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Old 05-16-2016, 11:55 AM
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Default Nurses and doctors need better support

I found this article interesting and thought it would be a good one to share and get feedback going.


http://www.kevinmd.com/blog/2015/12/...ampaign=buffer
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Old 05-16-2016, 03:24 PM
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Interesting article.
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Old 06-08-2016, 11:14 PM
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I've had instances where I think a formal debriefing would have helped. I mean I can tell my husband I had a rough shift, my pt died etc., but he doesn't get it. I mean he's not a jerk about it, but yes I know death is part of life, and I certainly know it's part of my job. My mom and my sister are easy to talk to about feelings, but how do you call up someone who's having a good day and say "yeah mine wasn't so good...my dying pt's family brought her 2 yr old baby to say goodbye."

I'm one who can focus like a laser beam when stuff needs to happen, but get me in front of heartbroken families, and it affects me physically. To my husband's credit in this regard, he is really good about helping me get stuff done at home that typically would be "my" jobs so I can rest. I'll also say, I started working out about a month ago -- a very high-intensity cardio and strength training routine, 6 days a week. I am already feeling a difference in my mental outlook and in stress's physical manifestations, when I push my body hard.

Now enough about me.

One other thought I had after reading the article was of those non-dr., non-nurses for whom helping with these heartbreaking situations is common. Think about everything the chaplains see... sure, they have some some routine spiritual care visits, but most times we call them is for those difficult situations. A few weeks ago we had a string of deaths which were particularly difficult, and our chaplains became more of a fixture in our unit. One day I asked the one on duty how she'd been doing, and she said "I'm fine...and how are YOU doing?" It makes me wonder what kind of support they have, if I try to offer mine and she puts the focus right back on me.
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Old 06-08-2016, 11:40 PM
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That does bring up something I may ask about. A de-briefing. It is part of our policy but I have yet to see it done.
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Old 06-27-2016, 04:35 AM
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The article raises the question about accountability. Nurses have such responsibility when dispensing medication alone. Mistakes are made and in this case ended so tragically. In the case of a child who cannot answer for him or herself, two nurses ought to be involved in checking the medication and dose but this is not always possible..

I work in an environment with vulnerable adults, most of whom cannot speak for themselves. One incident where a patient was given antibiotics they were allergic to was not picked up by the prescribing doctor but it was the RN who got the blame for administering it without checking for allergies. Fortunately, the resident did not suffer any adverse reaction, but the nurse in question was severely traumatised by her error, thinking she could have caused severe problems for the person concerned. Even the pharmacist should be looking out for this if they receive a script for ab's and should have a confirmation from the GP re no known allergies.
Another incident where an RN asked a third year student nurse to give medication she had checked was correct and clearly stated who it was for. The student then went on to give it to the wrong resident, causing great distress to the qualified nurse who was held accountable. Fortunately, no harm came to the resident, but the procedure which followed was stressful for the RN having to admit the error and get advice to ensure the resident's safety, inform next of kin of the error and report it to her manager, who then had to review her competency to dispense medication.
In hindsight, yes she should have gone with the student to the resident, but in reality you make a decision based on your knowledge of the student and trust them to carry out your instructions.
Nurses have a lot to carry on their shoulders dealing with staff shortages and trying to complete tasks and keep records when at the same time dealing with emergency situations. Mistakes happen. We need all the support we can get!
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Old 06-30-2016, 05:19 PM
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Quote:
Originally Posted by Deb View Post
The article raises the question about accountability.
...

Another incident where an RN asked a third year student nurse to give medication she had checked was correct and clearly stated who it was for. The student then went on to give it to the wrong resident, causing great distress to the qualified nurse who was held accountable. Fortunately, no harm came to the resident, but the procedure which followed was stressful for the RN having to admit the error and get advice to ensure the resident's safety, inform next of kin of the error and report it to her manager, who then had to review her competency to dispense medication.
In hindsight, yes she should have gone with the student to the resident, but in reality you make a decision based on your knowledge of the student and trust them to carry out your instructions.
...
Absolutely wrong, sorry to say. If the school or institutional policy for students is that a licensed person must directly supervise medications given by students, then the staff nurse had zero discretion to rely on her "knowledge of the student."

This anecdote is the perfect illustration of why that's the case.
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Old 08-04-2016, 10:06 AM
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A timeout seems like a good idea. I don't see why not
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Old 08-14-2016, 11:57 AM
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Quote:
Originally Posted by CathytheRN View Post
A timeout seems like a good idea. I don't see why not
Not sure I understand what you mean. How would a time-out have prevented this student from proceeding to the wrong bedside? The anecdote already says the RN quizzed her about the med, route, and to whom it was to be given, and yet ...
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Old 08-14-2016, 08:56 PM
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When I was a student, my instructor was right at my side when passing meds. I not only had to pull them, double check them, have her check them, and I had to tell her why they were given and after I checked for allergies... she went with me into the room to make sure I gave them to the correct patient. That was the university's policy, and I was and still am grateful for it.
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