What is the most incompetent thing you seen a fellow nurse do? - page 2
There were two patients in a double room on a 38 bed tele floor. One was an old fart with a sick heart an the other was a 35 year old male who was in an MVA being observed for a myocardial... Read More
May 28, '02The other day, I called report to a chest pain unit. I told the nurse the pt's NTG gtt was running at 10 mcgs. She then asked me how many cc's an hour that was. I thought-little bit strange-everyone is on a NTG gtt on your floor, how could you not know how to figure out cc's/hr. But anyway, I said "That's six cc/hr" She then repeated, "okay, NTG at sixty cc/hr" Hope she didn't have a need to titrate anytime soon.
May 29, '02One of the reasons I generally do not support the idea of new grads in critical care is the high potential for errors due to lack of basic skills, judgment, and experience.
Most of the incompetent acts I've witnessed in my critical care areas over the years are committed by brand new nurses trying to function in a critical area they are not ready for, IMO.
Here's another: I was told to precept a new grad RN. He had been promised he could work with me with a fresh heart. My boss insisted (she liked him). I talked aloud to him as I did a system by system asessment, showed him the swan/aline/CT/drips and explained them. Explained how we carefully watch K levels and how we administer K by parameters slowly via buretrol to post heart patients. He watched me do this repeatedly and I allowed him to do one in front of me. Later I was on the phone with a doc and he wanted to check K and give the buretrol dose this time. I said do you remember exactly how? He said of course....
I looked up to VTach on the monitor and ran into the room to find he had a prepackaged KRider infusing wide open into the proximal port. I bolused with Lido immediately and luckily converted it.....he was blase about it when I told him what he had almost done to our patient.
I felt obligated to refuse to precept him any farther...as this wasn't his first booboo...and after multiple complaints from other nurses, my manager eventually turfed him out to the floors for more basic experience. Which was what he needed to begin with.....!
Why put new grads through this kind of failure and risk our patients.....this is why I believe medsurg for a year before ICU is the best rule.
May 29, '02I'll never forget one evening years ago when I was working as a CNA in LTC...... (I was in my first year of) ..... the charge nurse that evening asked me.... 'what should I do, I'm running out of D5 and not sure what to do..... It will never last through the night..... She had NO clue how to even hook up the tubing, much less what TKO meant, nor the rate TKO..... needless to say, she was terminated shortly after that evening.....
May 29, '02I have seen plenty of scary things!!! One nurse pushed Dilantin thru a umbilical line without flushing it...and just pushed it quickly. Duh...and then the same person piggybacked 25%Albumin with her HAL and IL!!! She is relatively new and has the attitude that she knows it all..she is 23 and straight out of school.
May 29, '02We have a rumor... perhaps folklore... at one hospital. The story goes that an RN pushed aspirin through a central line because her patient, who c/o a HA, was NPO for surgery.
Sure hope that its not true.
May 29, '02Tube feed through a central line. Horrible mistake. Thankfully, the patient survived!
Another one . . . flushing a central line with potassium. That patient also survived, thankfully. (It didn't help that the heparin and kcl vials were the same color!!!)
The first nurse was new. Don't know how she mixed a central line with a dubhoff. The second nurse was a seasoned oncology nurse. She just didn't read the vials. . . just grabbed a brown colored vial and thought it was heparin.
I didn't actually see these occurances. We sure did talk about them during our staff meeting, though.
One last one. This one is a minor legend in the hospital where I used to work:
Giving vancristine interthecally (sp?) for brain mets. (was ment to have given another chemotherapy agent!!) This was done by two physicians, actually. The first physician handed the second physician the wrong chemotherapy agent. I guess neither read the prepared syringes. Patient did not survive.
May 29, '02I once worked with an RN on nights that always worried me. One night her patient had a 44-beat run of VT. I went running into the room and I think I scared the guy back into sinus. When I went back out to the nurses' station, she was sitting there reading a magazine. When I asked her if she was going to call the doc, she replied, "Why? He's in sinus now." Duh. I made her call and we started him on a lido gtt.
Another time towards the end of a shift, she was in one patient's room drawing labs or something, when her other patient alarmed with a high BP. I went into the room to check on him. He was on a ventilator and was paralyzed (with Nimbex). He was lying there with his eyes open, bloodshot and dry, but he just looked freaky. I checked to see when she had last sedated him, and he had had no sedation at all thoughout the night. She had been giving him Nimbex routinely every 30 min. and had a liberal order for morphine prn but had not given him any. When I questioned her about it, she had even performed a painful dressing change on him, thinking since he was paralyzed he couldn't feel anything. I no longer work in that unit, but whenever I see her, I pray for her patients.
May 29, '02Was working 3-11 on Peds unit...11-7 nurse was a floater and I decided to stay a while and get her situated and a little oriented to the unit before I left...she said she was confident and I was free to leave...was just talking with other nurse on shift when I had a wierd feeling I should check on floater before I left...she was giving liquid acetaminophen, IV, to child who was NPO... by the grace of God, I lept across the room,turned off the fluids,pinched the tubing above the catheter,and pushed her ass outta the room,all in one fell swoop... called for the other nurse, dc'd iv site, called supervisor, floater was sent back to her unit, I worked a double.
One laughable moment was when a nurse called me to help her...she had poured dry Metamucil down an NGT and followed it with water...needless to say,the tube.was clogged with "concrete"... this nurse, continued to do things like this...she was made manager of the med/surg unit...sometimes ya just gotta laugh....:roll :chuckle
May 30, '02I heard of a student who gave a peg tube enteric med by central line one day when I was off duty. Patient didn't make it.
The instructor was nowhere to be seen when this occurred. So the hospital blamed the nurse, who was a coworker of mine. They fired him for it.
May 30, '02[QUOTE]Originally posted by st4304
[B]I once worked with an RN on nights that always worried me. One night her patient had a 44-beat run of VT. I went running into the room and I think I scared the guy back into sinus. When I went back out to the nurses' station, she was sitting there reading a magazine. When I asked her if she was going to call the doc, she replied, "Why? He's in sinus now." Duh. I made her call and we started him on a lido gtt.
Oh-my-God! We probably would have had to put a "Y" site in somehow, and let me share his Lido! That chick is pure-D dangerous!
Just one, of many-I was in ER, responded to a code in ICU. A staff Dr. was "in charge" of the code. RT tubed the patient, an thin, frail, elderly lady. Suddenly, it began to look as though the lady was 3-4 mos. preg. I suggested to the RT that he should check tube placement-he kept bagging, and refused. I suggested it to Mr. Staff MD-he said it is fine, I listened after placement. This absurdity of a code continued for over 30 min!! At the end, the little lady looked as though she was about to deliver, and Mr. PT could barely squeeze the ambu! Duh! The family was outside-can't imagine how they explained to them that Momma got so pregnant, all of a sudden!:imbar
May 30, '02I've seen a nurse drop a catheter on the floor and go ahead and insert it, did not stop blood when evident reaction, because it was too much paperwork. Scary stuff
May 30, '02One of my colleagues gave supper pills to a few residents at breakfast, apparently realized it when a resident corrected her. Never told the oncoming evening nurse, so therefore, she unknowingly double doses some of them, then realizes a mistake was made when the pills became out of sequence, called the nurse at home, who then "remembers" suddenly. Evening nurse files med error and apparently NOTHING happens to this incompetent nurse who first makes a med error, and only admits it when she is caught, charts four days later "resident monitored." HOW CAN THE EVENING NURSE "MONITOR" WHEN SHE NEVER KNEW THE ERROR OCCURED!!! It sickens me.
May 30, '02When I was a new grad working in LTC, there was a resident with severe RA, and was on megadoses of narcotics for pain. She had an order for Demerol IM. The nurse drew it up, mixed it with applesauce, and gave it PO.
That was the first med error I ever saw. Obviously it made a huge impression on me, and hopefully, has helped me to remember to do my 5 rights and 3 checks!!!