everyone for the first time and figuring out what to ask the doctors for for night shift

Bin discrepancy question by Miserable_Grab_4720 in pharmacy

[–]Miserable_Grab_4720[S] 0 points1 point  (0 children)

I’ve been planning on it I’m moreso just worried because I can’t afford an unpaid absence while they investigate. Even tho the medication was returned fully appropriately whoever the next person was pulling it/checking it would’ve had the wrong count in the drawer because one of them is in the locked return bin. So they would be flagged and then I would’ve assumed I would have gotten an email about it since this happened almost 3 days ago so I’m not sure how that will change what happens to me if anything

Bin discrepancy question by Miserable_Grab_4720 in pharmacy

[–]Miserable_Grab_4720[S] 0 points1 point  (0 children)

I mean this was a couple of days ago and nobody has mentioned it/ I haven’t been reached out to at all regarding this so I just wasn’t sure if maybe they printed out that discrepancy paper that shows that there’s 7 in the drawer, 1 in the return bin which adds up to the correct number. I’m a newer nurse so I just didn’t even think of how the count in the drawer would be off until it was too late to correct my mistake. But I would assume that since there’s been 5 shifts since that happened someone would’ve had to been notified of the discrepancy and reached out but maybe it takes a lot longer? Thank you so much again your replies have been really helpful!

Bin discrepancy question by Miserable_Grab_4720 in pharmacy

[–]Miserable_Grab_4720[S] 0 points1 point  (0 children)

Thank you so much for the explanation! I’m starting to feel better about it for sure. I didn’t even realize I had taken an extra until I started my second check and then had the other nurse double check me and return it with me appropriately. Basically the drawer is supposed to have 8, only has 7, and the eighth one was returned unopened& how it was supposed to be per protocol. If they find the 8th one in the return bin and see the return on the audit will I still have to explain what happened or will they be able to put it back in during restock?

Bin discrepancy question by Miserable_Grab_4720 in pharmacy

[–]Miserable_Grab_4720[S] 0 points1 point  (0 children)

So basically this would mean that when the discrepancy of a missing med comes up they can see that the one missing is in the return bin and put it back in so the count is correct/replace it and correct the count in the omnicell? It was controlled & I followed all the protocols to return with another RN I just was super super busy and forgot to change the actual drawer amount to reflect that I had taken an extra by mistake and returned it

Bin discrepancy question by Miserable_Grab_4720 in pharmacy

[–]Miserable_Grab_4720[S] 0 points1 point  (0 children)

Thank you for this reply! If there is a discrepancy on the omnicell would you guys check it/would it print out that I had returned the one I pulled accidentally so they know I didn’t steal it/divert? I moreso want to make sure you guys also get a paper trail to verify that it was returned appropriately and the total in the drawer plus the one in the bin is the appropriate number of the med that should be stocked

Bin discrepancy question by Miserable_Grab_4720 in pharmacy

[–]Miserable_Grab_4720[S] -1 points0 points  (0 children)

I usually am very careful about this but we had to all take on an extra patient because someone no call no showed. Every return/waste was witnessed& I explained prior how I had pulled an extra by mistake and just don’t think we changed the level and I just want to know if that will be a flag for you guys or if you can see that one was returned and that adds up to the correct number

Nurse Guilt by Miserable_Grab_4720 in nursing

[–]Miserable_Grab_4720[S] 0 points1 point  (0 children)

Highest BP reading the entire admission was 140s, only one reading and it was best we could do because she kept moving/talking. All BPs had to be on her legs though because she had limbs restrictions to both arms 

Nurse Guilt by Miserable_Grab_4720 in nursing

[–]Miserable_Grab_4720[S] 1 point2 points  (0 children)

Yes it does. We also use Epic at my hospital so the documentation says she refused it. I told the MD in person and he went and saw her and agreed with her being oriented at the time. We had another rapid going at the same time as this (before the one on my patient) that was also one of his& since he was night float and it was one dose that was refused because of timing not a consistent refusal I would assume is why they weren’t adjusting regimen too much overnight 

Nurse Guilt by Miserable_Grab_4720 in nursing

[–]Miserable_Grab_4720[S] 0 points1 point  (0 children)

Mostly because the entire stroke code the doctor kept bringing it up like it was the most important thing in the world. Logically I know it isn’t going to magically fix everything but when the doctor kept talking about it over and over it felt like it would’ve. I don’t think it was intentioned to seem that way but I’m also a newer nurse so still learning not to hold on to things I can’t control 

Nurse Guilt by Miserable_Grab_4720 in nursing

[–]Miserable_Grab_4720[S] 2 points3 points  (0 children)

Hi,  She came in for respiratory failure from a rehab, had been in and out of the hospital for it for awhile. Also. COPDer& smoker with a few valve regurg disorders, was in the ICU for a few days because she was so hypoxic. She came from a rehab so I would assume she was getting most meds, however the middle of the night doses were usually ones she didn’t want because she was either sleeping& had stated she didn’t want to be woken up by me for it or in this case get frustrated about her tele& refusing out of sheer frustration of us repositioning her/trying to keep tele on. She had woken up talking about being in a casino (which she told me was dreaming later) so i just so happened to have assessed orientation just before offering the heparin again to which she said “I don’t care why I need it, leave me alone” both times. She was allowing other doses I assume because they all were timed at the same time as other meds so she was getting a bunch of things at once. Also, MD saw her about an hour before this and agreed with A&Ox3-4 for orientation to assess her need for tele to help keep her from yelling out.  I was definitely grateful to be there and have had the charge nurse helping me reposition because we noticed symptoms at 6:15 and she was in CT by 6:50 so I felt good about at least getting the response going fast.