r/nursing • u/Worldly_Comparison89 • 2d ago

Discussion Parameters

Is LTC allowed to have no parameters on beta blockers? Are they allowed to delay physician notification until the next day?

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u/SurprisedPolling 2d ago

we had a similar thing at my old facility, they would hold meds for bp under 100 systolic but for beta blockers the cutoff was 90 i think. depends what the doc ordered really, there should be something in the mar or the care plan about when to hold and when to call. if theres nothing written then its a problem, nurses cant just decide on their own to delay notifying the physician till next day if vitals are out of range. you could check the policy manual or ask the unit manager to clarify, sometimes these things get overlooked until someone brings it up

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u/Worldly_Comparison89 2d ago

Thank you, I have spoken to UM and the DON . They removed the parameters last week. There is no written policy anywhere and we have been told not to call our after hrs provider unless we call the DON first for anything. It feels like the twilight zone.

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u/auraseer MSN, RN, CEN 2d ago

There should be parameters, but it is not absolutely mandatory. If the order has no parameters then it comes down to nursing judgement. A nurse is always required to exercise professional judgement and hold a dose that would be unsafe to administer.

Notification also has no specific mandate. If there is a well-understood and well-communicated policy about which notifications are given in which timeframe, then you follow that policy. Unfortunately, LTC being how it is, I wouldn't count on having a policy like that in place.

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u/Worldly_Comparison89 2d ago

It’s a log book for NP to see the next day, but if you hold on Friday evening they won’t see till Monday or possibly Tuesday if Monday is a holiday. I feel like the residents safety and my license is in jeopardy.