[Dolce]

Never shoot 6.25 mg of Demerol into your eye while attempting to draw the medication out of the carpujet with a syringe. My eye was "pain free" the rest of the day!

Never cut the y port on a Foley to drain the balloon instead of using a 10 cc syringe. If you cut the y port and it doesn't all drain your patient may have to have a cysto to take the catheter out.

[prinsessa]

Make sure the pt doesn't have any procedures or tests that day before giving meds. Some of the meds might have to be held until later.

[Ivanna_Nurse]

Hey All! Here are my contributions...
Always assess your patient, not the monitor.
Follow lines and tubing from the pt to the equipment.
Never give something you arent familiar with.
Never feel like you cant ask for help or that your questions are bothersome. ~They very well might keep you from making a fatal mistake.
When doing a procedure for the first time, dont forget your policy and take the most experienced nurse with you.
Never Ignore your gut instinct.
If you make an error, fess up right away so the patient can be treated if necessary.

Cheers, ~Ivanna

[Indy]

Never ignore sudden personality changes in your non-psych patient.

Never ignore a (mostly non-psych) patient that tells you they are going to die.

Never ignore any patient, psych or otherwise, who tells you they are about to kill themselves. Me: Really? Him: Yeah, I'm gonna hang myself with the bedsheet. Me: When? Him: as soon as you leave. What'd I do, panic and run out of the room. Fortunately someone else went right in and sat with him.

If you see a substance... offloaded from a human... that is so vile you want to puke, never just flush it without taking a second to ask yourself if you shouldn't get a sample of it. My first GI bleed missed diagnosis by a shift or so because I nearly puked and flushed his dead-possum sized black tarry stool without thinking of it. Told my preceptor. He didn't poop again until he nearly died. At that point, reporting findings isn't nearly as effective as when you have proof to back it up.

Never say never.

Never say quiet.

Never assume people are harmless just because they're a) smiling at you, or b) not moving right at the moment.

[NYDreamer]

I second this. I had a (prev. psych) patient who would tell me that his "mind was not right" and was always threatening to kill himself. He would get very angry when I reported him to the nurse, but I would report EVERY TIME he made a threat or wish to die.

Originally Posted by Indy

Never ignore any patient, psych or otherwise, who tells you they are about to kill themselves. Me: Really? Him: Yeah, I'm gonna hang myself with the bedsheet. Me: When? Him: as soon as you leave. What'd I do, panic and run out of the room. Fortunately someone else went right in and sat with him.


.

[MIA-RN]

Never forget that just because a patient is combatitive, angry and acting out..that they are still a person, and deserve to be treated as well as your other non-combatitive patients.
Always remember to check your orders..it sucks when the meds you've just given had been d/c'd hours ago but the order was never taken off.
Always remember to go with your gut. If you think there is a problem, then there probably is.
Never assume that the person who listens sympathetically when you complain about management, processes, or coworkers is really just a sympathetic ear. They might possibly be telling other people what you are saying...likely people who you'd rather they didn't tell. And they will likely exaggerate or make it sound worse than your original comments.

[Spidey's mom]

It is fun to play the "don't say quiet game" but . . . . .you can say quiet if you want. Research (mine and actual researchers) says there is nothing to the old wives' tale.



steph

[swee2000]

Originally Posted by Aprilhere

Never assume the new LPN working with you on a team knows this. You might have a beta blocker given to a pt with a HR of 48, and SBP in the 80's.

Originally Posted by Aprilhere

I'm sorry. I didn't mean for that to sound like LPN's didn't know this. Just that we shouldn't assume.

I'm sorry, but I find these comments about LPNs to be asinine.

First of all, why would you assume that LPNs don't know they're supposed to verify a patient's HR & BP prior to giving a beta-blocker or other antihypertensive med?

Does this also mean that you assume LPNs don't know they're supposed to check a patient's blood sugar prior to administering insulin?

And in the case of Lasix, do you assume that LPNs don't know about verifying a patient's potassium level(in addition to the HR & BP) prior to administering the medication?


Unless I've missed something, none of this is privilaged, top-secret, RN-only information. LPNs learn the same exact stuff during nursing school and are expected to remember & apply it during clinicals, on their Board exams, and out in the "real world"....just like RNs do.

[weezledawg]

If you're good, there are ways to expedite the pill-taking process...

Pills in one hand and cup of water with straw in other. Pills up to mouth, you give them or hand them over and watch steadily as they take them.

Say, "Talk later, take the pills now." Or, "I have to watch you take these or I have to leave the room with them."

As I pop them out of packages IN FRONT OF THE PATIENT I tell them what they are (name them) and what they are for. Asking them right afterward, "Does that sound right?" "Do you take these at home?" Sometimes they freak out because they look different than the ones they get at home and that's when we talk dosages etc. If they are really iffy, I go check the order in the chart and come right back. That works really good.

[weezledawg]

Never microwave blood to heat it up. (A nurse really did this.)

If a patient looks really crappy for weeks and then all of a sudden one day says, "I'm doing much better" and they are end-stage, they could be about to die.

Never ask your CNAs and ancillary staff to do stuff you won't do yourself. Don't sit around and delegate if you're not busy.

Don't trust that RT's assessment of a patient sounding "fine" if you hear lots of ronchi that don't resolve with coughing and you know it's different than last night's breath sounds.