. : s i e s t a : .

Wednesday, July 02, 2008

It Wasn’t Me

Someone I hardly know went our house this afternoon. She’s from the farthest compound of our barangay; very far from our house. She said, she was looking for a nurse and found me. Her purpose for her visit was to ask favor if I can insert an IV line (dextrose) on his sick father. Her father is bedridden and needs vitamin infusion. And so, I said “yes.”

After a very long walk to their house, she introduced me to the patient and gave me the materials needed. I was saddened when I saw the needle I’ll be using. It was a butterfly IV, an old and nearly faced off needle use in IV insertion. I was worried ‘cause I seldom used this kind of needle. Insytes or introcan are the IV canulas commonly use nowadays.

While I was preparing the IV line, I was shocked when she told me to add vitamin c on the dextrose. As nursing standard, I asked if there’s any prescription so I can give the medication. The lady showed me a prescription saying, “Infuse 1 ampule of Vitamin C to D5LR to run for 20gtts/min.” The order was clear. But when the lady gave me the vitamin, I was surprised again. She handed me a bottle of vitamin c capsules, branded “Vital-C”. On a nice manner, I clearly state that I can NOT give that medication. It was not as prescribed by the doctor. So, I refused to give it. But they insisted that the doctor instructed them that if ampule is not available they may use diluted vitamin c capsule instead. That was COMPLETELY strange. I never heard nor learned that an oral medication may be given through IV injection or infusion.

What I did was to explain clearly my side and reasons why I can’t give that medication. I don’t want to take any risks.

Then, she called the doctor who gave the prescription. The doctor clarified the order. “I understand why the nurse wouldn’t give it because it is unusual…but it may be given that way,” the doctor said. I never knew this doctor and this ‘Vital-C’ and so I still refused to give the drug. But they seem so sure. She even told me that the nurse yesterday just did it. Since they insisted, I gave them an option.

The option was that I will insert the IV (since there is an order) but I won’t give the medication. I said, it’s up to them to give the drug and I won’t give any responsibility in it. So, I explained the legality again CLEARLY, and they understand that I have no legal accountability. I successfully inserted a butterfly needle on the patient’s right hand vein, aseptically. And SHE gave/incorporated the said vitamin on the dextrose solution. Not me.

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posted by arnie at 9:20 AM


And I thought I've heard and seen everything in Nursing, til I read this. lol.

Wise decision, colleague.

10:31 AM  

if i were in your place, i'd do the same thing as you did.

i wouldn't take the risk. mahirap yun.

10:40 AM  

same here..mahirap na ang nagbabakasakali especially if life is at stake.

4:13 PM  

napadaan lang...

4:45 PM  

first time i heard such as thing. pero i would have done what you did. good for you. =)

4:52 PM  

hmmm, ur one of the good nurse! :)

same thing gagawin ko rin yung ginawa mo, but since undergrad ako ng nursing course malabo na mangyari un! lolz

i added u na sa links ko!


5:14 PM  

@ kris jasper,
oo, sa dami ng books/reviewers na binasa ko noong nagreview ako for board hindi ko akalain na marami pa rin mga bagay ang matutunan mo naman clinically.

@ trina,
yup, ayoko mapahamak ang pasyente ko.."safety first."

@ ponchong,
oo nga...bakit ko gagawin ang alam ko hindi tama diba? salamat.

@ pensuck,
no problem...come back anytime.;)

@ madz,
oo, diba? kelan pa ginawang throuhg IV ang isang oral med?:O

@ veradik,
salamat.:D basta, pag nasa ganong senaryo ka..gawin mo ang tama.
masaya ang nursing...galingan mo sa studies mo.:D

5:59 PM  

what a nurse! what a nurse! hahaha! legality.. tsk tsk... hehehe... wadapak, butterfly? The last time I've seen it was during our IV Training! Uso pa pala yan? LOL... Sana naman IV 3000 ang ginamit mong plaster... Hahahaha...

6:57 PM  

Are you from UPM? With your experience and other compounding medical incidence in the country, I felt that the the profession is loosing it. You know that my thesis is on: "Physicians' Discernment on Euthanasia involving Terminally Ill Patients" where euthanasia is defined as both active and passive. Anyway, just so you now. ^^

Re my post, as much as I wanted to serve the people here,...The push factor is much stronger. My future tax remittance would keep the economy floating though. Or I could do diaspora philanthropy.

7:54 PM  

hindi ka ba magiging accessory to the crime pa rin dun? aware ka sa nangya(ya)ri pero wala kang ginawa.
hala. :)

-padaan lang po-

8:57 PM  

i dont know much about injections and stuff but I think you did the right thing.

9:41 PM  

napaka-wise ng decision mo. mahirap mag risk lalo na kapag may title ka. mawawalan ka niyan ng license if ever.

Napaka-clear ng explanation mo kahit hindi ako nurse.

12:12 AM  

good boy! hehehe :)

6:35 AM  

hey arnie..KBI's actually the call center i worked for, nlo2ko ku lan cla tentay jham at pel! ;) nways, im feelin kinda sick cure me pls! heheh

2:00 PM  

@ janus,
oo nga e. nagulat ako...sa clinical practice ko, wala na akong nikikitang butterfly. Akalain mo, may natitira pa palang ganon sa mundo. hehe!

@ eliot,
nope, i am not. your study about euthanasia is very interesting. though i am pro life, if i only have two option as nurse on either passive or active...i prefer passive euthanasia.
i admire philanthropists like you.

@ amicus,
hindi. walang crime na naganap. haha! yun nga, wala akong ginawa.;)

@ nico,
thanks. if you are interested, you can take up nursing. (recruiter) hehe!

@ redlan,
hehe...oo, syempre ayokong matanggalan ng lisensya kaya hindi ako nagtake ng risk.
natutuwa ako at nakarelate lahat kahit hindi nurse.:D

@ odin hood,
:D i just did what's right.

@ damsel,
ohh..yun pala yun.
teka, anong sakit mo? kung sa puso yan e hindi ko magagamot. hehe! pero, pede akong magrender ng nursing care sa yo. hehe!

7:17 PM  

i am proud for you arn,sana naman ganyan lahat na worker sa atin..peace

8:01 PM  

good move pare...kakaloka naman...oral drugs to iv fluids?

3:02 PM  

@ nice,
salamat. nakakatouch naman... im sure marami pang ibang nurse na mabait jan...hehe. basta, pinoy.;)

@ shiela,
oo nga e... pede ba yun?
mukhang more on alternative medicine nga sila e...

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7:35 AM  

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