What is the most incompetent thing you seen a fellow nurse do? - page 6
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 12, '02Why has the staff tolerated such poor nursing care as you describe, RNDIVA?
It's time to start some documentation for the manager when a nurse consistently 'doesn't know the vent settings' or the last PTT...because indeed, this is the nurses job to know such things..
Or..are your coworkers a tad passive aggressive and choosing to not 'share' info with you...I have worked with a few of those too.
Don't let 'em get ya down...doing well is the BEST revenge!
Jun 12, '02Matt...to say these nurse are passive-regressive is putting it mildly. Also, when I questioned this nurse as to what the vent settings were, she replied "the vent settings are good". That was really amusing considering I could find "Good" anywhere on the vent:-). I'm new at this hospital (well will be leaving soon). This is a very small community hospital, and I came from one of the largest trauma centers in Chicago (telemetry). I try to make my reports to the oncoming shift as comprehensive as possible, and they just stare at me like I'm speaking Latin or something. The unit I work on harldy qualifies as a telemetry floor. If the pt. needs NTG or Dopamine, they go to the unit. The RNs there are not trained to think for themselves. They will call the MD if pt BS is 65, without even intervening first with say OJ and graham crackers. The administartion is so hung up documentation (they use Meditech). If you don't document on that "hep-locked" IV ever 2 hours, you'll find yourself in a lot of trouble:-). And, they wonder why I'm leaving......
Jun 12, '02I had that problem recently where this "nurse" I received report from kept telling me everything I asked her something about the pt she had supposedly taken care of for 16hrs. She told me...it's on the chart...or it's on the med sheet, or its on the door!!...!! Finally I got the chart and noted there was an order for 1200cc fld restriction!! I asked her if this pt was indeed on fld rest. She states...I didn't know anything about that...I didn't get that in rerport...and then finally...IT'S ON THE DOOR!!!!! Now if it was on the door...why did she not know about the restriction, and why couldn't she tell me how much the pt had taken in?? I finally asked her...why did she bother to give me report if all the infomation WAS ELSEWHERE!..! She complained to the oncoming "charge nurse"...that "I" embrassed her!!! Yeah RIGHT!Last edit by Brownms46 on Jun 12, '02
Jun 13, '02I know what you guys mean, Diva and Brownie...we can forgive someone who is scatter brained from a horrendous shift...if it happens once in awhile...but if this stuff goes on CONSISTENTLY it really needs to be addressed. I sure wouldn't want someone like you guys describe taking care of MY loved one....
Jun 13, '02Mattsmom, when I talked to the nurse manager of this nurse's unit, I was told she had made similar errors in the past, like giving Mag Citrate instead of Mag Ox. Seems she had a habit of "borrowing " from other patient's med drawers, and could not make a distinction between drugs with similar sounding names. The manager had suggested a pharmacology course for her, but the nurse had refused, and promised she would be more careful. She was terminated after I filled out the incident report. Most of the time in our facility, these reports are not used to terminate an employee, but this girl had numerous med errors in the past, and had been warned she would be terminated.
Jun 13, '02This is from personal experience...My husband was admitted w/ A-fib and was ordered Dig 0.5mg IVP x2 as a loading dose. He did not get up till his room until late and was asleep when the night nurse came in to give his meds (she hadn't bothered to assess him first). His normal resting heart rate is high 30's to low 40's. This nurse was about to push the dig when I asked her "Aren't you going to check his apical pulse first?"She replied "Well, he's on tele anyway." My husband was 24 and this is the first time he had ever had this med. Isn't there a litttle thing called ASSESSMENT?
Jun 13, '02My hubby was admitted with new onset a-fib last summer (33 years old). The night nurse came in when we finally got to the floor at 3am and did his assessment. She asked alot of questions, but never put a stethascope to his chest, or even checked a radial pulse for that matter. Later the med nurse came in and told my husband "I have your blood pressure medicine". My husband told her that he does't take any meds, and his B/P was low in the ER. (My husband said the way she worded it made it sound like it was a routine med for him, and that is why he said that he doesn't take any meds, meaning ROUTINE meds). Before I had a chance to say anything she snapped "well, you can REFUSE the medicine if you want too!" I called down to the ER (I worked in that hosp. ER at the time) and asked the nurse taking care of him there if the doc ordered B/P meds, and he said NO! the B/P was low. Then said, oh, he did order Lopressor, but more for the rhythm. When the cardiologist came in, I told him that my husband was not trying to be difficult or refuse meds, but the nurse didn't attempt to see what the med was prescribed for. The doc said, "well, half these nurses around here don't know what they are giving or why!"
Jun 13, '02Amy ER NUrse,
Glad to know that I'm not alone! If I'm ever sick and have to be in the hospital, I'm going to make sure I have another nurse there. You never know what's going to happen. Sad, isn't it?
Jun 13, '02So true! Just last night in the ER where I work now the ER doc said she called the pts pvt MD and he ordered TRIAVIL 3cc, but she was not sure how he wanted that administered, so call the pharmacy. I called, and THANK GOD the hospital did not have TRIAVIL in cc's, only PO. About that time the pvt MD came down, and I asked him about the order. He said he ordered TRIDIL (Nitro drip) to be run at 3cchr via pump!!! I thought the ER MD would have been clear on the order the pvt MD gave!!!
Jun 13, '02Incompetence is everywhere, including hospitals. I work in a teaching hospital... I wonder how some of these residents ever got through med school. Very, very scary.
Jun 13, '02Originally posted by Amy ER Nurse
So true! Just last night in the ER where I work now the ER doc said she called the pts pvt MD and he ordered TRIAVIL 3cc, but she was not sure how he wanted that administered, so call the pharmacy. I called, and THANK GOD the hospital did not have TRIAVIL in cc's, only PO. About that time the pvt MD came down, and I asked him about the order. He said he ordered TRIDIL (Nitro drip) to be run at 3cchr via pump!!! I thought the ER MD would have been clear on the order the pvt MD gave!!!
Jun 15, '02Some of the blame for incidents like the Triavil/Tridil one must lie with the drug companies. New drugs coming on the market are being given proprietary names that are too similar in bothand sound to already existing drugs. One way around this potentially disastrous little conundrum is to create a policy whereby physicians must order all meds by the generic name, although this isn't totally without risk either. Fluoxetine/fluvoxamine is just one example of a possible mix-up there. Physicians are notorious for illegible handwriting, so maybe computerized charting will reduce some of these errors. I just thank God that nurses are the questioning sort and don't hesitate to clarify seemingly incongruous orders! Think of all the folks who never know they had a close call.
Jun 15, '02Originally posted by mario_ragucci
I've only worked in a hospital as a cna now for almost 2 months. I went two months before coming to the worst I've seen. My mouth activaed, and I started bad feelings on nurses part, and nurse wound up bad mouthing me and ??.
Pt is young guy recovering from rollover auto accident, head trauma+ body. I am a sitter, and the night before he pulled out his trach. Then his foley was removed. He's a nice young guy, his mom spent time with him, but the nurse rarely came in, said they just got back from vacation, and the sentences were broken when she spoke. by days end, the poor guy scratched his head wound (lil blood) and keeps trying to stand up to urinate (like a male would) after having the foley removed.
In CNA school, and in nursing school so far, the use of restraints is mentioned often as a last resort. They say you need a DR's order every time. So I am conditioned to believe yewd need a dr. to come in and say put them on. They really emphasize restraints are last resort.
Nurse makes a cameo appearance in the room, sees a little blood on his hand, and over reacts. She starts drilling me about not noticing it. Pt tried to stand up (he can't too well) and the nurse starts barking about putting him in restraints. Her voice and demenour were bad. I just said one word, "threat" and she left the room in a tizzy angry at me.
I think if your gonna use restraints, for a patients own good, you should just puttem on and not talk about it. And not threaten their use. The nurse had no empathy for this patient at all.
All these stories are very interesting, and I learn much from reading them. The vocabulary I reap is what I am thanking you for, and the introduction of various scenarios as well. I can not feign to understand all the drug names and proceedural descriptions, but I am loving to imagine.
If you use restraints you have to have a dr.s order, always. The order has to read the reason for the restraint, and that you loosen it Q 2 hrs and at meal times, and a restraint order is only good for 24 hours. But it can be written the same way the next day. It's ALWAYS prudent to check with the family before the restraint order, it could save you and the facility alot of headaches and possible law suits.