Yesterday my team nurse was at lunch when a certain high and mighty 1st year resident came up to look at one of my patients. She had spiked a temp of 102.7 at 0000 (she has pneumonia). The RN gave her Tylenol and called the doc on call.
Anywho, this resident shows up and calls me to the desk. She b*tches at me b/c they gave her Tylenol without conferring with her first. OK, 1-she wasn't on call for that patient. 2- The primary doc has standing orders for Tylenol on the computer, as he trusts us to give this. 3- This happened on NOCS. WTF am I supposed to do about it at 1300? 4- Why in the hell am I responsible for what the night nurse did?
I didn't say anything to that extent (because I didn't know the first 2). I just said that that happened at 0000, and if the doc was called, it would be in the chart (which it was). I also gave her 0800 and 1200 VS's (which were FINE). She THEN started to chew me b/c it doesn't show that her temp was taken until 0400 after the Tylenol was given. Again, I am not psychic....how am I supposed to know? I'm assuming that the temp was taken before that, but I can't say for sure. I just shrugged my shoulders and said, "I can't help you. That wasn't my shift and nothing was said in report."
What should I have said?
I told my team nurse and she left a note for our supervisor b/c this resident is a problem always.....
Anyway, just wanted to vent. This is my first doc chewing....
Feb 17, '03
I think you did very well, and in months to come, you'll perfect the "icy glare" to accompany giving info to those residents who make complete nuisances of themselves.
Last edit by Sleepyeyes on Feb 17, '03
Feb 17, '03
Well, I don't treat interns or residents like that. I know they are learning too. A nearly 103 temp on a surgery patient...yeah, cultures are in order. I know that. It's the best time to get the cultures with the temp that high, the best time to isolate the culprit and save the patient much discomfort, a prolonged hospital stay, and a higher bill...if you can get those preliminary cultures going and get the patient treated.
And yep, it's easier to give 2 tylenol, turn down the temp in the room, pull off a blanket, increase fluids. But, if it is your mom or your kid, which way would you want it to go. ?
Usually, the resident/intern is expecting you to pass on the info to the night shift. They are talking to you the same as they talk to the other members of the team. What this resident was really saying was: Which idiot - non thinking- lazy nurse saw this 103 temp and gave tylenol & let it go at that??? And , the patients temp may have been 104.4 at 0200 and WHERE is the follow-up??
Yes, they get *****y when the common-sense nursing follow-up responsibilities are not done and/or not documented. Yes, she knows you weren't there last midnight...but she is hoping you will pass it on to the next shift and also hoping this will "stik" with you the next surgery pt. you have with a 102 or > temp...
with 102 or >, you don't take temps q 4 hours.
Docs do get tired at our irresponsibilities too and they can't be there 24 hours a day. Calling her for every 100.4 and telling all the other nurses to do it too...........childish and unprofessional.
I don't play games at work. she had the patients welfare at heart. It's hard to carry all the nurses around on silk pillows and handle them with kid gloves. What would you have done if you were in her shoes? She wasn't chewing you out, IMHO. She's trying to get answers --why wasn't common sense basic nursing obligation carried out?? And, yes, she's ticked, and thinking of the myriad serious>devastating consequences of the 0000 nurses mindless "therapy.".2 tylenols
Last edit by passing thru on Feb 17, '03