Inquiring Minds Want To Know: Outrageous Orders! - page 6

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

  1. by   fedupnurse
    And July is right around the corner!!! Anyone else from a teaching hospital planning a mental health leave??????
  2. by   fedupnurse
    Vasotec IM. She is about to become a second year!!! God help us all!
    I have a feeling this thread is going to become very active in another 6 weeks or so!!!! Particularly for those of us in teaching hospitals!!
  3. by   OBNURSEHEATHER
    Originally posted by Stargazer
    "Place foley cath to wall suction"
    :chuckle :roll

    I don't have anything nearly as good to contribute, but thanks for making me laugh!

    Heather
  4. by   Curlytop
    Originally posted by NurseDennie
    Curlytop 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!

    Love

    Dennie
    By the way- I was referring to the "QID" part of the order -- NOT "up to chair". After 11 years of ICU nursing I know how beneficial increased activity and the upright position is.
  5. by   BadBird
    My favorite was STAT Hot tea with lemon.
    And this Dr. was serious!!!!!
  6. by   Fervous
    Got an order once for 10-15% O2....
    Up in chair qid for comatose pt....
    Ambulate tid for pt that needs at least 3 people to get into a chair right beside the bed...
  7. by   JeannieM
    Originally posted by Vicki K
    I'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.

    Vicki K
    Did the flowers live???:chuckle :chuckle
  8. by   okihusker
    I would have written a progress note on the care given to the flowers! I would have also put a yellow sticky in the chart requesting an H&P on the flowers before I provided care.
  9. by   caroladybelle
    Not to mention, accurate I&O, and vital signs on the flowers.

    If the root intake of fluids was too low, at 0200 AM be sure to call and inquire as to the need to start IV fluids.
  10. by   fedupnurse
    I can't believe I nearly forgot this one because I had an absolute cow when I found out about it during report. The medical Resident involved is about to become a 3rd year now and she was a first year at the time. We had a brittle and I mean brittle diabetic in the unit. He also had a problem holding onto his potassium. Many ICU patients do. We order K+ supplements. Not this doctor (the attending did the ordering the resident didn't see a problem with it). This attending and resident decided it would be a wise thing to hold his insulin. Day shift did!!! I stopped getting report mid sentence and did a finger stick. I also brought in stuff to draw a tube of blood because I knew his sugars would be way to high to register on the accucheck. His sugar was 900 something and yes folks there was acetone. These 3 had put the man into DKA!! Scary thing was this nurse (Agency and never was allowed back after this) took his sugars all day and didn't report the high numbers and never sent a sepcimen when the accucheck said too high to read. The family came in and saw the insulin drip hanging and hit the roof. Cannot say that I blame them!!!!
  11. by   okihusker
    I worked in a Military Teaching Hospital where our stellar physicians (not) would want all sedation stopped cold turkey at 2400 for intubated, ventilated patients. They also refused to apply restraints on 90% of the intubated patients. The truth of the matter was that they did not start vent weaning until they grand rounded the following morning at 0800. The patient, after fighting with the nursing staff that was lying across them all night to prevent extubation and bucking the vent for 8 hours, were then too tired to pull good negative inspiratory force and vital capacities. Essentillay they would fail weaning parameters. Needless to say this was a repeated vicious cycle. The point of the story is that the physicians and residents would accuse the nursing staff delivering unordered sedation thus causing the wean failures. So they started writing in the orders: DO NOT ADMINISTER SEDATION FOR NURSING CONVEINANCE! This used to make my blood boil!
  12. by   ratchit
    "May eat anything he wants including raw fish." (Intubated patient with an NG tube, no reason to suspect he was a sushi lover...)

    Love the thread!
  13. by   fedupnurse
    I hear you on that one Okihusker! I have worked nights for all but 2 years of my 10 as a nurse. I am so sick of docs who either don't order sedation and wonder why their patients are still vented after a month or who think we snow these poor slobs so we can sit at the desk and eat BonBons all night! Make the patient a 1:1 and you can forget about restraints. If the patient is calm minus sedation, fine. But if they are agitated and anxious, they will fail weaning. Perhaps they should use Diprivan and wean it to off starting at 6 or 7 am. I have frequently offered to intubate these types of docs to see how they like breathing thru a straw!!! None have taken me up on the offer yet...go figure!

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