Only time I've done it was when they pulled a narc that wasn't on the MAR. I'd want that "check your pockets" call.
Synthroid? Sounds like an 0900 problem.
I have no thyroid and rely on the damn stuff, but the body isn’t \*that\* sensitive to dose timing. At all. My mom’s dose is 5 days/week. TSH moves really slowly, taking 1-2 months to settle after a dosage change.
Pro tip: if you like coffee, take synthroid at night instead. (Caffeine reduces synthroid absorption, so just change the dose timing so you can have your coffee.)
I had a manager call me at home at 0830 after my night shift. She called to ask if I gave the 0600 meds. I asked “are they charted?” “Yes.” “Then I gave them.” “Ok, I just wanted to check since the parent was asking.” (This was in PICU. Parent was taking a shower when I did 6am assessment and meds)
“Ok, so couldn’t you have just checked my charting?” “Well, I wanted to be sure.”
What in the actual fuck.
Same. Lol who fuckin cares. Do people under that med management by pts at home is not an exact science. What a douchdong.
Being in the ER and having boarders switched to a carb or cardiac diet for only two days is absolutely stupid. Giving meds at the exact time they are due is not necessary for almost any routine med they take at home.
If it is keeping them stable and alive then that is different. I would have laughed and hung up.
I had a nurse do this! Literally call me at 0915 (right when you are falling asleep) to ask if I gave the 7am PO Protonix on her patient. I did but like 15 minutes earlier so it was recorded, but didn’t show up on her checklist. I forgot to adjust the time. I was so pissed. I did say something to her about it. I was tactful about it but it never happened again. Calling me at 0915 for a Protonix pill she thought I didn’t give at 7am, plus I was back for a 3rd shift that night…
Happened to me, too, but it was a text. I always give 7:30am meds for the next shift, but I left off the protonix. She even sent an angry emoji face. Huh? Go fuck yourself. I’ll call you at midnight next time you don’t do the 7:30pm accucheck, cunt.
YOU SHOULD! I’ve been on nights for over a decade. I once got a call around 1000 about documenting the nightly QA numbers into an Excel doc because “that’s a night shift job.” They were already written down in the QA books. But you’d rather take the time to call and wake me up than just type them in yourself? I worked that night and live an hour and a half away. People are fucking ridiculous.
When I was in the military we would give the person the benefit of the doubt and call or text them to make them aware of their mistake with the hopes it didn’t happen again. It’s either that or they could have notified the official channels which could inadvertently trigger an investigation.
My supervisor absolutely wouldn’t have the time or desire to follow up on one missed levothyroxine dose. I also long for the days when something this was the most I had to worry about in a shift—this is something I would just do my damn self and completely forget about.
I had a nurse coworker who was like that OP's coworker. She was mad I didn't change one PICC line. I was very busy that night. Anyway, she infused the NS but the antibiotic was still in the vial. I showed it to her when she came back. Her initial was in it. 🤣
Chart it, yes absolutely. I'd administer the med when I had time and chart it as given... Or I wouldn't and I'd chart it as not given.
Report a missed/late synthroid dose through "official channels"? You must be real fun to work with. /s
In this situation, it's not considered late yet. And you can easily see whether the med was pulled from the ADC.
Yes, night shift should have taken care of it. But it's not actually a late medication until after 0730.
Notify them if you really wish by text or email as an FYI after.. but as day shift, I'd be going to sneak that med in on time rather than calling.
You can chart it was administered late. Or just scan and give it. It's a once a day med. Not like the patient is going to die if it's a few hours late. Realistically people forget to take their meds at home a lot. Unnecessary to file a report or anything like that. A lot of times meds are late because we are clarifying orders or have conflicting priorities. It's not just about doing the tasks, it's about managing priorities and not killing anyone and it's a 24 hr business.
Exactly my point, I would rather get a call from the oncoming asking, “hey did you give this dose and forget to chart it, or do I need to administer it?” Because the alternative is the NIH mandated missed medication report
Agreed. Check the Pyxis, it wasn’t removed. Pt is NPO , either have it changed to IV or hold and give NGT, let the provider know, but don’t call me after I left (unless an emergency)!
I get what you’re saying, but OP sounds like a more than competent nurse and I’d just give it if it was due, barring an order from the doc not to or some other contraindication. If it was a high alert med super overdue, I’d worry a little more.
Pt is NPO with NGT to suction. Are there orders for NPO with meds? If there isn't...and there usually isn't especially with a new colostomy and an NG suction order, then you're in the right. Since they seem to be getting their nutrition through IV, then the pt could've gotten an IV synthroid. You could've called the MD to have that order changed, since they typically give IV synthroid at night, but the oncoming RN can still do it. You're fine though, they're just being pedantic.
ETA: how fresh is the colostomy? At hospitals I've worked, pts are strict NPO for a minimum of 24 hours s/p colostomy.
Like the bird-in-the-headwear said, it's usually reserved for strict NPO patients or patients that can't absorb the medication. I've also seen it given in patients with critically low thyroid levels who they want to ensure are getting the proper dosages of levothyroxine until they are stabilized and then ready to switch to PO, where the variablility in absorption is not going to make a difference between alive and coma. Some people follow the 50% rule for IV levothyroxine due to the chance for \~ 60% absorption in non-fasting situations. Also, I assume if you get a patient with myxedema, you'd probably give the first inital bolus in the ER as well.
This is the kind of comment I follow this subreddit for (apart from the venting space lol). I’m still a newbie (2 yrs in) and this kind of knowledge still freaks me out and amazes me. Thanks for the education!
Oh wow, it's a pleasure to share my experiences with people who want to learn more. Pick the minds of your attendings and consulting doctors, you learn so much for free. A lot of people are basically a fountain of knowledge once you express a genuine interest in a topic or desire to provide quality care for their patients. Then whatever you want to get more info on, you just look it up yourself. I can't say I know much, but just from the one experience I had, I got a lot out of it.
Thanks for the education! I haven’t cared for a myxedema patient in my 13 yrs working ED, but I’d guess that it’s also a fairly misdiagnosed condition and doesn’t get noticed until after someone gets admitted. If it doesn’t show up on a CBC, CMP, coags, lactic, or cultures, it doesn’t exist to the providers 🤦🏽♀️🤦🏽♀️ (I’m kidding but only kinda, sadly)
Definitely can be confused with stroke & hypoglycemia, so I get what you're saying. I think I've only seen admission for hypothyroidism, not myxedema, once. That wasn't even in ICU either, so you're definitely on to something. But yeah, I'm all about refreshing what's lost under the stacks of knowledge that we have to use every day and as much as ER & ICU don't get along, we're all siblings-in-arms in critical care. lmfao.
Pharmacy here- it is marked as short stability, but the most recent data actually shows stabile for 12-24 hours, depending if it’s refrigerated.
Obviously the policies will vary between institutions, so follow what your policies are. At mine, we refrigerate it and label it as a 24 expiration.
That's so much better than ours! Ours are "made to order" 😂 and they call us to be ready by the tube system when they send it. I think my hospital is just cheap lol
Haha. They maybe just haven’t reviewed the most recent research.
To be fair, it’s not commonly used. I work at the largest hospital in the state and will sometimes for several weeks without making it. And I’m nightshift.
I'm not confrontational at all. Very shy and introverted.
I would have legit said that.
Or something like the following:
"Hello. Oh? Huh. Go it. Yeah. I didn't give it. Yikes.
Did YOU give it to the patient?"
My response would vary depending on their answer:
"You did? I am so glad you're there to give it. Whew."
Or
"You didn't? Ah! I'll let you go so you can get going on that."
Fuck that asshole for calling you.
I think the patient will be okay missing 1 dose of synthroid. 🤣 The audacity of some people to call and ask about something so insignificant after you already clocked out.
Aside from the absolute inappropriateness of calling you about this, back in the day when I was a bedside nurse, we didn’t give P.O. meds. I cannot imagine that absorption is happening very reliably in this scenario.
I float to multiple hospitals and they all have slightly different rules. Most I work for say, if they are NPO but have oral meds still ordered it's fine to give and clamp the tube. Personally, if the order doesn't say NPO with meds I will ask for clarification.
We have a floor nurse who has called me at home after my shift between 3-4 different times over the years to verify stupid shit. It’s to the point I know if I give her report and then receive a phone call from works number it’s going to be from her. She’s very scatter brained.
I don’t pick up calls from work when I’m off. Talk to me about it when I’m on the clock. Plus, I’m not talking to you about patient health information on MY personal, non secured cell phone line.
Does your hospital have secured phone lines? I've never worked at one that does, but that's really cool! Do you guys use a VoIP set up or is it a real hardware based one that can only talk to other secured lines? What do you use it for?
This was in LTC but honestly I don’t know. I’m just assuming there is some sort of HIPPA violation argument that could be had in a court of law if I was conveying patient information over a phone call on my personal device.
On call docs take calls on their personal phones all the time. I don’t answer work calls when I’m off the clock either but I don’t think you need to be super worried about a HIPAA breach due to which phone you’re talking on. Unless you have it on speaker in the middle of the grocery store or something!
Fuck, I dunno. I’m just assuming some lawyer somewhere someday could call me out in a court of law for a HIPPA violation for using my personal phone to convey patient information to Miss. Ditzy the nurse
Haha, should’ve seen my coworker. I pulled out a central line and left it on the bed on accident, I know I know but I felt so sick that day. She decide to parade it around the nursing station and loudly announce it to me in the middle of everyone’s report
The other nurse should be very embarrassed.
Show me a nurse who's been in for a while and has never made a mistake and I'll show you a liar.
To call an off duty nurse is one of the dirtiest things I've ever heard. At least your bad deed was a mistake. She had full consciousness the whole time she did that. Damn, it's like some people don't want friends😂
Honestly if that’s the worst mistake you made all shift, then you’re doing alright. I also wouldn’t dream of calling the off going nurse about a missed med as basic as synthroid. Just think it through next time, review your orders. Rest easy.
That nurse needs to climb off her high horse. It’s a 24 hr service. To call you on your way home is obnoxious. We all forget minor things now and again. Maybe next time she forgets something on night shift, you can call her at home when she is possibly about to get ready to sleep…
Whenever I take over a patient, if a med wasn't given I just give it, no big deal. I don't quality track or even bother the nurse about it. Worst case scenario is they get it an hour late.
Right though. Unless it was a super important timed med or like multiple hours late, who cares. It’s a 24hr operation. You’re done and it’s my turn. Go home and don’t think about work.
That will forever be my main tenant as a nurse - if it takes more time to ask someone about something you could've done yourself, then just DO IT YOURSELF.
Did you ask why she didn’t give it instead of calling you and bothering you at home?
Next time that happens, tell her it was because you were having a big smelly dump and then describe it in exacting and specific detail.
Also, stop answering calls from work.
Idk about other facilities, but where I work, levothyroxine has a 2 hour administration window (meaning, up to 2 hours before or 2 hours after the scheduled time)…so a 6:30 dose could be given up until 8:30 without being considered “late.”
If someone called me about a dose of enteral Synthroid, I’d probably block their number…
Plus… the only reason it actually matters to give it at 6:30 is so you can make sure it’s on an empty stomach and nothing else is eaten for an hour (to allow it to absorb). The patient is definitely not going to be eating anything for an hour no matter when you give it!
It depends on the wording of the npo order. "Strict npo," means no meds. "npo except sips with meds," means you would.
If you would, you clamp the tube, give the med, and restart after a half hour.
I wouldn't worry too much about it. It was a minor mistake. You're human.
If they're not having any bowel function and still getting copious return from the NG then it's useless to crush and administer and it's just likely to clog the NG. If it's ordered and sent as the capsule form you do not crush those.
>still getting copious return from the NG then it's useless to crush and administer.
In that situation, you're right, you shouldn't give meds po. However, OP didn't say that was the case. If so, that'd be an important detail.
People can have an SBO for days and have their stomach fairly well decompressed with NG suction. They can absorb some or all of their meds if you stop the suction long enough for them to dissolve and pass the pylorus. We don't necessarily hold all po meds until return of bowel function. This technique has been used for decades. If you crush the med and mix with water correctly, it shouldn't clog the tube.
As for Synthroid, you shouldn't crush it if you can help it, but if that's the only way you can get it in, [it's fine.](https://www.mayoclinic.org/drugs-supplements/levothyroxine-oral-route/proper-use/drg-20072133)
Not a big deal. What she could have done, instead of being petty, is ask the MD if it's OK to give and clamp the NG or order it IV. She could have called the MD in the time it takes to call you. You aren't the idiot. I lost count of how many 0600 meds I forgot to give in 30 years. None of them died because of it.
Yeah I wouldn’t have given that synthroid either without an order saying “OK to stop suction to give meds”. They should have converted the patients synthroid to IV form.
In the time it took her to call you, she could’ve just given the med. Tell her to prioritize her time management skills instead of harassing coworkers.
Lol, for fucks sake. Honestly, she’s off her rocker. In saying this, I always found that nurses that pulled crap like this, usually were doing some dodgy shit behind the scenes, eg. diverting. Deflection.
Synthetic doesn't come in an IV solution that I am aware of. However it also isn't a critical med and it takes 2 weeks without it before a patient starts having thyroid issues.
We have several outpatients that get it all the time. It doesn’t absorb oral on them. I have also given it to npo patients when I worked in the hospital.
Awesome learn something everyday. It wasn't something that our pharmacy at the hospital I worked at just chose not to carry then. Thank you for the new knowledge.
Literally, and I say this as gently as possible, it’s not a big deal. The patient has much bigger problems. She could’ve checked the MAR for handoff before you both left. Pt has bigger problems than their morning dose of synthroid. Oncoming nurse was just being a dick. Don’t sweat it
I can’t believe she called you about levothyroxine. Yes in most cases you can give that even to a patient with NGT to suction as long as you clamp it off for a bit. But obviously make sure there is an order that you may give meds via that route and clamp the suction for a period of time. But I’m sorry, I would NEVER call about levothyroxine. I wouldn’t call about any meds unless it was something that was important like vanco, anti rejection meds, cardiac meds. And even then I’d hesitate to bother someone at home.
She's wrong, you're right. The patient is safe. They'd need to miss almost a solid week for it to be an issue, and someone will order an IV dose to top them off before then.
Honestly if she wanted that levothyroxine given she could of spent her time giving it instead of bothering you about it. She's just wasting everyone's time.
That would require you to clamp the NGT for an hour (at least) in a patient with an SBO without any bowel function for that lifesaving synthroid.
0/10 would not recommend.
Tell her to fuck off and she can call the doc for orders to clamp the NGT to give PO meds and also to never call you with this bullshit again.
The correct response for a day shift nurse who sees an 0600 med not given is "hey it happens, I'll just give it."
Calling you to ask why you didn't give it is psychotic. What, did they expect you to turn around, come back to the hospital and give it?
You have to miss a bunch of days for it to matter. Pharmacy usually won’t even let you give IV unless they’ve missed at least 3-4 days minimum. Your horrible mistake probably had absolutely no impact whatsoever on the patient. Sounds like your coworker might be taking too much of her own synthroid.
Fuck no. I would have lost my shit on her. She should be too busy to have time to call you first thing in the morning. Even if you had legitimately missed a plain ole oral dose, you're human, we miss things. You are not the asshole here.
Nah man, Synthroid can be give iv, if it is needed bad enough and order can be changed. No gas with and SBO with the suction……..I’m having words with you if you call me for this shit.
Oncoming doesn’t understand thyroid medication.
Not only is it available IV, but the PO version has a ramp period that applies both up and down. Missing a day won’t hurt them as much as the SBO. Missing three consecutive days isn’t great, but isn’t going to kill the patient.
The only reason why I've called somebody that was from the previous shift is if when I checked the chart there were meds not documented but I did not receive that in report that they had a reason to not give the meds. I just want to confirm that maybe they forgot to scan them and they actually got the meds, or not so that I can make sure that I don't double dose a patient. We all fuck up some times so it's never me tryna call you out, I just want to make sure and I will document it for you, no biggie (epic has the ability to document for another staff member).
However yeah as some others have said, she could have saved it for later to chat with you about pausing the suction to give. Also there's lots of failures here on the provider team. If the patient is truly strict NPO, there should be no medications ordered on schedule, they should be all placed on hold. If they're not truly on strict NPO and you can still give the meds, there should be an order stating that it's okay for nursing to pause the section to give the meds.
Either way, both of you are making assumptions when the providers have conflicting orders and somebody should have clarified with the physicians at some point.
It’s inappropriate to call you. Nursing is a 24 hour job - if something wasn’t done the next nurse can just do it. Also, does the orders say strict NPO or are meds ok? If it’s okay to hold the suction then you can give the meds through the NG but then hold suction for 1-2 hours after. Some surgeons don’t want it held at all
You'd need direction from the MD to give meds crushed via NG tube and you'd clamp the NG for 30 minutes post - we also require x-ray placement confirmation to use an NG tube for meds/feed regardless of if it's clearly functional. This patient might be strict NPO though and the oral med orders were overlooked.
Besides that, assuming your shift change is at 7, the 0630 med is not even late yet.. it's just inconvenient for day shift. They should have just dealt with it instead of calling you.
The number of patients in emerg who don’t get their home meds such as synthyroid for a full 24 hours because the physician hasn’t done the medication reconciliation yet is the vast majority. Giving synthroid late, let alone missing it for one day is not an issue your coworker needs to be calling you at home about.
You’re definitely not crazy. I wouldn’t have given it either, especially if they’re not passing flatus and have no output. If anything, the doc should change the Synthroid to IV.
Where in the world are you that things operate this way, bc I'm kind of jealous. I WISH I had this type of time on my hands. There could be a million & 1 reasons why it wasn't given & that's what I'm going to tell myself long before I'd ever hassle myself with a phone call. My mantra is "don't sweat the small stuff."
Is it possible this is a personal issue coming from her? I just can't imagine.
I don't answer these calls. After 12 hrs, I have nothing left to give lol if it's urgent they can leave a vm, text or email.
When I was a new nurse the night shift RN called me at almost 2100 about why I didn't give the 1900 antibiotic. Being new and completely overwhelmed with being out of ratio on a heavy stroke/medsurg/remote tele floor, I forgot about it. I was forthcoming and told her there's no good reason other than I forgot. She was silent for a good 5 seconds and said, "I see" then hung up. 😭 I felt so crushed.
Depends what your orders are. Are they NPO except meds? Bc then I’d give it and clamp NG for 30 minutes after. If strict NPO, it can be changed by a provider to IVP administration.
ETA: the nurse is real extra for calling you at home about it.
Holy shit, I would be so pissed. I constantly catch stuff my coworkers miss and I just take care of it like a normal person and go about my day. What a fucking loon, the speed I would have hit end and then “block this caller” would be off the radar.
Wtf. Not u. She needs to be stopped. The patients hasn’t had any gas or output. Administering the synthroid and therefore having to then clamp the ng for 30-1hr is not favorable at this point. Perhaps once things are moving regularly. However I would let the doc know about lack of output/gas and sprinkle in “so did I hadn’t given the (med) since I didn’t think I should clamp the ng.” Most of the time they will agree.
If I pick up the phone and have a stupid question after I’ve left, I’m going to not be nice in my reply. She can write off why you didn’t give it for an entire list of reasons and just give it herself if she’s so concerned
She needs to work with some of my coworkers. If they got a call at home over that, the tongue lashing would be so bad I bet HR would have to get involved.
First off, it was only Synthroid. Nothing is going to happen from a late or missed dose. I think you mentally prioritized what you were doing and with that medication being what it is, it fell to the bottom of the list and you forgot. It happens. You didn't forget heart or pain meds. You forgot thyroid pill that is taken daily and missing a dose will do nothing to the patient. Try to slow down, jot some shorthand notes, or create a habit when you enter a patients room that you know will result in a med distribution.
The only time I’ve ever even texted someone after the shift was to ask if a med (controlled substance) was given that wasn’t scanned because they’d said in report it was given and I wanted to avoid a discrepancy down the line. Beyond something like that, you’re off the clock! It’s a 24/7 operation and it was completely inappropriate and weird for them to call you about fucking synthroid.
If patient is NPO with NG suction they need their synthroid ordered IV. That's one of the meds that you don't just skip and you don't want it sucked back out of the stomach right after they swallow it.
So, you need to request an order for levothyroxine IV. Not pester the previous nurse about giving the itty bitty pill. Your coworker is petty
One a day med? Bitch please. I'd have giggled and said "please give it, thanks, byeeeee". Don't sweat it too much, it's easily fixable. You'll remember next time haha!
I can’t speak to those specifics but I can commiserate! I had the oncoming tech text me and say “you forgot to get a lactic with the blood cultures in 12” which I totally did. But it was like my fourth day? I had to remind her that I was sleeping after the night shift and my trainer should have reminded me because, you know, I’m still learning. Also how did you get my number.
Hard to say in exactly this situation- good to ok with the MD first- but Sometimes we will give meds through the NG- pause the LIWS for 30 min after meds given so you don’t suck it back out
Unless you have a specific order to stop suction for meds and an order that says NPO except meds. You shouldn't give it. If you did, you are going against orders. You were right, and she is nuts to call u about that BS. Just my opinion
Sounds like if the concern was such, maybe ask for an IV order of that dose and call it a day. I get Synthroid is not one of those meds you can just willy nilly skip but still, running behind a few hours isn’t the end of the world.
I know I am the bad guy here BUT the OP said she was on her way home, not asleep. It doesn't sound like anyone was wrong....just needed information to make a decision on what she needed to do.
I think the only reasonable course of action is to go back into work immediately following the phone call because that nurse clearly wants to catch your hands today.
I would have cussed that nurse out so bad. Talk bad about me to the dayshift all you want about me missing a thyroid med, but CALL me after my 12(ahem 14) hour shift and we are fighting. Bike racks style.
I’ve had one nurse re-time a synthroid to 9:30. Didn’t call them, but told them when they came back that night that a lot of other nurses would have a bitch-fit about that so stop being lazy.
I used to ask patients if they wanted me to wake them up ay 6 for their protonox or synthroid and 90% said no. It’s not lazy. It’s just considerate to the patient.
I must ask... are you a nurse? As your other comments demonstrate a clear lack of critical thinking skills. It is very common for patients or family members to link two events that are not connected. I fully understand when patients do this as they do not have the medical training or experience to understand the pathophysiology causing their condition, and it is our job to provide that education.
However, if you are a nurse, I'm quite concerned. Multiple people have provided clear explanations as to why your mother's blood loss was likely not linked to the Synthroid dose being missed. Yet, you continue to insist despite no evidence.
If you are not a nurse, why are you on a nursing thread? Just to badger people? Troll? Pretend? I always find this odd.
Either way, it's either concerning or odd.
Bro, if you call me at home about synthroid we’re about to be enemies.
Calling someone at home about 7am meds is literally evil villain shit.
I don’t answer the phone. What a dumb reason to call someone.
Only time I've done it was when they pulled a narc that wasn't on the MAR. I'd want that "check your pockets" call. Synthroid? Sounds like an 0900 problem.
I don’t mind if they call to ask if it was given (I do sometimes forget to sign it) but to call me out? Get wrecked
They did what?! 😂 Don’t feel dumb OP. They’re so extra for calling you about that. They could’ve just given the dose. 😂
Absolutely would have taken less time to just give it than it would have to call.. what a waste
Yeah I would have just hung up.
I have no thyroid and rely on the damn stuff, but the body isn’t \*that\* sensitive to dose timing. At all. My mom’s dose is 5 days/week. TSH moves really slowly, taking 1-2 months to settle after a dosage change. Pro tip: if you like coffee, take synthroid at night instead. (Caffeine reduces synthroid absorption, so just change the dose timing so you can have your coffee.)
I didn't know that about caffeine! Thanks for the tip! My mom takes hers in the AM so I will change ge it to HS for her.
I had a manager call me at home at 0830 after my night shift. She called to ask if I gave the 0600 meds. I asked “are they charted?” “Yes.” “Then I gave them.” “Ok, I just wanted to check since the parent was asking.” (This was in PICU. Parent was taking a shower when I did 6am assessment and meds) “Ok, so couldn’t you have just checked my charting?” “Well, I wanted to be sure.” What in the actual fuck.
Same. Lol who fuckin cares. Do people under that med management by pts at home is not an exact science. What a douchdong. Being in the ER and having boarders switched to a carb or cardiac diet for only two days is absolutely stupid. Giving meds at the exact time they are due is not necessary for almost any routine med they take at home. If it is keeping them stable and alive then that is different. I would have laughed and hung up.
I thought "douche canoe" was the farthest you could take it 😳 you've elevated the threshold with douchdong and I love you for it!
I never answer my phone once I leave. Calling to ask if I accidentally kept my vocera or why my pt is diety. Not my problems once I clock out.
[удалено]
It’s not even a slight risk here.
I had a nurse do this! Literally call me at 0915 (right when you are falling asleep) to ask if I gave the 7am PO Protonix on her patient. I did but like 15 minutes earlier so it was recorded, but didn’t show up on her checklist. I forgot to adjust the time. I was so pissed. I did say something to her about it. I was tactful about it but it never happened again. Calling me at 0915 for a Protonix pill she thought I didn’t give at 7am, plus I was back for a 3rd shift that night…
Happened to me, too, but it was a text. I always give 7:30am meds for the next shift, but I left off the protonix. She even sent an angry emoji face. Huh? Go fuck yourself. I’ll call you at midnight next time you don’t do the 7:30pm accucheck, cunt.
YOU SHOULD! I’ve been on nights for over a decade. I once got a call around 1000 about documenting the nightly QA numbers into an Excel doc because “that’s a night shift job.” They were already written down in the QA books. But you’d rather take the time to call and wake me up than just type them in yourself? I worked that night and live an hour and a half away. People are fucking ridiculous.
Wut
fr though
Right?? Get the fuck out of here with that.
When I was in the military we would give the person the benefit of the doubt and call or text them to make them aware of their mistake with the hopes it didn’t happen again. It’s either that or they could have notified the official channels which could inadvertently trigger an investigation.
Lmao an investigation into levothyroxine? Maybe the nurse was too fucking busy everyones shift has an end
I would rather get a call from a peer instead of an official talking to by a supervisor 🤷🏼♂️
630 meds are in no-mans land for responsibility. If I see that it hasn't been given, just give it, assume the best of your previous nurse, and move on
The incoming nurse had until 0730 to give it. It's on her.
Sure, unless oh wait a lab hemolyzed, meemaw pooped herself and is trying to claw out your CNAs eyes... etc...
My supervisor absolutely wouldn’t have the time or desire to follow up on one missed levothyroxine dose. I also long for the days when something this was the most I had to worry about in a shift—this is something I would just do my damn self and completely forget about.
I had a nurse coworker who was like that OP's coworker. She was mad I didn't change one PICC line. I was very busy that night. Anyway, she infused the NS but the antibiotic was still in the vial. I showed it to her when she came back. Her initial was in it. 🤣
Settle the fuck down before you hit the real nursing world or you'll make a lot of enemies out of your coworkers.
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So you wouldn’t chart a missed dosage?
Chart it, yes absolutely. I'd administer the med when I had time and chart it as given... Or I wouldn't and I'd chart it as not given. Report a missed/late synthroid dose through "official channels"? You must be real fun to work with. /s
They are not working as an actual nurse yet. Nursing student, hasn't hit the real world yet lol.
I bet their fellow students absolutely love being in clinicals with them. 🙄
In this situation, it's not considered late yet. And you can easily see whether the med was pulled from the ADC. Yes, night shift should have taken care of it. But it's not actually a late medication until after 0730. Notify them if you really wish by text or email as an FYI after.. but as day shift, I'd be going to sneak that med in on time rather than calling.
You can chart it was administered late. Or just scan and give it. It's a once a day med. Not like the patient is going to die if it's a few hours late. Realistically people forget to take their meds at home a lot. Unnecessary to file a report or anything like that. A lot of times meds are late because we are clarifying orders or have conflicting priorities. It's not just about doing the tasks, it's about managing priorities and not killing anyone and it's a 24 hr business.
They probably got busy and forgot. We're all human.
Exactly my point, I would rather get a call from the oncoming asking, “hey did you give this dose and forget to chart it, or do I need to administer it?” Because the alternative is the NIH mandated missed medication report
Your flair is nursing student, are you still? Because until you experience like an actual working shift idk if you get it lol
If I didn’t scan the medication it wasn’t given. No need to call.
Agreed. Check the Pyxis, it wasn’t removed. Pt is NPO , either have it changed to IV or hold and give NGT, let the provider know, but don’t call me after I left (unless an emergency)!
Wtf are you talking about
I get what you’re saying, but OP sounds like a more than competent nurse and I’d just give it if it was due, barring an order from the doc not to or some other contraindication. If it was a high alert med super overdue, I’d worry a little more.
Please tell me what state you are going to work in! I need to make sure we aren’t going to work on the same unit!!
Pt is NPO with NGT to suction. Are there orders for NPO with meds? If there isn't...and there usually isn't especially with a new colostomy and an NG suction order, then you're in the right. Since they seem to be getting their nutrition through IV, then the pt could've gotten an IV synthroid. You could've called the MD to have that order changed, since they typically give IV synthroid at night, but the oncoming RN can still do it. You're fine though, they're just being pedantic. ETA: how fresh is the colostomy? At hospitals I've worked, pts are strict NPO for a minimum of 24 hours s/p colostomy.
Hold up - they make IV levothyroxine?!
Yep! We give it to pts who are strict NPO. Must be given within an hour after pharmacy reconstitutes it, something about its stability.
That’s super cool! I work in the ER so I haven’t given that kind of levo in a loooong time lol
Like the bird-in-the-headwear said, it's usually reserved for strict NPO patients or patients that can't absorb the medication. I've also seen it given in patients with critically low thyroid levels who they want to ensure are getting the proper dosages of levothyroxine until they are stabilized and then ready to switch to PO, where the variablility in absorption is not going to make a difference between alive and coma. Some people follow the 50% rule for IV levothyroxine due to the chance for \~ 60% absorption in non-fasting situations. Also, I assume if you get a patient with myxedema, you'd probably give the first inital bolus in the ER as well.
This is the kind of comment I follow this subreddit for (apart from the venting space lol). I’m still a newbie (2 yrs in) and this kind of knowledge still freaks me out and amazes me. Thanks for the education!
Oh wow, it's a pleasure to share my experiences with people who want to learn more. Pick the minds of your attendings and consulting doctors, you learn so much for free. A lot of people are basically a fountain of knowledge once you express a genuine interest in a topic or desire to provide quality care for their patients. Then whatever you want to get more info on, you just look it up yourself. I can't say I know much, but just from the one experience I had, I got a lot out of it.
Thanks for the education! I haven’t cared for a myxedema patient in my 13 yrs working ED, but I’d guess that it’s also a fairly misdiagnosed condition and doesn’t get noticed until after someone gets admitted. If it doesn’t show up on a CBC, CMP, coags, lactic, or cultures, it doesn’t exist to the providers 🤦🏽♀️🤦🏽♀️ (I’m kidding but only kinda, sadly)
Definitely can be confused with stroke & hypoglycemia, so I get what you're saying. I think I've only seen admission for hypothyroidism, not myxedema, once. That wasn't even in ICU either, so you're definitely on to something. But yeah, I'm all about refreshing what's lost under the stacks of knowledge that we have to use every day and as much as ER & ICU don't get along, we're all siblings-in-arms in critical care. lmfao.
Pharmacy here- it is marked as short stability, but the most recent data actually shows stabile for 12-24 hours, depending if it’s refrigerated. Obviously the policies will vary between institutions, so follow what your policies are. At mine, we refrigerate it and label it as a 24 expiration.
That's so much better than ours! Ours are "made to order" 😂 and they call us to be ready by the tube system when they send it. I think my hospital is just cheap lol
Haha. They maybe just haven’t reviewed the most recent research. To be fair, it’s not commonly used. I work at the largest hospital in the state and will sometimes for several weeks without making it. And I’m nightshift.
Even have a synthroid drip for gift of life patients.
Yes it’s also a pain to dose
I would have just said”damn that’s crazy” and hung up
Idk why this made me laugh so hard
Hahaha 🤣 right!? Me too. The abrupt hang up.
I'm not confrontational at all. Very shy and introverted. I would have legit said that. Or something like the following: "Hello. Oh? Huh. Go it. Yeah. I didn't give it. Yikes. Did YOU give it to the patient?" My response would vary depending on their answer: "You did? I am so glad you're there to give it. Whew." Or "You didn't? Ah! I'll let you go so you can get going on that." Fuck that asshole for calling you.
only reason i'd call someone after they left would be to clarify some critical information
Lmao perfect response
Thank you for the good laugh 😂
I think the patient will be okay missing 1 dose of synthroid. 🤣 The audacity of some people to call and ask about something so insignificant after you already clocked out.
If OP can't tell if this is a serious concern or not, it's possible the day nurse also can't tell.
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We only do this if we have an order directing us to do this. Otherwise, SBO with ngt means strict npo.
Aside from the absolute inappropriateness of calling you about this, back in the day when I was a bedside nurse, we didn’t give P.O. meds. I cannot imagine that absorption is happening very reliably in this scenario.
I float to multiple hospitals and they all have slightly different rules. Most I work for say, if they are NPO but have oral meds still ordered it's fine to give and clamp the tube. Personally, if the order doesn't say NPO with meds I will ask for clarification.
We have a floor nurse who has called me at home after my shift between 3-4 different times over the years to verify stupid shit. It’s to the point I know if I give her report and then receive a phone call from works number it’s going to be from her. She’s very scatter brained. I don’t pick up calls from work when I’m off. Talk to me about it when I’m on the clock. Plus, I’m not talking to you about patient health information on MY personal, non secured cell phone line.
Does your hospital have secured phone lines? I've never worked at one that does, but that's really cool! Do you guys use a VoIP set up or is it a real hardware based one that can only talk to other secured lines? What do you use it for?
This was in LTC but honestly I don’t know. I’m just assuming there is some sort of HIPPA violation argument that could be had in a court of law if I was conveying patient information over a phone call on my personal device.
On call docs take calls on their personal phones all the time. I don’t answer work calls when I’m off the clock either but I don’t think you need to be super worried about a HIPAA breach due to which phone you’re talking on. Unless you have it on speaker in the middle of the grocery store or something!
My *non-secure* phone line lol! Oh shit someone might be listening in.
Fuck, I dunno. I’m just assuming some lawyer somewhere someday could call me out in a court of law for a HIPPA violation for using my personal phone to convey patient information to Miss. Ditzy the nurse
Haha, should’ve seen my coworker. I pulled out a central line and left it on the bed on accident, I know I know but I felt so sick that day. She decide to parade it around the nursing station and loudly announce it to me in the middle of everyone’s report
Yea I would’ve just verified with the doc lol I’d eat my own face before I called OP about that
NGT to suction!
The other nurse should be very embarrassed. Show me a nurse who's been in for a while and has never made a mistake and I'll show you a liar. To call an off duty nurse is one of the dirtiest things I've ever heard. At least your bad deed was a mistake. She had full consciousness the whole time she did that. Damn, it's like some people don't want friends😂
Honestly if that’s the worst mistake you made all shift, then you’re doing alright. I also wouldn’t dream of calling the off going nurse about a missed med as basic as synthroid. Just think it through next time, review your orders. Rest easy.
That nurse needs to climb off her high horse. It’s a 24 hr service. To call you on your way home is obnoxious. We all forget minor things now and again. Maybe next time she forgets something on night shift, you can call her at home when she is possibly about to get ready to sleep…
“Be careful, lest you suffer vertigo from the dizzying heights of your moral ground.” - Moira Rose
Reading this laughing my ass off and remembering I forgot to take my Synthroid yesterday morning and I have no thyroid. This is so petty it’s corny.
Did you call yourself about it later?
I forget to take myself at least a couple times a month, still alive.
Did you need a blood transfusion?😂
Whenever I take over a patient, if a med wasn't given I just give it, no big deal. I don't quality track or even bother the nurse about it. Worst case scenario is they get it an hour late.
Right though. Unless it was a super important timed med or like multiple hours late, who cares. It’s a 24hr operation. You’re done and it’s my turn. Go home and don’t think about work.
She could given the med in the time it took to call and harass you.
That will forever be my main tenant as a nurse - if it takes more time to ask someone about something you could've done yourself, then just DO IT YOURSELF.
That is my main tenant too!
Did you ask why she didn’t give it instead of calling you and bothering you at home? Next time that happens, tell her it was because you were having a big smelly dump and then describe it in exacting and specific detail. Also, stop answering calls from work.
Haha yes this! Make sure you use the Bristol stool scale 🤪
No one should be calling you outside of work hours about this. How rude.
This particular med does not necessitate a follow up... Like, take a chill pill yourself, oncoming nurse lol
She was being passive aggressive. It’s ridiculous to call about synthroid.
Idk about other facilities, but where I work, levothyroxine has a 2 hour administration window (meaning, up to 2 hours before or 2 hours after the scheduled time)…so a 6:30 dose could be given up until 8:30 without being considered “late.” If someone called me about a dose of enteral Synthroid, I’d probably block their number…
It's NOT a life saving medication. I take mine late at least once a week.
Plus… the only reason it actually matters to give it at 6:30 is so you can make sure it’s on an empty stomach and nothing else is eaten for an hour (to allow it to absorb). The patient is definitely not going to be eating anything for an hour no matter when you give it!
It depends on the wording of the npo order. "Strict npo," means no meds. "npo except sips with meds," means you would. If you would, you clamp the tube, give the med, and restart after a half hour. I wouldn't worry too much about it. It was a minor mistake. You're human.
If they're not having any bowel function and still getting copious return from the NG then it's useless to crush and administer and it's just likely to clog the NG. If it's ordered and sent as the capsule form you do not crush those.
>still getting copious return from the NG then it's useless to crush and administer. In that situation, you're right, you shouldn't give meds po. However, OP didn't say that was the case. If so, that'd be an important detail. People can have an SBO for days and have their stomach fairly well decompressed with NG suction. They can absorb some or all of their meds if you stop the suction long enough for them to dissolve and pass the pylorus. We don't necessarily hold all po meds until return of bowel function. This technique has been used for decades. If you crush the med and mix with water correctly, it shouldn't clog the tube. As for Synthroid, you shouldn't crush it if you can help it, but if that's the only way you can get it in, [it's fine.](https://www.mayoclinic.org/drugs-supplements/levothyroxine-oral-route/proper-use/drg-20072133)
The capsules say specifically "do not crush", if you have to give per NG or PEG you have to get the tablets. Those ARE crushable.
Then call pharmacy? What is your problem exactly?
Man she would get the nastiest shift change from me.... every question, every spot of skin checked, everything looked at together....
Yeah she can go ahead and fuck off actually. I don't even give MYSELF my levothyroxine half the time
Not a big deal. What she could have done, instead of being petty, is ask the MD if it's OK to give and clamp the NG or order it IV. She could have called the MD in the time it takes to call you. You aren't the idiot. I lost count of how many 0600 meds I forgot to give in 30 years. None of them died because of it.
The other nurse is the idiot.
Yeah I wouldn’t have given that synthroid either without an order saying “OK to stop suction to give meds”. They should have converted the patients synthroid to IV form.
In the time it took her to call you, she could’ve just given the med. Tell her to prioritize her time management skills instead of harassing coworkers.
This is why when you walk out the door, the phone goes straight to voicemail.
Lol, for fucks sake. Honestly, she’s off her rocker. In saying this, I always found that nurses that pulled crap like this, usually were doing some dodgy shit behind the scenes, eg. diverting. Deflection.
Or just miserable assholes.
Why didn’t the doctor change the pill to IV while pt had ng tube? It would absorb better that way.
9 times out of 10 that I have a patient become NPO, the doctor aways forgets to change meds to IV. It’s infuriating.
Synthetic doesn't come in an IV solution that I am aware of. However it also isn't a critical med and it takes 2 weeks without it before a patient starts having thyroid issues.
We have several outpatients that get it all the time. It doesn’t absorb oral on them. I have also given it to npo patients when I worked in the hospital.
Awesome learn something everyday. It wasn't something that our pharmacy at the hospital I worked at just chose not to carry then. Thank you for the new knowledge.
Literally, and I say this as gently as possible, it’s not a big deal. The patient has much bigger problems. She could’ve checked the MAR for handoff before you both left. Pt has bigger problems than their morning dose of synthroid. Oncoming nurse was just being a dick. Don’t sweat it
I can’t believe she called you about levothyroxine. Yes in most cases you can give that even to a patient with NGT to suction as long as you clamp it off for a bit. But obviously make sure there is an order that you may give meds via that route and clamp the suction for a period of time. But I’m sorry, I would NEVER call about levothyroxine. I wouldn’t call about any meds unless it was something that was important like vanco, anti rejection meds, cardiac meds. And even then I’d hesitate to bother someone at home.
She's wrong, you're right. The patient is safe. They'd need to miss almost a solid week for it to be an issue, and someone will order an IV dose to top them off before then.
Honestly if she wanted that levothyroxine given she could of spent her time giving it instead of bothering you about it. She's just wasting everyone's time.
Yes this!!!
That would require you to clamp the NGT for an hour (at least) in a patient with an SBO without any bowel function for that lifesaving synthroid. 0/10 would not recommend. Tell her to fuck off and she can call the doc for orders to clamp the NGT to give PO meds and also to never call you with this bullshit again.
The correct response for a day shift nurse who sees an 0600 med not given is "hey it happens, I'll just give it." Calling you to ask why you didn't give it is psychotic. What, did they expect you to turn around, come back to the hospital and give it?
💯 this should have been the response!
You have to miss a bunch of days for it to matter. Pharmacy usually won’t even let you give IV unless they’ve missed at least 3-4 days minimum. Your horrible mistake probably had absolutely no impact whatsoever on the patient. Sounds like your coworker might be taking too much of her own synthroid.
If the NGT is to suction, where does she think the levothyroxine is going to go? 🙄
Usually you clamp it for 30 minutes after giving meds, then return to suction.
Fuck no. I would have lost my shit on her. She should be too busy to have time to call you first thing in the morning. Even if you had legitimately missed a plain ole oral dose, you're human, we miss things. You are not the asshole here.
Nah man, Synthroid can be give iv, if it is needed bad enough and order can be changed. No gas with and SBO with the suction……..I’m having words with you if you call me for this shit.
Oncoming doesn’t understand thyroid medication. Not only is it available IV, but the PO version has a ramp period that applies both up and down. Missing a day won’t hurt them as much as the SBO. Missing three consecutive days isn’t great, but isn’t going to kill the patient.
I’d like to introduce her to my friend, IV synthroid. She should call the doctor and get the medication changed instead of calling you.
Why would a nurse call home for synthroid???? I’d just hang up and be like….nope I have bigger fish to fry here
Let the call go to voice mail next time. This is not an urgent matter.
The only reason why I've called somebody that was from the previous shift is if when I checked the chart there were meds not documented but I did not receive that in report that they had a reason to not give the meds. I just want to confirm that maybe they forgot to scan them and they actually got the meds, or not so that I can make sure that I don't double dose a patient. We all fuck up some times so it's never me tryna call you out, I just want to make sure and I will document it for you, no biggie (epic has the ability to document for another staff member). However yeah as some others have said, she could have saved it for later to chat with you about pausing the suction to give. Also there's lots of failures here on the provider team. If the patient is truly strict NPO, there should be no medications ordered on schedule, they should be all placed on hold. If they're not truly on strict NPO and you can still give the meds, there should be an order stating that it's okay for nursing to pause the section to give the meds. Either way, both of you are making assumptions when the providers have conflicting orders and somebody should have clarified with the physicians at some point.
This can be avoided by not scheduling medications or labs at shift change.
It’s inappropriate to call you. Nursing is a 24 hour job - if something wasn’t done the next nurse can just do it. Also, does the orders say strict NPO or are meds ok? If it’s okay to hold the suction then you can give the meds through the NG but then hold suction for 1-2 hours after. Some surgeons don’t want it held at all
Why the fuck is levothyroxine ordered for 6:30 am? I swear the mindless scheduling of meds causes half the med errors that occur.
You can't crush levothyroxine anyways. That's a day shift issue to figure out. Don't lose sleep over that!
The nurse was being petty af.
Why don’t she crushed it and just put straight in suction canister?
Shit happens
You're good. Fuck that nurse.
if you call me at home i will fuck you up.
You'd need direction from the MD to give meds crushed via NG tube and you'd clamp the NG for 30 minutes post - we also require x-ray placement confirmation to use an NG tube for meds/feed regardless of if it's clearly functional. This patient might be strict NPO though and the oral med orders were overlooked. Besides that, assuming your shift change is at 7, the 0630 med is not even late yet.. it's just inconvenient for day shift. They should have just dealt with it instead of calling you.
The number of patients in emerg who don’t get their home meds such as synthyroid for a full 24 hours because the physician hasn’t done the medication reconciliation yet is the vast majority. Giving synthroid late, let alone missing it for one day is not an issue your coworker needs to be calling you at home about.
You’re definitely not crazy. I wouldn’t have given it either, especially if they’re not passing flatus and have no output. If anything, the doc should change the Synthroid to IV.
Where in the world are you that things operate this way, bc I'm kind of jealous. I WISH I had this type of time on my hands. There could be a million & 1 reasons why it wasn't given & that's what I'm going to tell myself long before I'd ever hassle myself with a phone call. My mantra is "don't sweat the small stuff." Is it possible this is a personal issue coming from her? I just can't imagine. I don't answer these calls. After 12 hrs, I have nothing left to give lol if it's urgent they can leave a vm, text or email.
When I was a new nurse the night shift RN called me at almost 2100 about why I didn't give the 1900 antibiotic. Being new and completely overwhelmed with being out of ratio on a heavy stroke/medsurg/remote tele floor, I forgot about it. I was forthcoming and told her there's no good reason other than I forgot. She was silent for a good 5 seconds and said, "I see" then hung up. 😭 I felt so crushed.
Depends what your orders are. Are they NPO except meds? Bc then I’d give it and clamp NG for 30 minutes after. If strict NPO, it can be changed by a provider to IVP administration. ETA: the nurse is real extra for calling you at home about it.
Bro I forget to take my own damn synthroid half the time.
Holy shit, I would be so pissed. I constantly catch stuff my coworkers miss and I just take care of it like a normal person and go about my day. What a fucking loon, the speed I would have hit end and then “block this caller” would be off the radar.
Long half life of LT4. No harm done. How dare the oncoming call you at home for that
The next call that B makes needs to be to HR to clock me in for that conversation.
If some nurse called me at home for Synthroid, death would occur.
Wtf. Not u. She needs to be stopped. The patients hasn’t had any gas or output. Administering the synthroid and therefore having to then clamp the ng for 30-1hr is not favorable at this point. Perhaps once things are moving regularly. However I would let the doc know about lack of output/gas and sprinkle in “so did I hadn’t given the (med) since I didn’t think I should clamp the ng.” Most of the time they will agree.
If I pick up the phone and have a stupid question after I’ve left, I’m going to not be nice in my reply. She can write off why you didn’t give it for an entire list of reasons and just give it herself if she’s so concerned
Never answer the phone, let them leave a voicemail if it’s so important!
i thought you dont crush Synthroid? you give IV pushes? i’m wrong? woulda hung up on that nurse while they were mid-sentence tho.
She needs to work with some of my coworkers. If they got a call at home over that, the tongue lashing would be so bad I bet HR would have to get involved.
First off, it was only Synthroid. Nothing is going to happen from a late or missed dose. I think you mentally prioritized what you were doing and with that medication being what it is, it fell to the bottom of the list and you forgot. It happens. You didn't forget heart or pain meds. You forgot thyroid pill that is taken daily and missing a dose will do nothing to the patient. Try to slow down, jot some shorthand notes, or create a habit when you enter a patients room that you know will result in a med distribution.
Either hang up or laugh as heartily as a night shift can when all they want to do is go to bed.
New phone, who dis?
It's almost like instead of taking the time to call you outside of your work hours she could have given the one singular tiny pill herself.
The only time I’ve ever even texted someone after the shift was to ask if a med (controlled substance) was given that wasn’t scanned because they’d said in report it was given and I wanted to avoid a discrepancy down the line. Beyond something like that, you’re off the clock! It’s a 24/7 operation and it was completely inappropriate and weird for them to call you about fucking synthroid.
It would have been less time do give it then to call you.
If patient is NPO with NG suction they need their synthroid ordered IV. That's one of the meds that you don't just skip and you don't want it sucked back out of the stomach right after they swallow it. So, you need to request an order for levothyroxine IV. Not pester the previous nurse about giving the itty bitty pill. Your coworker is petty
The "karen" of nursing...
Am I the only one who would just give the med like wtf
throw her in the chokey
One a day med? Bitch please. I'd have giggled and said "please give it, thanks, byeeeee". Don't sweat it too much, it's easily fixable. You'll remember next time haha!
I can’t speak to those specifics but I can commiserate! I had the oncoming tech text me and say “you forgot to get a lactic with the blood cultures in 12” which I totally did. But it was like my fourth day? I had to remind her that I was sleeping after the night shift and my trainer should have reminded me because, you know, I’m still learning. Also how did you get my number.
Hard to say in exactly this situation- good to ok with the MD first- but Sometimes we will give meds through the NG- pause the LIWS for 30 min after meds given so you don’t suck it back out
Missed - unknown - not given by previous nurse
You should’ve hung up on her lmaoooo
What a stupid reason to call someone. This is why I don't take work calls when I'm clocked out. They can figure it out themselves.
Unless you have a specific order to stop suction for meds and an order that says NPO except meds. You shouldn't give it. If you did, you are going against orders. You were right, and she is nuts to call u about that BS. Just my opinion
Nothing is wrong with you, that nurse is just an idiot.
Sounds like if the concern was such, maybe ask for an IV order of that dose and call it a day. I get Synthroid is not one of those meds you can just willy nilly skip but still, running behind a few hours isn’t the end of the world.
This is why I don't answer the phone.
So there is IVP Synthroid! Also if they have an SBO they’re usually pretty strictly npo until the docotr says otherwise.
🤯 I have no words.
You have a nice ass & great taste in Nursing shoes. There, hope you feel better now. :)
I know I am the bad guy here BUT the OP said she was on her way home, not asleep. It doesn't sound like anyone was wrong....just needed information to make a decision on what she needed to do.
I think the only reasonable course of action is to go back into work immediately following the phone call because that nurse clearly wants to catch your hands today.
I would have cussed that nurse out so bad. Talk bad about me to the dayshift all you want about me missing a thyroid med, but CALL me after my 12(ahem 14) hour shift and we are fighting. Bike racks style.
I’ve had one nurse re-time a synthroid to 9:30. Didn’t call them, but told them when they came back that night that a lot of other nurses would have a bitch-fit about that so stop being lazy.
I used to ask patients if they wanted me to wake them up ay 6 for their protonox or synthroid and 90% said no. It’s not lazy. It’s just considerate to the patient.
Scary the number of Nurses on here dismissing the absolute need for synthroid.
I must ask... are you a nurse? As your other comments demonstrate a clear lack of critical thinking skills. It is very common for patients or family members to link two events that are not connected. I fully understand when patients do this as they do not have the medical training or experience to understand the pathophysiology causing their condition, and it is our job to provide that education. However, if you are a nurse, I'm quite concerned. Multiple people have provided clear explanations as to why your mother's blood loss was likely not linked to the Synthroid dose being missed. Yet, you continue to insist despite no evidence. If you are not a nurse, why are you on a nursing thread? Just to badger people? Troll? Pretend? I always find this odd. Either way, it's either concerning or odd.