Absolute No-No's

[Drysolong]

Hi: I hope to get a lot of input from this question. As experienced nurses, what are some things especially related to medication administration, but anything else, that you would classify in red for a nurse to never, ever do? Also, what have been the consequences of nurses doing these things? Thanks, in advance!!!

[sleepyndopey]

Dang! I knew in my gut this was wrong!!! Are they hiring where you are sleepy n dopey? Like I said, I quit yesterday morn. But not in time to prevent physical illness. Just got word fr doc's office of occult bleeding to accompany what sent me to ER last Friday night of straight pee bleeding!!!

Scared and out of work and determined to watch pills go down,

Chloe

I hope you are okay Chloe! Please take care of yourself. As for if they are hiring where I work, yeah, they are, but believe me-my place of work has issues of it's own. Plus, from your name I assume you are in a warm climate. There is snow on the ground here in NJ.

[Chloe'sinNYNow]

I hope you are okay Chloe! Please take care of yourself. As for if they are hiring where I work, yeah, they are, but believe me-my place of work has issues of it's own. Plus, from your name I assume you are in a warm climate. There is snow on the ground here in NJ.

Oh hun, I MISS snow. It's lousy traffic commutes, nasty attitudes, bigotry, high cost of living, snobbery, pissy attitudes (oh drat, did I mention that twice? Harumph!), crime, etc...that I can do without.

I'm in metro Atlanta and just quit a job in redneck territory. They filmed Deliverance there! And they still have Klan meetings. I kid you not. I hid my Jewish horns.

We get ice here, and the whole town shuts down for days after they clean out the Kroger from bread and milk.

I'm running at the first sign of work! Thank you for your kind words, but the mystery illness prevails.

:icon_hug:

Chloe

[smk1, LPN]

never ever lie!

never flush a hickman line with 10 cc of kcl (20 meq) rather than 10cc of ns. the patient arrested.

don't lie about what you've done when you are horrified to find that the syringe in your hand says "kcl" rather than "ns."

never push a gram of lidocaine for pvcs. (ok, this probably wouldn't happen now, but 20 years ago our ccu got three patients from a smaller hospital in a six month period, all of whom had their pvcs "treated" with a gram of lidocaine. correct dose would have been 100 mg.) and when all cardiac (and other) activity ceases on said patient, never hide the gram syringe and claim "i only gave 100 mg."

never give blood without checking the patient's name band. no it isn't the same thing to check against the addressograph plate in the hallway. especially not when mrs. roberts and mrs. charles are in the same room. mrs. charles did not benefit from mrs. roberts' blood -- in fact, it was quite detrimental. (and never ever say "i told you so" to your preceptor, who insisted that checking blood against the addressograph plate was acceptable and was quite angry with you when you refused to participate!)

never lie about how the transfusion reaction occurred.

never mistake nitropaste for hand lotion.

if you drop a bottle of nitroglycerin on the floor, never ever attempt to pick up the glass shards with your bare hands. really. just don't do it. the headache is punishment enough, but listening to your co-workers tell the story over and over about how you (pristine in your new white dress uniform and white hose) wound up on the floor with your legs in the air is excrutiating!

and if you are allergic to pcn, never ever attempt to mix up a piggyback with your bare hands. never spike a piggyback with your bare hands. never inject too much air into the bottle when reconsituting pcn, causing the bottle to explode into your face.

(you'd think after the first trip to the er with hives and respiratory distress i would have learned.)

and last but not least, never ever lie! your patients are amazing creatures and can survive all sorts of med errors. but only if you own up to it as soon as you discover your mistake and set about doing all that is humanly possible to correct it. if you lie and try to cover things up, a near-fatal drug error can become fatal.

this is such good info. i am very allergic to pcn and probably wouldn't have thought twice about priming/spiking and hanging pcn and the possiblity of getting a little on me. :uhoh21:

never ever assume you know what a drug is based on part of the name. not all 'olol's are beta blockers and not all 'ipines are calcium channel blockers and not all 'prils are ace inhibitors. look up drugs you aren"t sure of!

[leslie :-D]

do not ever (ever, ever) take the keys, unless you have done count with the other nurse.

i have known nurses who claim that "count is fine", or "this is the way we do it here".

always do count.

always.

no exceptions.

this is right up there with witnessing a waste.

protect your license, always.

leslie

[Dolce, RN]

Never shoot 6.25 mg of Demerol into your eye while attempting to draw the medication out of the carpujet with a syringe. My eye was "pain free" the rest of the day!

Never cut the y port on a Foley to drain the balloon instead of using a 10 cc syringe. If you cut the y port and it doesn't all drain your patient may have to have a cysto to take the catheter out.

[prinsessa]

Make sure the pt doesn't have any procedures or tests that day before giving meds. Some of the meds might have to be held until later.

[Ivanna_Nurse, BSN, RN]

Hey All! Here are my contributions...

Always assess your patient, not the monitor.

Follow lines and tubing from the pt to the equipment.

Never give something you arent familiar with.

Never feel like you cant ask for help or that your questions are bothersome. ~They very well might keep you from making a fatal mistake.

When doing a procedure for the first time, dont forget your policy and take the most experienced nurse with you.

Never Ignore your gut instinct.

If you make an error, fess up right away so the patient can be treated if necessary.

Cheers, ~Ivanna

[Indy, LPN, LVN]

Never ignore sudden personality changes in your non-psych patient.

Never ignore a (mostly non-psych) patient that tells you they are going to die.

Never ignore any patient, psych or otherwise, who tells you they are about to kill themselves. Me: Really? Him: Yeah, I'm gonna hang myself with the bedsheet. Me: When? Him: as soon as you leave. What'd I do, panic and run out of the room. Fortunately someone else went right in and sat with him.

If you see a substance... offloaded from a human... that is so vile you want to puke, never just flush it without taking a second to ask yourself if you shouldn't get a sample of it. My first GI bleed missed diagnosis by a shift or so because I nearly puked and flushed his dead-possum sized black tarry stool without thinking of it. Told my preceptor. He didn't poop again until he nearly died. At that point, reporting findings isn't nearly as effective as when you have proof to back it up.

Never say never.

Never say quiet.

Never assume people are harmless just because they're a) smiling at you, or b) not moving right at the moment.

[RNDreamer]

I second this. I had a (prev. psych) patient who would tell me that his "mind was not right" and was always threatening to kill himself. He would get very angry when I reported him to the nurse, but I would report EVERY TIME he made a threat or wish to die.

Never ignore any patient, psych or otherwise, who tells you they are about to kill themselves. Me: Really? Him: Yeah, I'm gonna hang myself with the bedsheet. Me: When? Him: as soon as you leave. What'd I do, panic and run out of the room. Fortunately someone else went right in and sat with him.

.

[MIA-RN]

Never forget that just because a patient is combatitive, angry and acting out..that they are still a person, and deserve to be treated as well as your other non-combatitive patients.

Always remember to check your orders..it sucks when the meds you've just given had been d/c'd hours ago but the order was never taken off.

Always remember to go with your gut. If you think there is a problem, then there probably is.

Never assume that the person who listens sympathetically when you complain about management, processes, or coworkers is really just a sympathetic ear. They might possibly be telling other people what you are saying...likely people who you'd rather they didn't tell. And they will likely exaggerate or make it sound worse than your original comments.

[Spidey's mom, ADN, BSN, RN]

It is fun to play the "don't say quiet game" but . . . . .you can say quiet if you want. Research (mine and actual researchers) says there is nothing to the old wives' tale.

:sofahider

steph;)

[swee2000]

Never assume the new LPN working with you on a team knows this. You might have a beta blocker given to a pt with a HR of 48, and SBP in the 80's.

I'm sorry. I didn't mean for that to sound like LPN's didn't know this. Just that we shouldn't assume.

I'm sorry, but I find these comments about LPNs to be asinine.

First of all, why would you assume that LPNs don't know they're supposed to verify a patient's HR & BP prior to giving a beta-blocker or other antihypertensive med?

Does this also mean that you assume LPNs don't know they're supposed to check a patient's blood sugar prior to administering insulin?

And in the case of Lasix, do you assume that LPNs don't know about verifying a patient's potassium level(in addition to the HR & BP) prior to administering the medication?

Unless I've missed something, none of this is privilaged, top-secret, RN-only information. LPNs learn the same exact stuff during nursing school and are expected to remember & apply it during clinicals, on their Board exams, and out in the "real world"....just like RNs do.