What is the dumbest order you ever read? - page 11

I thought I had seen some AH orders but yesterday took the all time win! I had a 97 year old man admitted from ER with impaction and the order said---- "Give oil retention enema and have pt. hold ... Read More

  1. by   tvccrn
    Quote from RainDreamer
    Just had an order last night that read:

    "Minimum feeds: 50 cc Q4 hours."

    Then that whole line was CROSSED out and had "error" written next to it.

    Then below it, it said "Minimum feeds: 25 cc Q2 hours"

    HUH?!?! Seriously?! I really want to know what's going on in these residents' minds sometimes. A lot of times I think to myself "ok, that musta made sense to someone at some point". But this one I'm just not seeing :uhoh21:

    This could mean that they want to make sure the patient gets 25ccs at least every 2hours. As opposed to 0ccs an hour for hours 1,2, and 3 then 50 ccs for hour 4. That way there is a slow steady rate instead of one big dump.

    tvccrn
  2. by   JaredCNA
    We once had this patient for months with MRSA and a TON of psych issues. It was one of those pt's that gets a different nurse every night so the nurses can keep their sanity. I mean, bipolar, manic depressive...the full load. I was surprised to read these orders:

    "Ativan 50.0 mg q3h prn anxiety."
    "Haldol 100mg IV" no frequency.

    Damn, I guess the doctor couldn't stand the patient either. :-D
  3. by   AuntieRN
    We had a mainly spanish speaking pt who had emergency surgery done. The doc wrote this order :Pt to speak spanish only!
    What if he wanted to speak another language?
  4. by   Alois Wolf
    Quote from AuntieRN
    We had a mainly spanish speaking pt who had emergency surgery done. The doc wrote this order :Pt to speak spanish only!
    What if he wanted to speak another language?
    are those "to"s just a force of habit? Did he mean Pt speak Spanish only!
  5. by   AuntieRN
    Quote from Alois Wolf
    are those "to"s just a force of habit? Did he mean Pt speak Spanish only!
    I dont know Alois but the pt spoke enough english to get us all by and we have a translater phone service.
  6. by   Alois Wolf
    lol that's pretty funny. I know enough German to get around and I would like to learn Spanish... and most definitely Sign Language. I've always considered going around the world as a nurse.... but yeah. That's a dream to be realized some day in the far off future.
  7. by   Alois Wolf
    Quote from JaredCNA
    We once had this patient for months with MRSA and a TON of psych issues. It was one of those pt's that gets a different nurse every night so the nurses can keep their sanity. I mean, bipolar, manic depressive...the full load. I was surprised to read these orders:



    "Ativan 50.0 mg q3h prn anxiety."
    "Haldol 100mg IV" no frequency.

    Damn, I guess the doctor couldn't stand the patient either. :-D


    You think the nurses have it bad? I have to deal with these guys as a means of income... just last night i had to transport 3staff for 1individual to a psych hospital in SKIP. He had stopped taking his medications since that is his "right"... but this also makes me go absolutely nuts. He punched a nurse in the face and the doc was like... yeah.... Ancora Psychiatric Hospital.

    I would take the guy with the colonm bag over the real violent types any day. I'll even empty the damn thing for you. You'll never here me shouting "BAG CHANGE IN RM 6!". lol... ah.... the pleasures of working a state facility...
  8. by   JaredCNA
    Quote from Alois Wolf
    You think the nurses have it bad? I have to deal with these guys as a means of income... just last night i had to transport 3staff for 1individual to a psych hospital in SKIP. He had stopped taking his medications since that is his "right"... but this also makes me go absolutely nuts. He punched a nurse in the face and the doc was like... yeah.... Ancora Psychiatric Hospital.

    I would take the guy with the colonm bag over the real violent types any day. I'll even empty the damn thing for you. You'll never here me shouting "BAG CHANGE IN RM 6!". lol... ah.... the pleasures of working a state facility...
    Hey, no, more power to you. Psych just isn't my cup of tea. I can't stand when we get the patient's from the psych hospital next door and they're only with us for a few days.
  9. by   nursemike
    Quote from deespoohbear
    Oh, I just love those orders, especially the call MD with any significant change in status. Just bugs the daylights out of me.

    I love it too when they give us parameters of when to call. I have had orders that say to call for SBP less than 80 (ya, think?), HR greater than 120, resp greater than 28, etc. Give me some credit, for pete's sake.

    My other favorite order that goes with the same thing is call abnormal labs (you mean like the K+ of 2.1, or the Na of 115?) :stone
    I guess I'm still new enough to kinda like the parameters. It gives you something to show the resident after paging at 0300. But I had a pt recently with an old order to page for sys bp>160 (typical), then next day page for sys bp>170 (see that regularly, too) then next day don't page unless sys bp>200. Guess somebody was getting tired of answering pages, but the nurse who gave me report said the attending had decided to let bp ride, up to 200, presumably for CPP. We see let it ride up to 180 occassionally. Had another order to maintain sys bp 140-160. Crap! Bolus...hydralazine...bolus...hydralazine...I checked on that and what he meant was sys<150ish. (I wasn't really alternating boluses and hydralazine!)

    Funniest one I've had, recently, though, was "hold all narcotics after 0400 until rounds have been completed." Actually, we see that a lot, but this time I just had to ask,"Should I hide her PCA button?"
  10. by   Alois Wolf
    Quote from JaredCNA
    Hey, no, more power to you. Psych just isn't my cup of tea. I can't stand when we get the patient's from the psych hospital next door and they're only with us for a few days.
    I really didn't mean to make that sound hostile. It was said with a smile on my face, I promise.
  11. by   JaredCNA
    Quote from Alois Wolf
    I really didn't mean to make that sound hostile. It was said with a smile on my face, I promise.
    You know, reading that a second time, I see that now.

    You know us shift workers...I've been up since I got off at 7am...going on 22 hours now, so I can sleep like a "normal person" tonight so I'm somewhat out of it.
  12. by   Alois Wolf
    Quote from JaredCNA
    You know, reading that a second time, I see that now.

    You know us shift workers...I've been up since I got off at 7am...going on 22 hours now, so I can sleep like a "normal person" tonight so I'm somewhat out of it.
    I feel your pain, I got off work at 8am. and slept till about 3... when my brain is like, "The sun is out you fool, what are you doing when you should have been asleep last night". I've been on the shift for 3 years... you think I would be used to it by now lol
  13. by   buggal1989
    "wash pts feet"-

    he was 300+ lbs and was a "preacher" of his own little religion made up by his own little mind which allowed him to have 15 wifes who dressed in nun's outfits who supported him by doing roofing work - and yes in the nun's uniforms. I SWEAR to you that this is TRUE. The man broke our leather restraints, had a string tied to his waist with an "attachment" - you just get to guess where! - which allowed him to "whip it out" to urinate. He had upwards of 30 children. He treated every female nurse with contempt and every time we walked in the room shouted "Wash my feet", he DID NOT ask this of our two lone male nurses - and we all refused his "polite" request - so the MALE doctor WROTE an order and we were forced under duress to MAKE the male nurse do it! ha!

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