Just Call Him Hal

, , , , | Healthy | August 2, 2020

I’m a nurse on a busy med surge floor. Shift change has just occurred. My CNA calls me to let me know one of my patients’ blood pressure readings is high. I pull up the chart, check the newest results, and realize their drug test is positive for absolutely everything drug we test for and they also have a very high alcohol score. I go into the room to access my patient and as soon as I get in, I know they are starting to go through withdrawals.

I call the doctor immediately to get a drug and alcohol withdrawal medication bundle on. I end up getting a brand-new resident. I introduce myself and explain the issue.

Me: “…and I need a stat order on the drug and alcohol withdrawal med bundle. Thanks!”

Resident: “I’m new; I don’t know what that is.”

Me: “No problem.”

I list the meds I need, the dosages, frequency, etc.

Resident: “I can’t write those orders; those are controlled medications.”

Some of them are, but most are anti-nausea and anti-diarrhea meds.

Me: “You’re a doctor; you can write controlled meds. This is a standard medication bundle for this issue.”

Resident: “I don’t think I can write those.”

Me: “Is [Doctor] there? Can you put him on speaker, please?”

He does and I repeat the request.

Doctor: *To the resident* “Start typing what the nurse tells you.”

Resident: “But I can’t write those orders; they are controlled.”

Doctor: “I’m only going to tell you this once more. Put in all the orders the nice nurse tells you right now. We have a patient who is about to go into severe drug withdrawals. She is trying to avoid the massive projectile vomiting, diarrhea, and seizures that are about to happen. Nurse [My Name], how long do you think we have?”

Me: “Thirty minutes, maybe less. They are already starting to sweat and look a bit green around the gills.”

The new resident was still arguing with the doctor that he couldn’t write those orders. The doc got fed up with him and told him that from then on he was to write every effing order I told him. I got my orders.

A few days later, the new resident was on the floor. I went up to get a med order and he started again with the “I don’t think I’m allowed to write that.” I smiled and let him know that I was nurse [My Name], and that he might remember that the doctor in charge of him told him not to argue with me about med orders. I did have to show him how to put them on, but it got done.

The other nurses asked how I managed to get orders out of him because he’d been pulling the same garbage with all of them. The doctor ended up giving him blanket orders that he was to listen to the nurses, and if he really wasn’t sure to call him or the pharmacist, but he was not allowed to utter “I don’t think I can write that” ever again.

We are wondering if he’ll last through the end of the month.

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