What is the dumbest order you ever read? - page 12
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
Nov 2, '07Quote from tvccrnYeah it could mean that, but it didn't lol. The resident had just asked me how the baby had been eating and I told her she'd been eating fine, about 50-60 cc's every 4 hours .... she said that was great, as her total fluid amount was to be at least 50 cc's every 4. About to be discharged too ..... can't imagine the mom is going to be feeding that kid every 2 hours, especially with a twin at home!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.
I've actually never seen an ad lib feeder be ordered to feed every 2 hours. Just thought it was WEIRD!
Nov 2, '07Quote from buggal1989I'm sorry, but this is hilarious"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.
every time we walked in the room shouted "Wash my feet"
Nov 2, '07Quote from buggal1989I suppose it isn't very nurse-like, but I can't help hoping he got some really clean feet. (Where's that scrub-brush smiley when you need it?)"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!
Nov 2, '07
Nov 3, '07Quote from Emmanuel GoldsteinWe had fun for, oh I say, years - until too many people rotated out of ICU and there were to few of us to remember! Did I mention he was in for HTN?????? I mean like BIG TIME! I'd mention drugs - but most of y'all would scratch your heads (then the ICP would come out in me and I'd do a lice check) and look bemused!I'm sorry, but this is hilarious
Nov 3, '07A consult for erectile disfunction on a pt that met brain death criteria, written right below a Gift of life referral order. (I am sure it was written inadvertently in the wrong chart... I hope)
Nov 4, '07Quote from Zee_RNWahahahah!!!Same cardiologist (different patients):
Baked potato P.O. QD with evening meal
Milkshake P.O. q.h.s. - nursing to prepare (YEAH, RIGHT!)
Pepsi 1 can P.O. QID with meals
(He's not a very good cardiologist but he makes an excellent food director.)
Fluid resuscitation orders in a patient who had lost peripheral iv access and whose BP was rapidly dropping (who BADLY needed a central line): 500 cc H2O via NG stat. Oh yeah baby that's gonna fix him. GET HIM A CENTRAL LINE, STUPID. (resident's order).
Nov 4, '07Quote from emily_momDifferent strokes for different folks, Kristy. Not all cultures have the fathers at the births. Birthing is a woman thing.I live in Amish and Mennonite country, so I see this a lot. We've only had Mennonites come in for high risk pregnancy, never the Amish. I love how they will speak English to you and as soon as you turn to walk out, the Pennsylvania Dutch comes out. Makes you wonder what the heck they're saying. They are very private people. All the husbands I have dealt with left during checks and during the birth. Haven't seen a lot of support.
Nov 4, '07[quote=deespoohbear;262885]Place fan in pt's room. (Just ask me for crying out loud!!)
This order may not be so silly...I worked in a hospital at which an order was required for fans to be placed in patient rooms...
perhaps this person had come from a hospital such as this...
Nov 4, '07Quote from tshoresUh, who obtained the champagne???Inderal 20 mg IV now and q8h--and the pharmacy sent it!--20 1 mg amps!--so I talked with them, too, since I had a bunch of new graduates on the night shift then; most would ask, some not sure about.
On a patient in complete heart block with some PVC's, HR in the 20's and 30's: Lidocaine 100 mg IV bolus, then 4/mg/min drip.
Morphine 100 mg IVP now.
Then it seems like everyone's called a tired resident for a patient with chest pain and got orders to insert a foley.
Champagne slurry 20cc q4h NGT--clamp for 1h after giving. Order was supposed to be Carafate slurry, but the patient got champagne all night long with no c/o anything all night! (Nope, I wasn't the nurse!)
Nov 4, '07Quote from longtermcarernI don't blame him. I have never understood why we have to call in the middle of the night to tell a doctor his patient died - when it was an expected death. What is he supposed to do about it?Vital signs q hour until 8am on a dead patient when the doc was angry for being woke up at 2am to tell him his patient had died.
Why not hold that call until about 5:30, at least?
Oh, and don't forget - taking VS on a presumed corpse just might yield some sign of life still there! It's been known to happen. Creepy, I know.
Nov 4, '07Quote from longtermcarerni had an order for q 1 hour arterial blood gases on a dnar patient. she had an intraaortic balloon pump, but her radial art line had fallen out days ago. since our policy forbade using the aortic line on the iabp for blood draws, that meant we had to stick her for abgs. since the lady was a "no code" and still somewhat awake, none of us wanted to stick her for blood gases. so when i arrived on shift at 3pm, i called to clarify those orders.vital signs q hour until 8am on a dead patient when the doc was angry for being woke up at 2am to tell him his patient had died.
"yes i do want q 1 hour blood gases on mrs. dnar," the resident screamed at me.
so i stuck her at 4, 5, 6, 7, and 8 pm. by then her radials were getting harder and harder to find, and the blood gases were getting a bit further and further apart as we struggled to get them. the resident came by at 10 and wanted to know why we hadn't gotten a 9 pm blood gas, and when i tried to explain that they were getting harder and harder to find, he wrote an order that said "yes i do (underlined "do" four or five times) want the q 1 hour blood gases just like i ordered at 0700 and again at 1200 and 1500"
so we figured that if he wanted q 1 hour blood gases, he must want to know the results. we paged him q 1 hour to tell him.
the night charge called in sick and there wasn't anyone to do charge on the night shift, so i stayed over to do it. the night nurse absolutely could not get the blood gases by sticking the patient, so we drew midnight labs off the aortic line.
the patient died around 1am. she was a dnar, so we didn't attempt to code her. she had a permanent pacer, a balloon pump and a ventilator. a balloon pump on a dead patient will give you a pulsitile pressure of about 42/20 . . . do you see where this is going?
so i paged the resident again to tell him that no one could get blood gases, and did he want to d/c the order. (i'm a little evil, aren't i?) after he screamed at me for a full two minutes, i sweetly said, "yes doctor, but if you want those gases, you'll have to come and do a femoral stick."
so the resident stomped out of the on call room, slamming the door after him, stomped into the icu and grabbed a blood gas kit. then he stomped into the patient's room and closed the door while the entire nursing staff clustered around, waiting to see what would happen next. nothing did. he was in there for about half an hour and i was sure he'd fallen asleep in there. then the door slammed open and the resident stomped back out of the room, flung the dirty (glass) blood gas syringe against the wall and screamed "ok, you *******! you can d/c the blood gases. you won!"
"thank you, doctor," i said in my most calm and professional manner. "now do you mind pronouncing the patient?"
he'd been in the room for 30 minutes, trying to draw blood gases on a dead patient! then despite his humiliation, he had to stay and pronounce her, call the family and the attending and do the death paperwork! he was much better behaved from then on!