Another Nursing Incident

July 16, 2008

I wasn’t going to bore you with stories from work again, but again something happened. Yesterday I was taking care of the same patient that I have had for at least a week now. And every day, her potassium is low. Every day the doctor makes rounds in the morning, sees that it is low, and orders us to replace the potassium through her IV. Yesterday her potassium was 1.5 (normal is 3.5 to 5.0), which is a critical level because abnormal potassium can cause life-threatening heart rhythm problems. Nurses worry when it drops below 3.


The day before, her potassium had been 1.8. I was with my preceptor that day, and she informed me that although it was low, it was best if we just waited for the doctor to make his rounds instead of calling him. She said that he is very particular and hates to be called about things like low electrolytes which he can take care of on rounds. Yesterday, my preceptor wasn’t there and so I was more or less on my own. I waited for awhile for the doctor to make rounds, but he didn’t come. Finally I consulted another nurse. She also told me not to call the doctor for low electrolytes. So I didn’t.


I recorded my report, and in it I said that her potassium was 1.5 and so the next shift should keep an eye out for the doctor. When the nurse from the next shift heard my report, she came flying out of the room. She asked someone, “Is her potassium really 1.5 and nothing has been done about it all day? Did I hear that right?” And all of a sudden I was being bombarded by nurses asking me what was going on and why I hadn’t done anything about it.


I told them what my preceptor had said to me the day before, and what the other nurse had told me that day. Apparently I asked the wrong person. They wanted to do a formal patient safety report, so they went and talked to the nurse who gave me the advice. I was really upset because I like her, have to work with her frequently, and it was not my intention to get her in trouble. I was also given a “talking to” by more than one person.


They ended up asking the nurse practitioner on our floor to write an order for potassium replacement. The nurse who gave me the advice caught me before I left and said that she had put the patient safety report in her name. She said, “I personally still wouldn’t have called him. That’s my professional judgment. Reason being her potassium is low every day, the doctor is aware of it, and he is expecting it to be low again today. But anyway, I’ve been a nurse for 12 years and I can take the heat. Don’t worry about it.”


Everything ended up being ok, but it was very frustrating to have such an incident happen to me right at the end of my shift, when I thought I had had a good day. But I learned to never take one person’s advice if I’m not comfortable with it, and to always be an advocate for the patient even in the face of grumpy doctors.

Today her potassium is 1.6 and I had someone else call the doctor for me!

Posted in: personal

Comments on Another Nursing Incident

  1. 1

    From Tabaitha Kaye:

    I’m sorry you have had a hard week. The weekend is just around the corner and hopefully that will mean some down time.

  2. 2

    From Barry:

    Well, I say you did the right thing.

  3. 3

    From SarahThe:

    I know what that means! You’re the universal recipient! Just learning about blood types in lab, and finally, in lab, i feel a fantastic grasp on the information. Blood typing is really fascinating to me. Not enough to go into pathology or anything crazy like that, but fun, nevertheless.

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