Orders from hell... - page 2

From time to time I run into real gems of medical writing. Levaquin 750 gm P.O. q. 48 hours for 2 more days the trick is to find how many pills this will be Can you?... Read More

  1. by   SilleLu
    "Walk this patient in the hallway without oxygen and then figure out how much oxygen he needs and record it to satisfy hoop-jumping to get patient what he needs."
  2. by   blondy2061h
    Quote from NurseSpeedy
    Respiratory or blood pressure parameters for a comfort measures only patient's Morphine
    Our opiate drip order set includes a PRN narcan order by default for RR<8 or a lower dose for severe itching. You have to uncheck it on the computer for it not to show up. I am always calling new fellows telling them they need to d/c that order on comfort care patients.
  3. by   KatieMI
    Quote from blondy2061h
    Our opiate drip order set includes a PRN narcan order by default for RR<8 or a lower dose for severe itching. You have to uncheck it on the computer for it not to show up. I am always calling new fellows telling them they need to d/c that order on comfort care patients.
    My personal pet peeve are hypertensive meds and blood thinners' orders which have to be cancelled if patient starts to go South. It takes insane time to figure out who ordered what, call each provider and then the QI people come by full force to ask why a patient on Levophed and with suspected internal bleed is not getting his B-blocker and heparin "as per policy".

    Mind you, these ladies are still technically RNs
  4. by   SobreRN
    Shame, it sounds like a fabulous order to me! When I worked in an outpatient chemo-infusion center one of the docs really wanted to be able to have a candy dish with Ativan in the waiting room...
  5. by   NurseSpeedy
    Quote from SilleLu
    "Walk this patient in the hallway without oxygen and then figure out how much oxygen he needs and record it to satisfy hoop-jumping to get patient what he needs."
    Ah, yes, the home o2 eval. Especially crazy when they are only 90% on 4L/min at rest
  6. by   TraviesaRN
    I was working at a large teaching hospital and we had downtime one night. Well a lot of nights, but anyway the residents hated it because they had to use prescription pads and they weren't used to it. Well one of my residents hands me my patients prescription for DC. It was supposed to be a tapper steroid dose. He writes on the pad. Patients name and Prednisone tappered dose. That's it. I could not stop laughing and made him fix it. He didn't even understand what was wrong. They were so used to their little pre set boxes they just click. I showed everyone so he couldn't live it down. It was so funny.
  7. by   TraviesaRN
    We had a doc that would open for a Nursing Order and put "offer reassurance"
  8. by   SmilingBluEyes
    Back in the not-so-good-old-days of OB nursing, we used to get orders that read: "pit to distress" which meant keep cranking up the IV drip pitocin to induce and maintain labor until the baby could not tolerate it any longer and showed signs of fetal distress. THEN we could stop.

    HORRIBLE. Glad they don't do that any more.
  9. by   audreysmagic
    Quote from dirtyhippiegirl
    Former night nurse here. I can dig that order.
    Please send that doctor to my psych unit.

    ...I kid, but WOW, what parameters!
  10. by   audreysmagic
    My favorite, for a patient who was convinced she was pregnant...and she wasn't, the doctor actually wrote an order, "Stop asking for pt to be evaluated for pregnancy" after like the third nurse suggested a repeat HCG (which had already been done and was negative, of course).
  11. by   blondy2061h
    Quote from dirtyhippiegirl
    Former night nurse here. I can dig that order.
    Well I mean, yeah, it's a great order as long as you're not The Joint Commission.

    She had a variety of new complaints each night and the MD was sick of hearing about them and convinced they were all anxiety driven. She was the type of patient that was so anxious the people in the rooms next to her and the RN caring for her got anxious by osmosis.
  12. by   NurseCard
    Had a GI doc once that, when he would get mad about something the
    nursing staff supposedly missed.. would WRITE an order that said
    "Write an incident report about ___"
  13. by   blondy2061h
    Oh, I just remembered a great one. We had a patient on an uncommon specialty drug for an off label indication that had to come from a far away pharmacy and was exorbitantly expensive. The patient was dying and made a miraculous turn around on said med. We'll call this guy Patient A. At the same time Patient A was admitted, Patient B came in with the same condition under the same service. The physician immediately began trying to get approval to get Miracluzamab for Patient B but it was looking like it would take awhile.

    So he wrote an order "Please give one of Patient A's Miracluzamab pills to Patient B daily. We'll replace them when Patient B's supply comes in." Yep. So Patient A's name was actually in Patient B's chart.

    Incidentally, this was the same physician as the aforementioned highly inclusive Ativan order.

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