What is the most incompetent thing you seen a fellow nurse do? - page 5
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
Jun 5, '02Mario
I have seen many things that are said and done by nurses. Not all of them good. you see, take the best of what you see and incorporate it into your own practice.
Your own practice is just that. Yours.
YOU have to decide what kind of nurse YOU want to be. Compassionate, caring, understanding........ you get the picture.
Sometimes nurses become impatient, frustrated, and loose sight of their BEST practice.
Take all of it in, grow from it. You will see all kinds of things.......doesn't make it right.
Jun 7, '02just yesterday i answered a call light..complaint that his iv was stinging. walked into the room and found an k rider 20meq in 100cc, infusing at 300cc/hr!!!! thank goodness the patient was with it enough to notice. i spoke with the nurse and she said she must have hit an extra 0....no biggie. omg, i almost lost it. where do we find these people? no biggie?!
Jun 7, '02Many years ago when we used kangaroo pouches and didn't have infusion pumps, I witness an RN hang a bag, apparent forgot to check it. It went in a full drops per minute, the pt. aspirated and died. Then this same nurse misread an order for Dilaudid 2 mg Im and gave 4 mg IM (total 2cc each one in their own carpuject, so she had to combine then, ) then have the gall, to say "well, I didn't kill him." We whispered (this one you didn't)
She has since had a car accident and has brain damage and would you believe she is still practicing as an Rn, but it's on a rehab unit, where needles are seldom used, and she only works part time. She's past the age of retirement, we'll all breathe easier when she does, until then, we check just about everything she does.
Jun 7, '02In ER, there was a new graduate I worked with that was always checking my work (I'd been an RN for 5 years then), trying to find something wrong with it. He was a male, and seemed insecure, so I always kind of just took him with a grain of salt.
Sunday, we had an 18 year old young man with terminal bone cancer (who also had cancer in his heart-first time I ever heard of that) come in. He was very end-stage, but was AAOX3. His young wife and his parents were at the bedside. Their baby was with the other grandparents.
Anyway-this patient was assigned to the aforementioned male nurse. For some reason, the patient was to receive a heparin bolus, IVP, that was to be 30 units. Somehow, our Einstein thought it said *30,000* units, and gave him that dose, IVP!!! The charge nurse happened upon a whole stack of empty heparin vials, and asked who used them all. When Einstein said that he had, we all sucked in a deep breath, at the same time. When she found out that he had given them all to one patient, we all groaned, almost as one. This wasn't bad enough-EINSTEIN WASN'T WRONG!!! He got the chart, to show us that we were the ones that were wrong, and ruh-roh, busted! The charge nurse told me to leave trauma and hand over my patients to this smart a**, to do one-on-one with the affected patient and his family. As she called his PMD to report the incident and get orders, it was left to me to esssplain what was going on, to the family. When we got the order for the protamine zinc, another nurse was sent to Pharmacy to get it. They brought it in the room, along with the syringe and the order, for me to draw up. After I gave the med, his doctor came in-a very bright woman with the nickname "Ice Queen" for her lack of personality with the nursing staff. She was wonderful with the family, and very nice to me. She told me that I was not to leave the patient's side for the next 4 hours, as PTTs were to be drawn q4h until it was within normal range.
The patient and his family were wonderful, and I got to know them very well during the 4 hours I was with them. The story was heartbreaking-although, even that day, the patient looked very healthy, they had been told his demise was imminent. He was a high school football player who had some chest pain, and went to get it checked out. Bammo! CA of the heart! They then found it was all in his bones, brain, etc.
I was finally able to get him upstairs to a room. I brought the stretcher back down to the ER, locked myself in the restroom, and cried my eyes out-for the patient, his little wife and child, his parents, and because the people he trusted to take care of him had let him down!
Mr. Einstein left me alone after that, but never would admit that he had done anything wrong, even though the evidence was there, and he had admitted giving the drug! What ego!
Jun 7, '02Oh, Cathy...such a sad story about the 18 yr old with cancer and mets...sometimes it's soooooohard to be a nurse and this is one of those times. It IS different when the patient is older and has lived their life. Young folks and kiddos tear my heart out.
In my opinion, this nurse you described is THE MOST dangerous of all....he thinks he can do no wrong, and knows everything.
A cautious, thoughtful nurse who knows he/she is only human is much more competent and safe!
Jun 11, '02What an interesting and scary thread. I work with one nurse who has done some pretty unusual things. One night soon after she came to work in our unit, she was assigned to a teenager who had skiied into a tree and KO'd himself. The kid was really out of it at the start of the shift, but along toward midnight, he started coming around. We had him intubated and ventilated because his airway protective reflexes had been iffy and his GCS about 6. Well, he sat up in bed, circuit dragging on the ETT, reached down and yanked his foley. Our charge nurse climbed up on the bed and knelt on his shoulders to keep his head down (she in a dress, I might add) while his nurse was asking for a foley tray... We all were a little confused by that. A- airway, b- breathing, C- circulation... F- foley is pretty far down the list. Lately, a good three years since she came to us, she is still doing things that make me go "Huh?" She routinely aspirates nasojejeunal tubes q4h.Why? Because she's always done it. These days she has taken up outpost nursing, where she's the only game in town. I wonder how long it will be before we get a really sick admission from her post.
Jun 11, '02Originally posted by 911fltrn
I didnt witness this but aprrox 3 weeks ago a nurse hung norcuron thinking it was an antibiotic. Pt wasnt intubated and norcuron was found by code team. Pt expired. Supposedly nurse still has job and got a pay raise.Last edit by Brownms46 on Jun 11, '02
Jun 11, '02I work for a small county hospital in med-surg. I occasionally get floated to the 4 bed ICU as the "second" nurse. I usually don't have a problem with this because the ICU nurses always give me the less complicated patients. One day I was working in ICU with an RN who was new to our facility. I am not sure how long she had been a nurse or what kind of ICU experience she had. Anyway, her 75 year old female patient had a HR of 100, then 110, then 120. This kept going on for a while. I finally hinted that maybe she ought to call the doctor. She decided that she would call the doc. By this time, the little old lady's HR was in the 140-150's range, and her B/P is going down the drain. She calls the primary doc and just acts like the little old lady is just tachy. Didn't tell him about the high HR, the dropping B/P, and her increasing SOB. The family doc orders for our internist to consult. I ask "Jane" if she was going to page Dr. N for this patient. She called his office and they said he would be in his office about 2. This was like at 0900! I don't like to butt in on somebody's else's patient, but at that time I needed to. I told her that the internist needed paged STAT. She replies, why? I am going because the little old lady is going to code if we don't do something fast. I paged the house super, and told her of the situation. The super informed the nurse that she WOULD beep the internist STAT. Our internist who is a gem, of course came right away and the lady survived.
Had another nurse about a year ago that was really scary. She would sign of meds that she never gave, knowingly let IV's infiltrate and not pull them, did rotten assessments on patients. After about 6 months of her and numerous write-ups, she finally was released from her job. Caught her falsifying a chart.
Jun 12, '02I was asked by administration to investigate and document my findings regarding a code situation and the performance of the ACLS nurse. She cardioverted her patient for what she thought was V Tach.
It was a 100% paced rhythm. All earlier rhythm strips and 12 leads clearly showed this same paced rhythm. Nothing new.
Patient did not survive. Pacemaker pouch clearly was visible on chest wall, docs notes indicate PPM. I don't know how she missed seeing the pacer when she shocked him....
A spike was NOT clearly evident on the rhythm strip, but ....sometimes it isn't...we gotta be careful out there.Last edit by mattsmom81 on Jun 12, '02
Jun 12, '02How about giving KCl instead of Kayexalate? I floated to a medsurg floor last night, as charge, no less. Patient with a serum potassium of 7.1 was ordered Kayexalate. The nurse thought it wasn't up from the pharmacy yet, so borrowed from another patient's drawer. Only problem is, she borrowed KCl instead. I found the error at the end of the shift, when I found the kayexalate still in the med room, and asked why it wasn't given. She told me she had given it, just borrowed from another drawer. When I asked her to show me, because I knew there was no other patient on the kayexalate, she showed me the empty potassium bag. Not only did the patient get the wrong med, the other patient never got her potassium. When I explained the difference to her, she asked me not to write it up because she had been told one more error, and she would be fired. She didnot seem to be at all concerned about the potential harm to the patient. Of course, I wrote it up.
Jun 12, '02Resident on mechanical soft diet was served a WHOLE meetball at dinner and went down in the hall on the way back to the unit. RN did not know how to do the heimlich or CPR when the resident finally stoped breathing from having a meetball lodged in the throat. RN called 911 and did nothing. Resident died, family lawsuit pending. Entire episode in hall was filmed on security tapes, shouldn't be a hard case to prove.
Jun 12, '02KCL instead of Kayexelate. That is a biggie. I hope she realizes now the consequences of high potassium levels in a patient.
Jun 12, '02Although I've only been in practice for less than a year, I've witnessed my fair share of errors. Most recently, I had just received report from the night shift RN. I began to check my charts for any missed orders. I saw a TO for "30 units NPH stat & qam" written by the RN I had just received report from. I thought to myself this was odd because she didn't mention that the pt. had a DM history. He wasn't on accuchecks. I turned his chart inside out to check if he was ever on insulin. Luckily, I was able to catch her before she left. Turns out, she transcribed the phone order in the wrong chart! Sure, maybe she was exhausted and in a hurry to leave. But what If I wasn't the type of RN that wasn't prudent enough to double/triple check orders and question things that seem "odd". I've even witnessed pt's on the wrong IVF's (ie. pt getting D5W instead of 0.9). Also, another pt. had been getting Haldol days after the MD d'cd it. Everyone kept wondering why the pt. was so out of it. These are very experienced nurses with 20+ years behind them. I have less the 1 year of experience and am able to catch their mistakes. Never underestimate the knowledge of a new grad!:-)
Luckliy,I've only been at this hospital for a few weeks and I'm leaving on next week. Most of these RN's give you the most blanked reports (i.e. can't tell you what the vent setting are, don't know when the last PTT was drawn or result and pt is on heparin). I can't wait to move on.....