What have other nurses done that have freaked you out? - page 53

What has other peers done intentional/unintentional to freak you out? Good or bad. Happy or sad. On my FIRST day as a LVN, (LTC) a res was screaming in her room as I was walking out to leave. I... Read More

  1. by   thehipcrip
    One night in the ED, a tetraplegic patient who manages her bladder with a Foley and had previous experiences with nosocomial UTIs, was on a gurney while waiting for a bed in Med/Surg. Patient noticed her collection bag was full, and asked that someone come empty it.

    CNA arrives and, without washing her hands or putting on gloves, reaches to empty the bag. Patient stops her, explaining the hx of UTIs she's caught while hospitalized and asks the CNA to either wash/sanitize her hands or put on gloves before touching the collection bag.

    The CNA proceeds to argue with the patient about washing her hands, telling the patient how "all that hand washing makes her skin too dry" so unless the patient can provide her with hand lotion, CNA will not clean her hands.

    When patient holds her ground (telling CNA that patient does indeed have lotion, but the CNA is free to glove up if hand washing is too harsh), CNA finally relents and dons gloves, but continues to complain about having to follow protocol.

    The CNA's parting words to the patient? That she was "far more likely to catch something nasty from the patient than the patient was from her."
  2. by   pca_85
    Quote from thehipcrip
    One night in the ED, a tetraplegic patient who manages her bladder with a Foley and had previous experiences with nosocomial UTIs, was on a gurney while waiting for a bed in Med/Surg. Patient noticed her collection bag was full, and asked that someone come empty it.

    CNA arrives and, without washing her hands or putting on gloves, reaches to empty the bag. Patient stops her, explaining the hx of UTIs she's caught while hospitalized and asks the CNA to either wash/sanitize her hands or put on gloves before touching the collection bag.

    The CNA proceeds to argue with the patient about washing her hands, telling the patient how "all that hand washing makes her skin too dry" so unless the patient can provide her with hand lotion, CNA will not clean her hands.

    When patient holds her ground (telling CNA that patient does indeed have lotion, but the CNA is free to glove up if hand washing is too harsh), CNA finally relents and dons gloves, but continues to complain about having to follow protocol.

    The CNA's parting words to the patient? That she was "far more likely to catch something nasty from the patient than the patient was from her."
    Wow. Someone's so in the wrong line of work.
  3. by   cardiacmadeline
    I once got a post-op that had a bronch done during surgery. PACU tells me that they had to put him on CPAP because of breathing difficulties. He comes down to me, I listen to his lung sounds, and he has no lung sounds on his right side! Contact the MD who performed the bronch, orders CXR, R lung collapsed. Patient got a chest tube soon after and was off of CPAP soon after that.

    I have seen a couple of nurses administer ordered prn IV narcotics, but because the patient is still in pain, they administered it an hour early or gave them a "little extra"--without a doctor's order.

    One of our CABG patients had a low BP, the charge nurse goes in the room and finds IVF infusing at 200ml/hr. The nurse decided to turn up his IVF to help his blood pressure. I don't believe she notified the doc, but knowing the charge nurse, she probably made the RN call the doc and let him know.

    This one drives me nuts. Holding coreg per nursing judgment for a patient with CHF, because the RN felt SBP in the 90's was too low. If you are unsure of giving it, then notify the MD! This just shows lack of knowledge and that is why I think it drives me nuts. Same thing with holding Lantus without notifying the MD.

    This was during clinicals. I asked a CNA to help me get a patient who just had hip surgery out of bed. She goes in the room, grabs him by the ankles, and pulls him to the edge of the bed by his ankles! Needless to say, the patient was not happy and he ended up staying in bed.
  4. by   cherrybreeze
    Quote from rachelgeorgina
    Is this not common? On my last clinical every second patient was on IV infusions of paracetamol in the post-op period while they were NBM.
    In the US, acetaminophen (your paracetamol) is not available IV/IM. It comes in an oral form only.
  5. by   VegetasGRL03RN
    Quote from cherrybreeze
    In the US, acetaminophen (your paracetamol) is not available IV/IM. It comes in an oral form only.

    Don't forget about PR!
  6. by   maestrotee
    Quote from slinkeecat
    I saw a nurse sniff and then lick her finger and exclaim... "Yep, it's Jevity"... she touched goop that was around the stoma of a G-tube.... I damn near stroked out
    WHAT THE ...?!?! I think I just threw up in my mouth a little! Blechhhhh!!!
  7. by   meluhn
    Quote from cardiacmadeline
    This one drives me nuts. Holding coreg per nursing judgment for a patient with CHF, because the RN felt SBP in the 90's was too low. If you are unsure of giving it, then notify the MD! This just shows lack of knowledge and that is why I think it drives me nuts. Same thing with holding Lantus without notifying the MD.
    I do hold coreg for this reason all the time, I dont see the problem. I think holding it is a better option than letting the pt bp bottom out. Unless the pt is tachy, I don't see the problem with holding it. Beta blockers used to be contraindicated in chf, this one is used for tachy arrythmias. I hold it and then notify the md when I get around to it, chances are they will get it again later anyway. If you know otherwise, please enlighten me.
  8. by   belgarion
    When I was a student an RN one of my classmates was shadowing drew up an IM injection with a blunt and then forgot to switch needles. She somehow managed to force the thing through the patient's skin to give the injection. She then blamed the student for not catching her and in the interest of "maintaining the school's relationship with the hospital" the student received three demerits. I might add it was only our third week of clinicals.
  9. by   fiveofpeep
    ouch!
  10. by   Simba&NalasMom
    Didn't really "freak me out" so much as grossed me out: I showed up to work an agency shift at a medical group home and did rounds with the day shift staff nurse. One of the residents had a boil on his shoulder and she popped it with her bare hands and didn't wash up afterwards.
  11. by   Simba&NalasMom
    Quote from belgarion
    When I was a student an RN one of my classmates was shadowing drew up an IM injection with a blunt and then forgot to switch needles. She somehow managed to force the thing through the patient's skin to give the injection. She then blamed the student for not catching her and in the interest of "maintaining the school's relationship with the hospital" the student received three demerits. I might add it was only our third week of clinicals.
    Oooooooooooooo that reminds me of one of MY clinicals: a classmate's patient went hypoglycemic (I think he was in the 60's) so we tried to give him some OJ but he started choking on it. He became symptomatic shortly thereafter; diaphoretic and yelling. While he sat in the dining room sweating and yelling out, the charge nurse continued to pass her meds; she stopped once and gave us a piece of a Hershey bar to give the patient. She finally stopped her med pass to search for glucose frosting and squirted it all over his tongue instead of placing it in the buccal space. It didn't work at that point; his BS continued to drop. Put him back in his room and the charge nurse (who always bragged about being a nurse for 30 years) paged the NP who was in the building. NP ordered glucagon STAT. Guess what? Nobody could find an IM needle. The NP also mentioned to the charge nurse that the glucose should have been administered buccally and the charge nurse made the excuse that the pt was thrashing so badly she couldn't get it in right. They finally found an IM needle at the other end of the building and gave the shot.

    On top of that, some of the staff overheard me complaining about this nurse so she gave me a talking to about how I'm a student and don't know the patients, nursing is more than values that we read about in books, she knew better, blah blah blah. I was lucky she didn't complain to my school, although to this day I know I was in the right.
  12. by   cardiacmadeline
    Quote from meluhn
    I do hold coreg for this reason all the time, I dont see the problem. I think holding it is a better option than letting the pt bp bottom out. Unless the pt is tachy, I don't see the problem with holding it. Beta blockers used to be contraindicated in chf, this one is used for tachy arrythmias. I hold it and then notify the md when I get around to it, chances are they will get it again later anyway. If you know otherwise, please enlighten me.
    Coreg is a nonselective beta-alpha blocker given in HF to block SNS effects like increased heart rate, contractility, and peripheral constriction, all of which increase oxygen needs and increases the workload on the heart. Coreg is part of the core treatment of HF, with the goal being to decrease the workload on the heart and to maximize the ability of the heart. Coreg decreases heart rate to increase filling time and decreases afterload. So if a CHF'er has SBP in the 90's and this is their baseline while on coreg, I will give it. If it is a huge change from their baseline or they are symptomatic with the low BP, I would call the MD. A lot of CHF'ers have and are tolerant of low BP's and as long as they are tolerating it (have no s/s hypoperfusion or hypovolemia), they should receive their core CHF medications (diuretics, B-blockers, ACE inhibitors). You have to ask yourself if holding the medication would actually benefit the patient, and you can't base that decision on blood pressure alone, you have to look at the whole clinical picture. Also, I have always been taught that coreg therapy should never be interrupted or discontinued abruptly, so I will always call the MD before holding it unless there are parameters written.
  13. by   MNRN2009
    Quote from JennRN65
    Watched in horror as a nurse fast pushed UNDILUTED Phenergan through a peripheral IV. They did it so fast that by the time I said STOP, it was already done.
    That reminds me of a story my preceptor told me back when I was on orientation. This happened quite a few years ago. She said that at change of shift, the nurse reporting off to her told her she had just pushed Phenergan for a patient. When my preceptor went in the room to check on the patient she was not breathing, she called a code and ended up riding on the bed doing chest compression while the patient was being wheeled to the ICU. When she called the previous nurse at home, she stated that she hadn't diluted the Phenergan and didn't remember how fast she pushed it. Shortly after that, the facility stopped using Phenergan all together.

close