Inquiring Minds Want To Know: Outrageous Orders! - page 5
IVE RECENTLY HEARD SOME FUNNY AND SOMETIMES DISTURBING STORIES IN REGARDS TO PHYSICIANS ORDERS.SO I WAS JUST WONDERING: WHATS THE MOST OUTRAGEOUS MD ORDER YOU EVER HAD TO TAKE OFF OR WERE EXPECTED... Read More
May 16, '02Originally posted by RN2bNC
I did some time as a unit secretary, and can't remember all the crazy orders I saw, but there are a couple that stick out in my mind.
"Please make clear liquid diet more appealing" - The nurse wanted to know if we should put a picture of a T-bone at the bottom of the cup of broth, hehe!
May 16, '02I found this one funny/ sad.........
Doc ordered I&O on a resident at the LTC facility I worked at.....I asked Doc, "how long would you like her on I&O?" He replied, "until she dies". He could have just said indefinately. :stone
May 16, '02Curlytop said "Oh Yeah-- How about "Up to chair QID" for a total-lift patient who is half comatose. YEAH RIGHT!!" I can see why we do it, and I did it for a long time, it really is good for the comatose patients, and we had special chairs for people who were OOB but couldn't really sit in a chair! The unit got beds that adjusted more than the usual bed. So that "counted" as being OOB in a chair. Never got around to getting them for the floor!
May 18, '02We have a doc who is a real jerk, writes "turn pt q 2 hours." He once wrote to ambulate a patient in the hall who was a bilateral amputee. The same doc wrote in a pt's H&P that there were no testicular lumps or penile discharge. The patient was a 72 year old woman.
May 18, '02Originally posted by nurse kratchet
we have a chf pt on aspiration precautions with no gag reflex that nurses must supervise with all meals. order ,lasix 40 mg if pt eats more than 50% which she barely eats at all. dnr but needless to say she's out to the hospital q week in chf and pneumonia. he's our med director and will not change it!
May 18, '02Well all of these postings reminded me of so many squirrelly orders through the years, but the one that incensed me the most was written on an elderly, alcoholic woman who had fallen on ice in mid winter and laid there for a while. She was a popsicle on arrival to the ED, but we thawed her and sent her from ICU to the floor for a long convalescence. She sustained frost bite to her finger tips. Her doc was a fossil and was treating her with some sort of magnesium solution (it turned her fingers purple) and we bandaged her hands. Well, that meant she couldn't SMOKE!! Doc wrote an order said:
Nurses to hold cigarette for patient so that she can smoke.
There was never a day that that order would have fit into my schedule. Like she needed the vasoconstrictive effects of smoking to slow the healing to fingers...
May 18, '02Admit ICU: DX Physical Exhaustion
(Guess I should have been admitted on some days too)
Transfer to Inpatient Mental Health Unit: DX: Major Depressive Episode, Partner Relational Distress, Suicide Gesture, and Bilateral Ingroing Toe Nail.
Admit General Medical Ward: DX: Social Admission
Admit ICU: DX Rule Out MI (the patient's symptom were electrical shock feelings that started in the chest and rushed to hear head. Three to four of these 1-2 second episodes in 24 hours) Should have read Admit to Inpatient Psychiatric Unit: Axis II, Conversion Disorder.
Admit ICU: Palpatations, Rule Out Dysrhythmias (yes she was having frequent unifocal PVCs. After further enquiry by this RN, we discovered that she consumed 15-16 Mountain Dews a day and 2 to 3 liters of ice tea a day as well).
May 19, '02'Notify me if any ***** drainage occurs.'
We know what he meant, it just looked funny in writing. :chuckle
May 19, '02For physical assessment of pt in H&P....."Pt has no remarkable changes from the last time he was seen." One sentence, no more. That really helped us out a lot!
May 20, '02Angie, this type of stuff burns me too...particularly when I get a critically ill patient without any advance warning from ER, a piss poor report (ER is swamped, they have to run, will get me paperwork 'later' ) I call down to ER for 'some' orders and the ER doc yells "Call the attending for admit orders, it's not my job " but the attending has supposedly seen the patient in ER....(no orders written of course...)
BUT there IS a progress note saying "H & P" dictated. Very helpful, right?
Nothing like flying by the seat of my pants...got an unstable new patient and I'm starting with nada. Not even a family member to talk to to who might be able to tell me what happened. <sigh>
Just another fun filled night in ICU...:rollLast edit by mattsmom81 on May 20, '02
May 20, '02Originally posted by fedupnurse
I do not want you to call me again for anything on this patient. I wrote that as an order. Boy was he *issed off!!
May 20, '02I've seen some outrageous orders, but the one that immediately comes to mind is "Flower care q 24 hours". (The ICU patient was worried that her flowers would die. Not only did this ignoramus bring the flowers to her bedside (NOT allowed in any of the ICUs I've ever worked in), but he wrote an order for the nursing staff to care for the flowers.
Another winner is "ABGs STAT q 1 hr" on a DNAR patient. To make it worse, no art line! And worse yet, when we called the results to the resident who wrote the order, he cursed at us! (He wrote for STAT labs every hour, he must want to know the results, right?)