Friday, September 7, 2012
Another night not so bad at the hospital…although I have to say, DOCTORS drive me crazy sometimes. There is a story…and it involves an order for 4 mg IV Dilaudid. Now if you don’t work in a hospital as a nurse, that may not mean anything to you, but Dilaudid is a very strong pain medication, so strong in fact, that there are warning signs all over the hospital in each unit, “Warning: 1 mg IV Dilaudid = 4 mg IV morphine” So to make a long story as short as I can, as I was getting report last night, the nurse who was taking care of the other two patients on the floor, left the floor to take a quick lunch break, without telling me ANYTHING about her patients, one who was a post-op for ?? (I didn’t know anything about her patients at the time). The intensivist came to the unit, because he was evaluating a pt from the ER, and happened to walk by this post-op patient’s room and she was gagging and moaning. He walked out of the room saying, “four mg IV Dilaudid now”. Of course I turn to the nurse I’m getting report from and say, “Did you hear him say 4 mg IV Dilaudid?” and she nods yes. So I go to write the order, thinking, “Damn, that’s a lot of pain med.” The order goes to pharmacy and OF COURSE they are not going to initially approve it, so the pharmacist talks to the doc and they get into a fighting match, basically the doc saying, “so my patient has to suffer because you won’t put through a pain med order??” This from the intensivist who HATES to give any pain med. Then he starts saying, “how can we make this work?” (to me). I say, “order one mg now and we’ll see how it goes, considering the pt already has an order for 1 mg IV dilaudid every hour which she hasn’t gotten for THREE hours!!!!” So the pt gets two mg total and is doing much better. Of course during this time, the nurse who left the floor comes back out and is like, “what’s going on?” I explain the situation and she’s like, “no nurse in her right mind would ever give four mg IV dilaudid.”
Then I hear later on from the secretary that when I was questioning the dosage of the pain med, the doc had said, “that’s one more than three, one less than five.” Really???!!! HOW unprofessional. Then later on he also states, “well I just meant to pull up two, give her two and then have the two additional to give if needed.” NO…that’s NOT what you said you MORON!!!!
Seriously, if that nurse had 1) medicated her pt hourly we probably NEVER would have gotten to that point and 2) told me she was leaving the floor so I knew something about the pt, I would not nearly be so upset.
I HATE that taking care of patients is like an afterthought for some nurses. And I hate that doctors think that they are God-like in their abilities…”this is the ICU and I should be able to order what I want.”
Well, NO, sometimes we actually have to think of the safety of the patient, stupid!
And I WISH that I would have had the balls to question that doc more, or stood up to him, but of course he’s the one that intimidates me, so I dutifully wrote the order.
Seriously, what a way to start the evening. Thank goodness I never needed to call him the rest of the night because he was in a MOOD.
Anyways, I’m off for two days…woo woo!!!
Here’s my favorites from around the web this week….
Favorite apple treats…it’s that time of year again…apples are in season and out come all the apple recipes…these all look so good.
Favorite inspirational posts…If you need a pick-me-up, these posts are for you!
Favorite breakfast bite…this Cinnamon Polenta with Molasses Butter looks SO GOOD. I’ve always seen polenta used in savory dishes, never sweet, so I’m intrigued!
Favorite INTENTIONAL posts…in a world of multi-tasking, it’s nice sometimes to just focus on one thing at a time…these posts really resonated with me.
A monk told Joshu, “I have just entered the monastery. Please teach me.”
Joshu asked, “Have you eaten your rice porridge?”
The monk replied, “I have eaten.”
Joshu said, “Then you had better wash your bowl.”
At that moment the monk was enlightened.
Favorite savory dishes…corn, tomatoes, quinoa…it all looks so good!
Favorite frugal post…when it hurts to save, read this article, and remember…there is an end!
Favorite sip…Pumpkin Spice Lattes…homemade!!!
Favorite portable sweet n’ salty snack…Peanut Butter Cookie Date Bites. These would be perfect for a quick pick-me-up at work!
Favorite indulgent bite…7-Layer Cookies…a la mode!!!!
Favorite football snacks…okay, so I DON’T watch football…but I TOTALLY WOULD if it involved these snacks
Favorite take-away quote…
GET OUT THERE AND DO IT PEOPLE!!!
Have a great weekend!!!!