Mr. Bells J Thomas reported for his shift on 6A. Mr. Thomas was receiving report from the previous nurse regarding a Veteran who was ventilated and on Cisatracurium (Nimbex). The reporting nurse indicated that she had just hung the Nimbex infusion at 1mcg/kg/minute. Mr. Thomas questioned the rate the medication was running, indicating that at the current rate, the medication would run out quickly.

Nimbex is a neuromuscular blocking agent, and having to change the bag out as quickly as it was going to run out alerted Mr. Thomas to a potential problem. When the day shift nurse re-checked the Alaris IV pump and the Nimbex IV bag, she immediately realized that the pump was running at mg/kg/hr. Immediately, the pharmacist, doctor, and nursing supervisor were notified, and the medication was calculated at mg/kg/hr to accommodate the IV pump settings.

Additionally, an assessment of the Veteran was completed, and it was determined that the Veteran was stable. Mr. Thomas demonstrates the ICARE principles each and every day by caring for the Veterans under his care. On this day, Mr. Thomas displayed-

Integrity: With his strong moral principles, he questioned a colleague during report about a medication that was just started.

Commitment: Being dedicated to ensuring Veterans receive the best medical care safely.

Advocacy: Speaking up on behalf of the Veteran who was ventilated and questioning the medication dose.

Respect: Mr. Thomas questioned his colleague about the medication dose in a non-accusatory manner without making her uncomfortable, to ensure the Veteran was safe.

Excellence: Every day, Mr. Thomas comes into the Syracuse VA Medical Center, bestowing outstanding care to our Veterans, but this day, questioned the medication rate, demonstrating an example of excellence.