Absolute No-No's

[Drysolong]

Hi: I hope to get a lot of input from this question. As experienced nurses, what are some things especially related to medication administration, but anything else, that you would classify in red for a nurse to never, ever do? Also, what have been the consequences of nurses doing these things? Thanks, in advance!!!

[Chloe'sinNYNow]

Ooh, here' s one. Lantus cannot be mixed w/ any insulin!

[AprilRNhere]

I don't dispute that nurses, both RN & LPN, make mistakes during medication administration, such as not verifying BPs prior to administering antihypertensive meds. But that is not what the poster said, nor why I responded in the first place and in the way I did. Personally, I didn't appreciate or care for her generalized opinion of LPNs. Even now as I read her comments, she appears to be implying, and in 2 seperate postings(!!), that LPNs don't have the where-with-all to safely administer medications, particularly those requiring

pre-administration assessments such as verifying a patient's HR & BP. That's an unfair assumption to make, in my opinion. Had her comments referred to ALL nurses in general, both RNs and LPNs, then I would've kept quiet. Instead, it seems like she's singling out LPNs just because their LPNs. And I'm not trying to start an RN vs LPN debate on this, as that was not my intention or the point to my post. But I don't think LPNs should be viewed as incompetent, or not competent enough, when they get the same exact info and education that RNs are given. That's all.

I apologize. I truly, honestly did NOT mean any offense here. It was just a quote based on an experience I had. And...honestly...the emphasis wasn't meant to be towards LPN's specifically...it was on the word new. I simply forgot how sensitive some people can be. I've learned so much from LPN's on my floor. My point was in not assuming a new nurse will remember to take vitals first. It just happened to have been an LPN. I wasn't saying anything about your education. I learned many things in school...that doesn't mean I remembered them all once I was on the floor. Thank GOODNESS the nurses I worked with in the beginning didn't assume I remembered everything. My point was I should remember the same...not to assume other new nurses remember everything they learned in school.

[P_RN, ADN, RN]

OK 2nd reminder.

This isn't a licensing thread.

This is a do not DO THIS (aka no-no).

There are many, many , many other places to mention educational options etc. Let's stick to the topic. Let's not allow this great thread to go skidding to a full stop OK? OK?

[Chloe'sinNYNow]

Giving Potassum directly into an IV - instant cardiac arrest...not good!

This was drilled into us in N.S. But probably not enough and can always stand to be reiterated. Good Muhaha!!

Chloe

[Dolce, RN]

Never do colostomy care bare-handed! I saw a nurse do this once and almost threw up. How gross can you get?

[Weeping Willow]

There is NO "5-second rule" in medication administration. If you drop a pill on the floor---GET A NEW PILL.

I don't even take pills that fall on the floor in my own home. Blech!

This is not always possible in unit dose situations, where only exactly enough pills for a certain time period have been provided by the pharmacist and there is no pharmacist on duty and no way to get a replacement except to borrow from another patient, which is illegal, I think, or call the pharmacist in from home, which could take quite a while. I agree, it would be nice to be able to get a clean pill but I have see too many times where this is just not feasible. I hate unit dose and long for the days when we had stock bottles available for most meds.

[Chloe'sinNYNow]

Never do colostomy care bare-handed! I saw a nurse do this once and almost threw up. How gross can you get?

Ewwwwwwwwwww!!! Yuck, and Gross!

Come to think of it, I've seen this done too. Seasoned nurses who will handle blood products, IV's (inserting), and colostomy care barehanded (I think it was the WOC nurse!!)

As if they are truly not going to get slimed? I know that tape part is problematic, but.....

:smackingf

[heawilreb]

Always check for allergies!! Called Dr. because pt was in pain. Dr. ordered morphine,pulled up medication, went into pt's room to give drug. Pt's family asked what the drug was--found out pt was allergic to morphine!! Should have check pt's allergies first,narrowly avoided a serious or potentially fatal error.

[P_RN, ADN, RN]

Oh that reminds me of my own experience. Just because the doc didn't list my allergy on the "admit from ER orders", BELIEVE me (and my medic-alert bracelet-paid $40 for that thing-) that I am allergic to _________. I had a very BAD adverse reaction to a certain drug previously and here you are trying to give it to me again.....thank goodness for my assertive hubby.

[poppy07]

"I want you to remember this statement when you have an 8 patient assignment on a floor when you are supposed to only have 5, the CNA and the Unit Clerk are out sick with a stomach virus which you know you will have tommorow. Your med pass is an hour behind, your three incontinent patients all need to be changed, two IVs just blew, one patient has a bp of 89/55 and the house intern hasn't responded to two pages."

Definitely does not take that long to make sure of the 5 rights when giving meds. best thing--just slow down a minute, and you will probably save a few. Remember the ABCs, if the med is not that critical--a few minutes or half hour or hour(s) sometimes won't kill someone. Not being thorough and checking, though, can.

[Ruby Vee, BSN]

ewwwwwwwwwww!!! yuck, and gross!

come to think of it, i've seen this done too. seasoned nurses who will handle blood products, iv's (inserting), and colostomy care barehanded (i think it was the woc nurse!!)

as if they are truly not going to get slimed? i know that tape part is problematic, but.....

:smackingf

prior to about 1985, we did everything without gloves. there weren't any gloves available for us to use except the one box that was kept in the dirty utility room for the intern to use when they did a rectal exam. once you've spent a decade doing nursing care without gloves, sometimes you forget to don gloves before hanging blood, and as for starting an iv -- i learned without gloves. i have a lot of difficulty starting them with.

[Chloe'sinNYNow]

prior to about 1985, we did everything without gloves. there weren't any gloves available for us to use except the one box that was kept in the dirty utility room for the intern to use when they did a rectal exam. once you've spent a decade doing nursing care without gloves, sometimes you forget to don gloves before hanging blood, and as for starting an iv -- i learned without gloves. i have a lot of difficulty starting them with.

yes, my retired msn-rn mom has told me these same stories.

doesn't mean it's right. besides we know better now, don't we. and they spent each semester pounding the universal precautions into our heads in ns between 2005-2007. it was even on nclex.

no excuses.