It appears I have misworded my story in an attempt to make it brief.
Please disregard this thread.
A.R. Cane - Hope you never need an ER Nurse - you have been mislead my friend.
[QUOTE=Male_RN]
It appears I have misworded my story in an attempt to make it brief.
Please disregard this thread.
A.R. Cane - Hope you never need an ER Nurse - you have been mislead my friend.
[/QUOTE]
On this particular board, threads are never “disregarded.” Explain how you misworded your story, then get on with it. I promise you that you will probably get some good suggestions after a while. That’s why you posted here in the first place. But you may have to endure some criticism for a while.
[QUOTE=Male_RN]
I told you I screwed up. I told you legally I was wrong. I told you what I did was outside of my scope. Again… I’m asking for help, not critisizm.
Perhaps you (A.R. Cane) should read the whole story, as posted previously.
I am not a trouble-maker, just a Nurse who cares deeply for my patients. How long can you watch someone suffer in agony? Not long… if you have any heart.
[/QUOTE]
I reread your web page and all your posts in this thread. I see no acknowledgement, by you, of any wrongdoing, only criticism of others you work with. I, also do not see you stating that you would never do a similar thing again. I applaud you for trying your best to get the patient some help, but I cannot agree that you were, in any way, justified in giving meds. w/o a drs. order. and I believe that you might repeat this behavior in the future. If that possibility exists, I strongly urge you to find another vocation.
Ok (all bloodied up). I knew I was making a mistake, I knew that I would get in trouble. My military training taught me to improvise, adapt and overcome. It appears I took the wrong route.
I did what I did because I couldn’t watch this little girl agonize in pain anymore. Other patients were asking: “Is anyone going to help her?” No one else would. I thought that when I told my Director, she would help me get an order for the medicine I gave. Instead she went to her office. I deserved what I got, that’s not in dispute.
What do I do now?
Have I been misspelling criticism all this time? Thanks again Sam.
[QUOTE=Male_RN]
My military training taught me to improvise, adapt and overcome.
[/QUOTE]
It also appears that you missed something during your military training. Perhaps you’ve heard the expression “lawful orders” a time or two?
I think you should just count your blessings that you didn’t manage to kill this girl.
How much toradol had she already had in the previous few days?
Toradol is a great med, especially for kidney stone pain, but I worry about giving it to my patients too often, as it has this nasty tendency to shut down the kidneys.
In adults, the drop-dead maximum dosing is 120 mg a day for no more than 5 days.
In pediatric patients, the basic premise is to be even more cautious: Use the lowest effective dose for the shortest possible duration. For 2 to 16 years old, 1 mg/kg IM as a single dose, MAX 30 mg OR 0.5 mg/kg IV as a single dose, MAX 15 mg.
I’d rather have her experience pain for a day than trash her kidneys for her lifetime.
I can guaranDAMtee to you I’ll never repeat this mistake in the future.
So… can we move on?
Thank you Qadgop. She had recieved 30mg (1 dose) since her arrival to the Emergency Room. She had taken one oral dose (60mg) prior to her arrival. 11 hours before I gave a 30mg dose.
Toradol should also not be given 24 hrs prior to Lithotripsy. This was not planned d/t her already increased doses of radiation.
[QUOTE=Male_RN]
I can guaranDAMtee to you I’ll never repeat this mistake in the future.
So… can we move on?
[/QUOTE]
Yeah can we move on instead of, for example, setting up a webpage and starting a thread on a message board?
As I see it you got fired for making a decision that was not yours to make…subordinateness is a valuable commodity in this day and age… 
I would immediately take down the web page …it is too easy too find and presents you as fairly recalcitrant.
Buck-up!..say you fucked up and get on with your life…:eek:
Thats my take…ymmv,
tsfr
Male_RN, my mom is an RN with over 30 years experience. She’s taught in a BSN program and even been the administrator of a program. She’s been known to take her students to Board of Registered Nursing meetings so the students better understood the process - the good, the bad, and the scary. She also used to play a specific scene from Terms of Endearment where the mother went on a screaming rampage because the nursing staff wouldn’t medicate her daughter’s cancer pain to make the point that patients and their loved ones don’t care what your problems are. They want their pain taken care of.
I’m emailing her this link and asking her to comment. I’ll post what she says. (I strongly suspect there will be some harsh chewing out and then some real world advice.)
[QUOTE=ThisSpaceForRent]
As I see it you got fired for making a decision that was not yours to make…subordinateness is a valuable commodity in this day and age… 
I would immediately take down the web page …it is too easy too find and presents you as fairly recalcitrant.
Buck-up!..say you fucked up and get on with your life…:eek:
Thats my take…ymmv,
tsfr
[/QUOTE]
Best advice I’ve heard. Thanks, maybe just what I needed.
treis - Imagine making decisions that involve peoples lives, I make them every day. Unfortunately I made a mistake. How would you deal with the kind of pressure I’ve been under. The web page and forum have been therapeutic.
[QUOTE=Male_RN]
Best advice I’ve heard. Thanks, maybe just what I needed.
treis - Imagine making decisions that involve peoples lives, I make them every day. Unfortunately I made a mistake. How would you deal with the kind of pressure I’ve been under. The web page and forum have been therapeutic.
[/QUOTE]
Shucks dude…I been in the dog-house a time or two…It will get better…
good luck…
GO Danica…(obscure Indy500 reference)
tsfr
Move to another State.
you’d be suprised.
There is a shortage of Health Care Professionals, & many places will just overlook major things.
[QUOTE=Male_RN]
The patient had a home prescription for Toradol and it had also been given twice prior to my shift, so knew she wasn’t allergic to it.
[/QUOTE]
That’s not what I meant. Just a wrong dosage might cause a negative reaction. And just because you’re not allergic at first doesn’t mean you can’t develop an allergy.
I originally wasn’t allergic to pencillin, but developed an allergy after using it to treat an abscessed tooth. It makes be break out in a terrible case of hives.
Like I said, your intentions were noble-but you know what they say about good intentions.
Guinastasia - True. Yes I do know what they say about good intentions (lol). This is a perfect example. I have learned a major lesson. Maybe just not making it again is all the answer I need.
[QUOTE=Male_RN]
Guinastasia - True. Yes I do know what they say about good intentions (lol). This is a perfect example. I have learned a major lesson. Maybe just not making it again is all the answer I need.
[/QUOTE]
I think that’s exactly right. I don’t think you’re well advised to relocate and/or try to hide this incident in any way. It’s out there and it’s too easy to discover. I think you’ve got to be up front w/ a perspective employers and simply try to convince them that you’ve learned a valuable lesson and won’t ever repeat your mistake again. As has been said, it’s not the end of your nursing career, just a real rough spot. Persevere and you’ll outlive it.
[QUOTE=picunurse]
Not in my world. Verbal orders, sure, but giving a drug after being told not to? Of course, I wasn’t in you position, since I always had a doc within reach to drag by the ear to the bedside.
Rather than give the Ketorolac, I’d have held the Promethazine, since it’s an opiate antagonist, the Hydromorphone would have worked better. (Of course she might have barfed on you.) I know Monday morning quarterbacking isn’t helpful now.
Were you reported to your state board? If you’re still licenced, put it behind you and look for another job. I’ve known several nurses who were fired for mistakes that were able to get others jobs fairly fast.
Don’t dwell on the fact that you were left out in the cold by uncaring physicians, they are part of life. Our job is the teach them the compassion they missed along the way, it isn’t always easy.
Good Luck.
[/QUOTE]
Not contrary to orders,but in the absence of orders. Big difference.
[QUOTE=A.R. Cane]
I think that’s exactly right. I don’t think you’re well advised to relocate and/or try to hide this incident in any way. It’s out there and it’s too easy to discover. I think you’ve got to be up front w/ a perspective employers and simply try to convince them that you’ve learned a valuable lesson and won’t ever repeat your mistake again. As has been said, it’s not the end of your nursing career, just a real rough spot. Persevere and you’ll outlive it.
[/QUOTE]
Perfectly put. Thank you.