What is the most incompetent thing you seen a fellow nurse do? - page 2

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 contusion. The old fart coded and... Read More

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    Nurses that do not know the difference between a unit of insulin and a ml, give me a break. How is this possible that a person can get through nursing school and not know the difference. In one case the person died of massive insulin overdose. In a second case a GN called the pharmacist saying you did not send me enough insulin and he caught on to the mistake. In a second case the second check rule was observed and the checker caught it.

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    Teshiee, Believe it or not, this woman worked in critical care in another state for 15 years, and came with glowing recommendations. Either her references were inaccurate, or she was just unable to adjust to the transition. We all have tried to help her, but she just can't catch on. Now we seem to be stuck with her, since administration will not allow her termination. No one here will ever let her patient's sink. We watch over her closely. I personally would not want to work where I wasn't trusted. Some of us have tried to talk her into going to a less stressful environment, but she refuses to consider it. Says she wants to prove she can do critical care to all of us.
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    I worked beside a new nurse in our CT ICU. She had a pt go bad on her. The resident (md) who was not very bright, ordered inderal IVP with a cardiac index below 2.0 for tachycardia....NOT! Well this nurse went to draw it up and give it. I said "Hold on a second, let's think about this..." Then I went to get the charge nurse, who called a senior doc who thank God stopped this med from being given. Later in the lounge in the am, I asked her why her pt was so unstable. She said I can't figure it out. I said what was the chest tube drainage? She got very pale, and said I didn't check it, I was so busy! WHAT?????? I told the charge nurse about that, she and I looked at her notes, and sure enough no CT output recorded. The next day, she went to show the notes to the manager, there were numbers filled in for the CT drng. Now that was one scary chick!!!!

    Another night, I came on and pt's CT were bubbling like crazy with huge air leak. The nurse said, I checked the system, and even changed the pleurovac, but the air leak is still there. I said did you change the drsg? Uh, No. I got up, took off the drsg, there were three drainage hole visible outside the skin! And this one went on to be our manager!

    Saw one nurse give a pt ear drops, into his eyes. The pt was AA&O, so WHY he never said I'm not supposed to get eye drops is beyond me. His eyes started bursing, and he started cursing and screaming at the nurse. I did feel sorry for her. He humiliated her so badly, I think I would have been afraid to ever come back to work, esp since this happened in my first month on my own out of school.
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    The other day, I called report to a chest pain unit. I told the nurse the pt's NTG gtt was running at 10 mcgs. She then asked me how many cc's an hour that was. I thought-little bit strange-everyone is on a NTG gtt on your floor, how could you not know how to figure out cc's/hr. But anyway, I said "That's six cc/hr" She then repeated, "okay, NTG at sixty cc/hr" Hope she didn't have a need to titrate anytime soon.
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    One of the reasons I generally do not support the idea of new grads in critical care is the high potential for errors due to lack of basic skills, judgment, and experience.

    Most of the incompetent acts I've witnessed in my critical care areas over the years are committed by brand new nurses trying to function in a critical area they are not ready for, IMO.

    Here's another: I was told to precept a new grad RN. He had been promised he could work with me with a fresh heart. My boss insisted (she liked him). I talked aloud to him as I did a system by system asessment, showed him the swan/aline/CT/drips and explained them. Explained how we carefully watch K levels and how we administer K by parameters slowly via buretrol to post heart patients. He watched me do this repeatedly and I allowed him to do one in front of me. Later I was on the phone with a doc and he wanted to check K and give the buretrol dose this time. I said do you remember exactly how? He said of course....

    I looked up to VTach on the monitor and ran into the room to find he had a prepackaged KRider infusing wide open into the proximal port. I bolused with Lido immediately and luckily converted it.....he was blase about it when I told him what he had almost done to our patient.

    I felt obligated to refuse to precept him any farther...as this wasn't his first booboo...and after multiple complaints from other nurses, my manager eventually turfed him out to the floors for more basic experience. Which was what he needed to begin with.....!

    Why put new grads through this kind of failure and risk our patients.....this is why I believe medsurg for a year before ICU is the best rule.
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    I'll never forget one evening years ago when I was working as a CNA in LTC...... (I was in my first year of Nursing School) ..... the charge nurse that evening asked me.... 'what should I do, I'm running out of D5 and not sure what to do..... It will never last through the night..... She had NO clue how to even hook up the tubing, much less what TKO meant, nor the rate TKO..... needless to say, she was terminated shortly after that evening.....
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    I have seen plenty of scary things!!! One nurse pushed Dilantin thru a umbilical line without flushing it...and just pushed it quickly. Duh...and then the same person piggybacked 25%Albumin with her HAL and IL!!! She is relatively new and has the attitude that she knows it all..she is 23 and straight out of school.
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    We have a rumor... perhaps folklore... at one hospital. The story goes that an RN pushed aspirin through a central line because her patient, who c/o a HA, was NPO for surgery.

    Sure hope that its not true.
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    Tube feed through a central line. Horrible mistake. Thankfully, the patient survived!

    Another one . . . flushing a central line with potassium. That patient also survived, thankfully. (It didn't help that the heparin and kcl vials were the same color!!!)

    The first nurse was new. Don't know how she mixed a central line with a dubhoff. The second nurse was a seasoned oncology nurse. She just didn't read the vials. . . just grabbed a brown colored vial and thought it was heparin.

    I didn't actually see these occurances. We sure did talk about them during our staff meeting, though.

    One last one. This one is a minor legend in the hospital where I used to work:

    Giving vancristine interthecally (sp?) for brain mets. (was ment to have given another chemotherapy agent!!) This was done by two physicians, actually. The first physician handed the second physician the wrong chemotherapy agent. I guess neither read the prepared syringes. Patient did not survive.

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    I once worked with an RN on nights that always worried me. One night her patient had a 44-beat run of VT. I went running into the room and I think I scared the guy back into sinus. When I went back out to the nurses' station, she was sitting there reading a magazine. When I asked her if she was going to call the doc, she replied, "Why? He's in sinus now." Duh. I made her call and we started him on a lido gtt.

    Another time towards the end of a shift, she was in one patient's room drawing labs or something, when her other patient alarmed with a high BP. I went into the room to check on him. He was on a ventilator and was paralyzed (with Nimbex). He was lying there with his eyes open, bloodshot and dry, but he just looked freaky. I checked to see when she had last sedated him, and he had had no sedation at all thoughout the night. She had been giving him Nimbex routinely every 30 min. and had a liberal order for morphine prn but had not given him any. When I questioned her about it, she had even performed a painful dressing change on him, thinking since he was paralyzed he couldn't feel anything. I no longer work in that unit, but whenever I see her, I pray for her patients.

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