What is the most incompetent thing you seen a fellow nurse do?

Nurses General Nursing

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Heather333

206 Posts

Amy 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?

Amy ER Nurse

43 Posts

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!!!

Heather333

206 Posts

Incompetence 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.

Brownms46

1 Article; 2,394 Posts

Specializes in Everything except surgery.
Originally 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!!!

Confusing an antidepressant with Nitro??? Whao...now that IS scary!! Something should have told that ER "doc"...that something didn't compute...:o

Pediatric Critical Care Columnist

NotReady4PrimeTime, RN

5 Articles; 7,358 Posts

Specializes in NICU, PICU, PCVICU and peds oncology.

Some 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 both spelling and 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.

eagleRN

22 Posts

Originally 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.

Brownms46

1 Article; 2,394 Posts

Specializes in Everything except surgery.

First of all....I have thought about this since I posted...and what the post referred to should not, have really resulted in a problem. As I'm sure it would have become evident...for many reasons. One when the drug arrived...I'm very sure...all would have known it was the incorrect durg..whether it came in cc's or not. Because any pt needing Nitro, was there for something cardiac, and would have been IV and not PO. I'm sure the ER MD would not have been calling the PMD for anything requiring a po med.....especially one needing nitro! And upon receiving a po med..the confusion would have been clear. Or.... upon receiving something odd from pharmacy. I think pharmacy would have become suspect also if they received an order for such a med from the ER. JMHO

I agree that similar sounding drugs can be confusing...but all the more need to repeat an order back to the person ordering it. I once wasn't sure what a MD was ordering over the phone...so I had him spell it! If I'm not sure what a med is..either generic or brand name...I look it up! These are the best ways to keep confusion down. And yes.... nurses and doctors need to have questioning minds. Never just think you heard someone correctly...KNOW!

nrw350

370 Posts

Man, this is frigthening from the patient's perspective. I pray that nothing like this ever happens to me if I need to be a patient at a hospital ever.

Nick

Amy ER Nurse

43 Posts

For the record, this pt was in for chest pain, but his anxiety level was high. MD stated that anxiety was a major contributor to his pain. I have always used Ativan in this case, though. At the time the ER doc asked me to get the med, I had just walked in the door, not even clocked in yet, much less gotten report on the pt. You would have to know how hyper this doc is! I told her to wait and let me get report on the pt, and she said, "ok, but go ahead and call to get pharmacy to send it so it will be ready." The report I got from the off going nurse was that the pt, 45yr old male , anxiety, chest pain, NSR on monitor, no ectopy. Pain at 3 on pain scale. V/S WNL, etc.....When I told off going nurse about the rx ordered, she acted like she was not suprised. I guess she must not have known what it was either!

Brownms46

1 Article; 2,394 Posts

Specializes in Everything except surgery.

Beleive me Army ER nurse, my post was not pointing to any fault of yours what so ever! It was pointing to the ER MD, who took the order from the PMD, and didn't realize what the drug was! As Triavil was totally countraindicated in the present of someone complaining of chest pain....even if the EKG was normal. Since I'm guessing that Cardiac panels hadn't been completed. And I'm also sure you would have looked the drug up...no matter what form it came in...:). Also..I felt pharmacy would have wondered why a drug, that requires a cumlative dosage to reach effectiveness(and is an antipsychotic.)..would need to be given in the ER, especailly stat.

Please believe me ...as I have worked with hyper docs before....and I know they can be a pain. I was merely stated that once the drug arrived...you would have known this was the wrong drug to give this pt....even if the ER MD didn't. I also believe you would have questioned why the PMD would order such a drug...because as you stated you would have usually used Ativan in this case. That is why I stated this wouldn't have really been a problem...:cool: But I have to believe that the ER MD would have known something was wrong also...at least I'm hoping so.

And well...maybe it could have been a problem...if no one checked out the drug and determined what it was before giving it....that is...if you haven't been there. I'm referring to your relief who showed no signs of knowing the difference either. But I tend to believe she too would have looked up this drug...:cool:

I hope this makes sense..:)

Amy ER Nurse

43 Posts

Yes, I would have to look it up because it is not something that we have ever given in the ER. It is not an emergency drug, and I would have to look up any med that I am not familiar with. I didn't get why the ER doc was so adamant that it HAD to be done NOW, but she can be like that. When I called pharmacy, he was puzzled about the drug being used in ther ER, and told me to just check with the 1st doc about it first, which is exactly what I intended to do. It did worry me that the nurse reporting off to me didn't seem to question the order. I hope she would have looked it up as well. This doc does some pretty bizarre things. She was going to have me start an IV on a 22 day old baby that had no hx of N/V/D, and was in for colic! The mother asked why the IV since she thought the baby had gas pain. I told her she had a right to refuse(and I hoped that she would, because I wouldn't want my child stuck for such a silly thing). The mom refused, and I told the doc. We gave Levsin gtts, and the baby was well relieved. She does some bizarre things in codes as well. We always try to direct the more serious things to the other doc on duty. LOL

Brownms46

1 Article; 2,394 Posts

Specializes in Everything except surgery.
Originally posted by Amy ER Nurse

[b. She was going to have me start an IV on a 22 day old baby that had no hx of N/V/D, and was in for colic! The mother asked why the IV since she thought the baby had gas pain. I told her she had a right to refuse(and I hoped that she would, because I wouldn't want my child stuck for such a silly thing). The mom refused, and I told the doc. We gave Levsin gtts, and the baby was well relieved. She does some bizarre things in codes as well. We always try to direct the more serious things to the other doc on duty. LOL [/b]

You have got to be KIDDING right???:confused: :eek:!!

Well you sure did the right thing in protecting your pt., from an totally unneccesary, and unsettling event!! WOw...I don't blame you guys for steering the real stuff elsewhere...:chuckle:

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