Orders from hell... - page 3

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   djh123
    I get one-time-only orders from one doctor for 6u Novolog for someone who's 600+ blood glucose. (Our stupid glucometers, even though they have 3 digits, don't go to '999' - if it's above 599, it just says "HI" - yes, some engineer should be drawn & quartered. Because if it says "HI", you have no idea if they're 601 or 851. Regardless, 6 units ain't gonna do much.)
  2. by   OlivetheRN
    "Please check rectal temperature" sounds benign enough except the patient had no anus. The MD then forgot this half an hour later and ordered a Tylenol suppository 🤦🏻*♀️ I ended up writing him a helpful sticky note that simply said "no anus" and left it stuck to his computer.
  3. by   LibraSunCNM
    Quote from 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.
    I think there are definitely OBs out there still doing that, I'm sad to say.
  4. by   blondy2061h
    Quote from djh123
    I get one-time-only orders from one doctor for 6u Novolog for someone who's 600+ blood glucose. (Our stupid glucometers, even though they have 3 digits, don't go to '999' - if it's above 599, it just says "HI" - yes, some engineer should be drawn & quartered. Because if it says "HI", you have no idea if they're 601 or 851. Regardless, 6 units ain't gonna do much.)
    The assay's ability to accurately determine a glucose in capillary blood is the limitation, not the display. At levels this high most institutes have policies that stat plasma glucose levels should be sent to the lab. Even in lab to get ab accurate reading they need to dilute the sample at levels this high.
  5. by   tch1920
    Sounds like the MD doesn't want to be called later. lol
  6. by   Amethya
    Even as a CMA I can see that order is weird... like what?
  7. by   Boomer MS, RN
    Quote from 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.
  8. by   fawnmarie
    Written by a psychiatrist on a long-term geri-psych unit, "Can she get a haircut? It's a mess!" The patient's conservator wouldn't agree to it.
  9. by   klone
    Quote from 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.
    Oh, some still do. They just can't blatantly call it that in black-and-white anymore for litigation reasons.

    Some physicians would call during the shift and ask what the pit was at, and get pissed off when you'd tell them it's at 6, and by their mental calculations of 2q20, it should be at AT LEAST 18 by now!!
  10. by   djh123
    Quote from blondy2061h
    The assay's ability to accurately determine a glucose in capillary blood is the limitation, not the display. At levels this high most institutes have policies that stat plasma glucose levels should be sent to the lab. Even in lab to get ab accurate reading they need to dilute the sample at levels this high.
    OK, thanks for the explanation. I didn't know that, nor does anyone where I work. And no, we don't ever do a stat lab on it, but I'll keep that in mind for sure.
  11. by   Extra Pickles
    Quote from blondy2061h
    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.
    Holy Cow!!
  12. by   ClaraRedheart
    Quote from KatieMI

    "Do not extubate penis" (postop Foley)
    Bahahaha! I guess the words are technically correct, a foley is a tube. Still funny though.

    Impossible orders are funny, but I think my least favorite orders that I have received were

    an enema on a bed bound patient

    manual disimpaction

    nit picking/combing a patient with headlice (Who even has time for that on a med-surg floor?! )

    I realize that they were all very necessary at the time. Still don't like them though.
  13. by   DeeAngel
    Quote from 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.

    Always amazing to me how quickly and casually doctors feel free to ask nurses to do things that are malpractice, will get them terminated, theft charges filed, and their nursing license removed. Just no, no to all of it.

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