Nurse A :

Nurse B :

Nurse C :

Pharmacy :

Nurse D :

NUM :

Dokter :

One day at the Widya Mandala hospital in the E3 room, the internal medicine
section included nurses who received instructions from the doctor but misinformed
because they did not repeat words that were not clear about the information ...

In the morning when the morning shift will be changed ...

NUM : Good morning everyone before making the morning shifts let's pray
first for smooth work. Ok nurse A please lead the prayer.

Nurse A : Well ma'am, Pray at the start .... finish

NUM : Good nurse B, please start the operation

Nurse B : - Good mom, there are 3 patients going home this morning at 6 in room
307 B now there are 2 patients first in room 305 A with Dengue fiver
temperature: 37oC TD: 100/80 RR: 20x / minute Pulse: 90x / minutes of
therapy are still professors 3x1, ceftriaxon 3x1

- Patient in room 305 B with typoid fever TD: 120/80 Temperature:

37oC RR: 21x / minute Pulse: 96x / minute therapy still ceftriaxon 3x1
ampicilin 3x1

It's just the patient now let's go around to the patient's room.

Nurse C & A : Oke mam ...

After that Nurse A B C and head the room around to the patient's room to make
shift shifts ....
Nurse B : This patient rooms 305 A with Denge Fiver temperature: 37oC TD:
100/80 RR: 20x / minute Pulse: 90x / minute. Patient in room 305 B
with typoid fever TD: 120/80 Temperature: 37oC RR: 21x / minute
Pulse: 96x / minute

Nurse C & A : ok mam ..

NUM : good please work for nurse A & C for nurse B please go home
carefully on the road

A & C Nurse : Ok mam thanks you

Nurse B : ok mam thanks you

After that, at 12 noon, nurse A checked TTV for each patient.

Nurse A : excuse me ma'am, I will do a mother's TTV check, well it's done, thank
you....excuse me.

After that nurse A notifies nurse C because the patient's room 305A has an
increase in body temperature and must be reported immediately to the doctor.

Nurse A : nurse C has a room 305A, her body temperature becomes 39oC the
patient's initial therapy gets ceftriaxon and profen mother.

Nurse C : oh then please report to Dr. First for the patient's condition.

Nurse A : I'll report nurse C, the patient's condition, I'll call him first.

After that nurse A reports the patient's condition to the doctor ...

Kriiingggg ...... kringggg ......

Dokte : hello good morning.

Nurse A : Good morning, my doctor Nurse A from E3 room, I want to report on

the condition of the doctor's patient. The body temperature increases to
39oC, the initial therapy is ceftriaxon and profen 3x1

Doctor : what diagnosis ?

Nurse A : dengue fiver doctor

Doctor : ok then change therapy with cefadroxil cefat, amoxan.

Nurse A : ok doctor thank you

Doctor : You're welcome

 Because Nurse A is in a hurry Nurse A does not return the medicine that will
be given to the patient.

Nurse A : Nurse C drug therapy is replaced by cefat and amoxan 2x1 instructions
from the doctor

Nurse C : OK nurse A later at 1 pm let me give the medicine

Nurse A : oh yeah, it seems like the medicine still doesn't have one if there is no
day and night if you order it to the pharmacy first.

Kringggg .... kringgg ...

Pharmacy : hello good afternoon, with a pharmacy installation can you help?

Nurse C : Hello, good afternoon, I want to order cefat and amoxan medicine, huh

Pharmacy : OK, I'll send it right away

Nurse C : Thank you, Ms.

After that nurse C prepares the medicine that will be given to the patient.

Nurse C : I prepare a nurse for medicine for the first patient

Nurse A : okee nurse C

After that nurse C goes to the patient to give medicine.

Morning shift hours have been completed and will be replaced by daylight

NUM : good please pass the shift on the day shift. Please nurse A

Nurse A : both patients have 2 rooms 305 A and B. Room A has increased body
temperature, the doctor has reported, and has changed drugs, then
ordered to the property pharmacy will be delivered later in the
afternoon.

Nurse D : what are the drugs that are replaced by nurses?

Nurse A : cefat, cefadroxil and amoxan 2x1

Nurse D : okee nurse

Nurse A : well then room 305 B TD: 120/80 N: 98 x / minute S: 37oC not fixed
heat therapy
NUM : nurse A doctor when visite?

Nurse A : This morning I haven't been able to visit tomorrow, maybe tomorrow
because if this afternoon the doctor practices at his house.

NUM : oh okay

After that, as always all the nurses go around checking the patient.

After that, at 4:00 p.m. came from the pharmacy installation to describe the
order of the drug that had been ordered.

Pharmacy : excuse me good afternoon. There is a medicine order from the E3 room

Nurse D : Yes good evening, Ms. Thank you, Ms.

Pharmacy : oh yeah, is this really the medicine given because this cefat and
cefadroxil drug should not be combined in one drink must be one of the
antibiotic choices

Nurse D : oh well, I will coordinate with the doctor again, bro

Pharmacy : okay, okay, mr. Excuse me ..

Nurse D : ok, thank you

Pharmacy : you are welcome

After that nurse D gave the medicine instructed by the doctor but before giving
the medicine the patient delivered his complaint after being given the medication this
morning and nurse D stopped giving the drug that was instructed.

After the morning nurse D gives the information to the morning guard nurse

NUM : Good morning everyone, let's pray before working.

Nurse D : Sorry in advance this mam therapy given by the doctor is it true that
there is cefat and cefadroxil because these are both antibiotics and
should not be given together and this patient has had an effect yesterday
afternoon so I stopped using it.

NUM : who's the doctor who gave instructions like this?

Nurse C : doctor ... who gave instructions

NUM : will the doctor visit today?

Nurse C : looks like today ma'am

NUM : I'll do it later to see a doctor

After a few minutes the doctor came to visit. Incidentally there are guardians C and B

Doctor : Good afternoon nurse B what about my patient today.

Nurse B : This is a doctor, there is a patient, N room 305, who was given
instructions yesterday with a hot report. 39 Is that right by giving 2
antibiotics at once.

Doctor : I never gave instructions 2 antibiotics were taken on an ongoing basis

who gave it yesterday

Nurse C : I was the doctor who gave the medicine yesterday afternoon, but nurse
A who gave the instructions yesterday after calling the doctor

Doctor : then why with these patients after being given 2 antibiotics at once

Nurse B : the patient complains of pain in the epigastrium but has stopped using
it yesterday afternoon.

Doctor: stop using

Nurse B & C : good doctor

NUM : doctor how can this antibiotic be given simultaneously

Doctor : I instructed only one antibiotic I also don't know how your nurse can
give 2 antibiotics simultaneously

NUM : sorry the doctor later I will reprimand the nurse in question

After that nurse A and C were called in the room of the Head of the room to
discuss this incident.

NUM : nurse A and C please enter my room. This is how it can be wrong to
receive information from a doctor. The life of a nurse patient please be
careful in receiving information

Nurse C : I'm sorry, mam all because of the information conveyed by nurse A
who called the doctor and I gave the afternoon medicine

Nurse A : Yes, but I received information that there were 2 antibiotics given

NUM : have you repeated the word or information conveyed

Nurse A : yes mohom sorry mam I did not repeat the information from the doctor
Nurse C : I'm also sorry, mam, if I don't ask for information again and I'm not
careful

NUM : I'm forgiving for this incident and I'm begging you to be more careful
in your next work. Then please continue the service for nurse A

Nurse A & C: yes thank you