What is the most incompetent thing you seen a fellow nurse do? - page 7

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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    I was asked by administration to investigate and document my findings regarding a code situation and the performance of the ACLS nurse. She cardioverted her patient for what she thought was V Tach.

    It was a 100% paced rhythm. All earlier rhythm strips and 12 leads clearly showed this same paced rhythm. Nothing new.

    Patient did not survive. Pacemaker pouch clearly was visible on chest wall, docs notes indicate PPM. I don't know how she missed seeing the pacer when she shocked him....

    A spike was NOT clearly evident on the rhythm strip, but ....sometimes it isn't...we gotta be careful out there.
    Last edit by mattsmom81 on Jun 12, '02

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    How about giving KCl instead of Kayexalate? I floated to a medsurg floor last night, as charge, no less. Patient with a serum potassium of 7.1 was ordered Kayexalate. The nurse thought it wasn't up from the pharmacy yet, so borrowed from another patient's drawer. Only problem is, she borrowed KCl instead. I found the error at the end of the shift, when I found the kayexalate still in the med room, and asked why it wasn't given. She told me she had given it, just borrowed from another drawer. When I asked her to show me, because I knew there was no other patient on the kayexalate, she showed me the empty potassium bag. Not only did the patient get the wrong med, the other patient never got her potassium. When I explained the difference to her, she asked me not to write it up because she had been told one more error, and she would be fired. She didnot seem to be at all concerned about the potential harm to the patient. Of course, I wrote it up.
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    Resident on mechanical soft diet was served a WHOLE meetball at dinner and went down in the hall on the way back to the unit. RN did not know how to do the heimlich or CPR when the resident finally stoped breathing from having a meetball lodged in the throat. RN called 911 and did nothing. Resident died, family lawsuit pending. Entire episode in hall was filmed on security tapes, shouldn't be a hard case to prove.
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    KCL instead of Kayexelate. That is a biggie. I hope she realizes now the consequences of high potassium levels in a patient.
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    Although I've only been in practice for less than a year, I've witnessed my fair share of errors. Most recently, I had just received report from the night shift RN. I began to check my charts for any missed orders. I saw a TO for "30 units NPH stat & qam" written by the RN I had just received report from. I thought to myself this was odd because she didn't mention that the pt. had a DM history. He wasn't on accuchecks. I turned his chart inside out to check if he was ever on insulin. Luckily, I was able to catch her before she left. Turns out, she transcribed the phone order in the wrong chart! Sure, maybe she was exhausted and in a hurry to leave. But what If I wasn't the type of RN that wasn't prudent enough to double/triple check orders and question things that seem "odd". I've even witnessed pt's on the wrong IVF's (ie. pt getting D5W instead of 0.9). Also, another pt. had been getting Haldol days after the MD d'cd it. Everyone kept wondering why the pt. was so out of it. These are very experienced nurses with 20+ years behind them. I have less the 1 year of experience and am able to catch their mistakes. Never underestimate the knowledge of a new grad!:-)
    Luckliy,I've only been at this hospital for a few weeks and I'm leaving on next week. Most of these RN's give you the most blanked reports (i.e. can't tell you what the vent setting are, don't know when the last PTT was drawn or result and pt is on heparin). I can't wait to move on.....
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    Why 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!
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    Matt...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......
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    I 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
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    I 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....
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    Mattsmom, 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.

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