A true life horror story

[nurse2it]

Several years ago I was working as an agency nurse on the 7p-7a shift and received an admit, a gentleman in his 40's with dx cp r/o mi, a&ox3. At this hospital the standard iv tubing was about 6 ft long with an extension set approx 18 inches long attached to the angiocath. After getting the pt settled, I pulled up a chair to his left and started entering the standard admission info into the laptop, his iv was in his right hand. Finished the admit in about 20 minutes and left to call the md for a clarification, tube orders to the pharmacy, etc. This probably took about 45 minutes. I went back to check on the pt and label the iv tubing, somehow the extension set had become disconnected distally to the site, blood dripping and what looked like about 2 units of clotted blood on the floor! Called the lab for a stat draw, changed the tubing, called the doc to report that the pt's hct had dropped by 3 pts and what had happened. Got the mess cleaned up, somehow the pt remained calm and went back to sleep shortly afterwards. Through the remainder of my contract, the first thing I did when I got a new admit was make sure that the iv tubing connections were super tight. When I think about what could have happened I get chills, in the incident report I suggested they get rid of that particular tubing, nothing changed. Does anyone else have a story to share?

[Tait, MSN, RN]

I had a patient with decreased 02 sats from a rehab. She was on a bi-pap when I first got there, however RT had swapped her to a venti. I was in her room when she started throwing up into the venti mask. I got her cleaned up, called RRT, and gave her some zofran. I had to get her back on the bi-pap as her sats weren't holding, talked to the fmaily and they made her a DNR.

Later, reiterating the story to another RRT, she told me that had the patient been on the bi-pap when she threw up she would have probably aspirated, choked, and coded on me right there. I hadn't even thought about a pressure mask causing that!

Luckily it seemed to be a case of flash pulm and she went home a few days later.

[emtb2rn, BSN, RN, EMT-B]

i had a 90 year old patient that came up from ER with mental status changes and had a fall at the nursing home. He came up wit his IV, with a piece of TAPE across the entry site. Usually IV therapy does our IV's, except in ER they do their own. So they come up to us with some crazy IV placements that we wonder where the nurses's heads are.

I mean, a piece of tape across the entrance site highly constitutes for a sterile placement. Usually we have at lease a tegaderm over it. It wasnt even "hospital tape" it was like a piece of the tape you use to wrap christmas gifts with.

Because we have IV therapy, I ended up calling them to start a new IV.

what happens if you lose access and it's an emergent situation? Do you wait for the iv team?

also, did you ask the er rn why the iv was taped that way?

[classicdame, MSN, EdD]

patient admitted with infected fistula to be repaired in a.m. During the night it ruptured spontaneously. Blood everywhere. Doc's advise was to hold pressure. DUH

[canesdukegirl, BSN, RN]

Weird that you posted this. I was just thinking today of a pt that I had when I first started my nursing career.

I had a Stage IV ovarian ca pt. Her K+ was very high. We gave her some Kayexalate and you can guess what happened. She was obese, and she was unable to control her bowels. She kept crying, yelling out that she felt like a "disgusting fat pig laying in her own s#$t". I cleaned her up as best I could, but the bowels kept moving, so I was constantly cleaning her and trying to calm her down at the same time. She said to me, "The only thing I want is to look presentable when I die. I can't deal with smelling like a garbage can and looking like this." She was from a strong Southern family. Her family was in the room, aghast at what they were seeing. She was alternately cold and hot, so I swiped a fan from the sister unit. I educated the family and gave them instructions on comfort care.

She was DNR, and did code during my shift. This was an experience that I will never forget. This poor woman did not want to die laying in her own feces. When the family left, I cleaned her up, changed the sheets and put some of my Bath and Body Works lotion on her so that she would not "smell like a garbage can". I know that she would have appreciated this, and it was an honor to make this last wish a reality, albeit a late one.

[K+MgSO4, BSN]

O.M.G, K+MgSO4 ! I am getting a visual on this!! I know it wasn't funny at the time but it is hysterical now! Hope he felt better. :rotfl:

He did feel so much better! Spoke to the docs and he was killing himself laughing! was back home at a wedding recently(I now live in Australia) of one of those colleagues and after a few drinks that story came up! We were getting some funny looks from other people from the shrieks of laughter!

[cogath]

I had a patient who kept violently rolling around and laying on their PICC. Kept thinking it was going to become dislodged!!

[SouthernPoint]

We had a patient who had been battling with a infected fistula on their lower forearm for a couple of months. It had been a couple of weeks since I had taken care of them, so I kinda lost track of their stay with us. Well one day as I was walking down the hall headed to the end nursing station I passed the housekeeper who was just cleaning, room by room. As I was heading back to my assigned area I had just walked passed the room the housekeeper was going into. I wasn't really paying to much attention to the housekeeper. Then all of a sudden the housekeeper started screaming bloody murder. After I collected my heart which just leaped out of my chest, I turned around to find out what the heck was going on. All the housekeeper could do was scream and speak in their native tongue. I was the 1st person to run into the patients room. Just as I entered the patients room, the patients nurse was right on my tail. The patients nurse spotted the floor before me and grabs me by my scrub top yanking me backwards. The patients fistula popped and they ended up bleeding out. It was a massive mess. It's always one thing to know just how much blood one person has, but until you see most of it on the floor it's always shocking. Needless to say the patient didn't make it and housekeeping had to have a crime scene cleaner come in to clean the room due to the amount of blood.

[canoehead, BSN, RN]

housekeeping had to have a crime scene cleaner come in to clean the room due to the amount of blood.

Weenies.

I'm surprised they didn't tell the nurses it was their job to "prepare the surface."

[SouthernPoint]

Weenies.

I'm surprised they didn't tell the nurses it was their job to "prepare the surface."

Oh trust me. They tried. The patients nurse and I did try and clean some of it up, but it was really bad. The house supervisor response's to all code's and once we got everyone to clear the room the house supervisor told us to stop and they would call the housekeeping supervisor and see what needed to be done. After having a mini-meeting it was decided to call in backup.

The room ended up being closed down for 2 days over it. They had to do a complete bed breakdown to get to the blood out of the nooks and screw heads.

[nurseprnRN, BSN, RN]

i have two gawdawful bloody mess stories

first: the classic ruptured esophageal varices. in the icu, we're pumping in blood eight ways to sunday, the melena is pouring out one end, the gastric tube is pouring blood out the other, we are all splattered and the room looks like a slaughterhouse. and there, standing in the middle of all this, is the chief of gastroenterology, a tall, regal, silver-haired gentleman in a white lab coat, directing the whole affair and not a spot on him. i have friends who remember that, and it was almost 40 years ago.

second, and not so much fun: the heart transplant patient whose sternal wound got infected with some sort of fungus. we couldn't stop it. he was packed open, and we could see his aorta right...there. hed been to the or once before when it leaked, for a patch, but... one day it just....eroded through. he got told we'd take him to the or again, and then had a huge dose of iv morphine, and fell asleep without fear. then we canceled the call or. this was the most merciful act i have ever witnessed a physician perform. helluva mess, though.

[Blindsided]

Wow! I want to thank all of you for these sometimes funny/sometimes horrifying stories.