Most shocking thing you've seen another nurse do? - page 2

SNF. RN supervisor summoned (overhead, at about 0300) me to one of her rooms. She was attempting to insert an NG tube in an alert man, about 40, alcoholic, with varices. Told me she felt a... Read More

  1. Visit  Baubo516 profile page
    I am a nursing student and I'm happy that I understand most of the stories in this thread... but what does this mean?

    "replace NG drainage IV q4h with NS"

    I would read that as "replace nasogastric drainage tube every 4 hours with normal saline." I know what a nasogastric tube is, and I know that it can be used to drain secretions from the stomach... what does it mean to replace it with normal saline? Or does this mean something else completely? Just curious...
  2. Visit  jmdRN profile page
    Quote from Baubo516
    I am a nursing student and I'm happy that I understand most of the stories in this thread... but what does this mean?

    "replace NG drainage IV q4h with NS"

    I would read that as "replace nasogastric drainage tube every 4 hours with normal saline." I know what a nasogastric tube is, and I know that it can be used to drain secretions from the stomach... what does it mean to replace it with normal saline? Or does this mean something else completely? Just curious...
    It means the replace the AMOUNT of NG drainage (usually between 150-300mls with the NG's I see per 8 hr shift) with an equivalent amout of NS. You dispose of the NG drainage wherever the bio-hazards for your unit go, DO NOT try to replace the goo that you drained from the pt back into the pt.
    Lev <3, metal_m0nk, nrsang97, and 3 others like this.
  3. Visit  salvadordolly profile page
    I worked on a psych floor for a short time. Patient was on a hunger strike and had a Gt inserted. They then found out she had SBO and put in CVL for TPN. The nurse took the meds meant for the Gt in those brown syringes and inserted them into the IV. Pt died instantly. Nurse lost her lisence. Still don't think the pt should've been on a psych floor.
    macfar28 and sallyrnrrt like this.
  4. Visit  Baubo516 profile page
    jmdRN - Thanks for the explanation! I did NOT think it meant putting nasty drainage back into a patient , but I wanted to know what it DID mean. So far the only NG instruction I have had is that NG tubes are sometimes flushed with saline - the example amount we were given (for an I & O exercise) was 30 mL.

    I am a beginner but I would definitely not try to put yucky drainage back into a patient!
    Here.I.Stand, Lev <3, 1feistymama, and 4 others like this.
  5. Visit  LTCNS profile page
    I'm a LPN who has inserted NG tubes under the supervision of a RN who had no clue, and I did a pretty good job of it. I know many RNs who I wouldn't let treat my cat, many LPNs who I wonder how they even got out of grade school, and many CNAs who are more competent than many nurses (RNs and LPNs) I know. There will always be those who think they are more skilled and competent just because of some letters behind their name, no matter how clueless and inexperienced they are.
    BelindaLPN, angikat, Jillybean48, and 18 others like this.
  6. Visit  SwansonRN profile page
    Can I ask that this thread not turn into a RN vs LPN ordeal? We get it. There's good and bad RNs and good and bad LPNs.
    macfar28, Jillybean48, yoga pants, and 36 others like this.
  7. Visit  sissiesmama profile page
    Quote from nrsang97
    I was working ICU and was called to our stepdown unit so I could assist with a drip. This was a drip they were totally capable of running. I get there and under the Alaris they can't find it under secondary. I told them it is a drip. Three nurses looking at me like I have a third eye in the middle of my head. I told them drips are PRIMARY. They had it on IVPB tubing too. I made them go get primary tubing. They were having a hard time getting a BP. It was high on the machine. I listened and was getting somewhere around 160 for the top number. We didn't hang the drip, but I was scared that three stepdown nurses couldn't figure out how to hang a Cardene drip.

    We had one nurse give a whole insulin drip thinking it was the pt dilantin. Denies that it was insulin. The pt was fine.

    We had one nurse who hung blood with D5, same nurse put atropine drops in the eyes of a pt and didn't tell anyone. The drops were to go sublingual to control secretions. This pt suddenly had non reactive pupils and had to go to STAT CT, and ended up with an unnecessary EVD. When confronted about the situation she never owned up to it.

    We had another nurse infuse a whole bag of fentanyl into a patient. Didn't report to the doc tried self treating with narcan. This pt ended up dying.
    Oh, that's scary!

    Anne, RNC
    angikat, sallyrnrrt, and nrsang97 like this.
  8. Visit  multi10 profile page
    I walked in and witnessed a nurse (colleague) stealing narcotics. He thought he was clever. He withdrew Dilaudid, MS04 etc, via needle and replaced with normal saline.
  9. Visit  Calabria profile page
    Didn't see this happen, but I saw the immediate aftermath... An RN unscrewed one of the connections to a central line while it was connected to the baby, and walked away from it without reconnecting (I have no idea why this happened, as she wasn't changing out fluids). The baby started to bleed out. Another nurse saw blood on the floor next to the warmer and wound up alerting her, the charge nurse, and the medical team. Not only did the baby have to be transfused emergently, but the line had to be removed and replaced emergently as well.
    sallyrnrrt likes this.
  10. Visit  yaneau profile page
    Not an RN, but a NA - During a short clinical day at a LTC facility I witnessed a NA assist a gentleman to the restroom, and assist him in his "duties" there. She wore no gloves, then preceded to the break room to eat a piece of pizza. So gross
    sallyrnrrt likes this.
  11. Visit  chicarn profile page
    I was new grad 4 months on the floor, the doctor put order for me to insert ng tube for a woman with esophageal varices vomiting blood. I told the doctor that I won't execute your order it is unsafe, he was mad. glad I refused.
    emjay:), Here.I.Stand, Jillybean48, and 17 others like this.
  12. Visit  AJJKRN profile page
    [COLOR=#003366]Baubo516, Hopefully this helps answer your question and makes sense

    In my facility we often get orders to replace the amount of a patients NG tube drainage. The order will say to replace 1/2 of the NG output with NS IVF over 8 hours and will show up in the MAR at 1400, 2200, and 0600 and Here's how it goes:

    NG tube drainage was 600 cc over 8 hours

    Divide the 600 cc in half and then divide by 8 hrs = 25 cc/hr

    Titrate Pt 0.9 or NS IVF to 25 cc/hr to help replace fluids lost from GI system

    *The replacement fluids may be the primary fuid or piggy-backed into the primary fluids in which case only the replacement fluid is titrated and if piggy-backed into a primary IVF, that IVF stays the same.
    Last edit by AJJKRN on Apr 5, '13 : Reason: Add information
    angikat, Kipahni, GrnTea, and 2 others like this.
  13. Visit  SuzieVN profile page
    Quote from ktwlpn
    This is why I hate threads like this-they always go down that road........I worked with an RN once who saw me flying into our patient's room with the crash cart and kept walking to the breakroom to apply lipstick after her lunch.Now what do her credentials have to do with anything? We have ALL worked with people who have done really dumb and dangerous stuff..Maybe I misunderstood your post-were you the RN supe or was the evildoer the RN supe? Why make the comment denigrating LVN's/LPN's? I think I'm done with this type of thread.Life is too short.
    I was the LVN that the RN called for help- she's the one who killed the patient. I'm the one that was suspended, because they knew she was an incompetent mess from day one, and I as the polar opposite was thrown under the bus. I can run circles around lots of nurses- fact. But, NG tubes and TPN, are meant for 'professional nurses', as some like to be called- and their background in science, theory, A&P, etc. It can't be both ways- either the scope of LVNs is limited by their education, or it isn't. And if not, explain the constant pressure for RNs for 'more school', constantly? I'm relating what I have seen in 30 years, and why I make such comments. Hardly, am I denigrating anybody- much less myself. Not only that? In PN school I never even 'heard' of an NG tube, that was 'on the spot' training in a SNF. Uncool. Dangerous. Out of my scope, anyway- even by now I've inserted 1000 of them, maybe- but they are becoming as rare as the dinosaurs, fortunately. I hail from the Dark Ages- what, he won't eat? Shove an NG tube down his throat! We all have opinions, fine by me. Obviously the controversial ideas I create in here are being enjoyed by the audience. It's an educational process, called 'reality check'.
    thekrazykook, angikat, Anna S, RN, and 9 others like this.

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