Blatant Nursing "No-No's"........what's your worst???

laurakoko · Oct 15, 2004

We must haved worked with the same nurse!!!

Sundowner · Oct 15, 2004

I am sorry to report, I know many nurses who operate the same way. Give all their 8ps along with their 4s....or worse...just plain not give any. Sick huh.

I would probably say however, the worst thing I have ever witnessed came from a nurse who had five or six years experience under her belt in ltc settings. We had a patient with a huge CHF history....Gtube, trach, foley and Diabetic to boot. Nurse wonder noted her foley to be empty at the end of her shift....and for some strange reason decided that she probably didn't have enough hydration..hence her lack of output. (never mind her continuous tube feeding) so she dumped a whole pitcher of orange juice down her tube. BRILLIANT!

Needless to say, she went right into CHF, Sugar through the roof.

Antikigirl, ASN, RN · Oct 15, 2004

I had this nurse..like you that had been there forever, and could do no wrong!

She was off taking an extra break when I noticed one of her patients was coughing quite a bit (I had a patient in the next room)...now when you are a nurse for a while...you know your coughs..and this was a very wet choking cough! I walked by and peeked my head in...oh my!!!

This gent was dying of liver failure, and sadly he was in the hospital to die (too bad the doc didn't tell his family..but that comes later!)...he was bleeding out his varicosies in his throat (hmmmmm wonder what the liver failure was caused from?!?!), and I quickly noticed that he was all gurgles..okay filled lungs..super...grrrrrr!

I grabbed suction and about put it in when I noticed that even the touch of my finger towards his lips caused severe bleeding, and knew he had no way to clot or stop bleeding. So I put the suction down and place him on his side so gravity would help while I rang for the nurse. Meanwhile a CNA came in freaking out saying "his family is on the way...we have to clean him up!". Ummm hello..dying patient here, no advanced directive or polst, cleaning him up is the last on my to do list! But no...that poor CNA was so scared of that old nurse that she tried to make the bed while this was going on and caused a huge skin tear that started pulsing out like crazy..uhhhgggg THANKS!

Then Mrs. Can do no wrong came in...and grabbed the suction and chewed me out for not doing immediate suction as I said "NO!"...sure enough...not only did she vagal him big time, but tore what little flesh there was clinging to his airway! And he coughed out large amounts of blood right at her face!

I was able to get him to the ICU very quickly (thanks to another nurse) and they were able to sustain him long enough to say goodbye to his family. I was pleased that my efforts helped that happen.

Then after all of this...she said that my assessment didn't happen! She said he was fine, lungs clear, and no signs of distress! Okay bullpucky total CYA! And tryed to blame me for the vagal "well she must have put the suction in before I came in, and obviously screwed up!". I was on the chopping block, and asked the CNA to explain what had happened...she agreed with the old nurse at first...but after seeing my face, she told the truth and I was found not guilty (and I didn't even know I was on trial!).

Needless to say this was devistating to the old nurse, and she did retire before she was to be fired because the family had a lawyer to investigate (because as I said, the family had no idea he was there to die...they thought he was going to be okay...) and I helped the family with all the info I knew which they really appreciated!

But oh my I was so mad at that nurse only thinking of herself and not her patient that was choking and drowning on his own blood! I acted quickly yet consciously to try to preserve his life or minimize the suffering...she could have cared less!

If she hadn't retired the next day, or wasn't fired, I would have had that family investigate her so hard she wouldn't have had a choice but leave nursing (this wasn't her only offence...just the only one I dealt with first hand).

lunakat · Oct 15, 2004

I am a new nursing student so I haven't been in clinical very long. However the other day I got to see the charge nurse change the dressing on a couple of stage II pressure ulcers that were on the coccyx of a pt w/MRSA. She was not wearing gloves. :uhoh21: The CNA who was hlping hold the pt on her side was wearing gloves at least. I was stunned. Reported it to my Clinical instructor, don't know what happened if anything.

BeenThereDoneThat74, MSN, RN · Oct 15, 2004

i cut off a broviac!!! it wasn't completely my fault. the line was 'occluded' on the pump, wouldn't flush or return blood. there was this contraption over the line, (right below the exit site). one of my genius co-workers invented this to prevent the line from twisting and thus occluding. i needed to get it off, it was taped to good...long story short, in came the scissors :nono: and off came the broviac!!! :eek:

the moral to this story: :nono: don"t play with scissors near a central line :nono:

also, don't tape something so good that no one else can remove it!!!

apaisRN, RN, CRNA · Oct 15, 2004

I am a new nursing student so I haven't been in clinical very long. However the other day I got to see the charge nurse change the dressing on a couple of stage II pressure ulcers that were on the coccyx of a pt w/MRSA. She was not wearing gloves. :uhoh21: The CNA who was hlping hold the pt on her side was wearing gloves at least. I was stunned. Reported it to my Clinical instructor, don't know what happened if anything.

EEEEEWWWWWWW!!! I don't change anyone's dressing barehanded, certainly not an MRSA pt. Yuck.

Limik · Oct 16, 2004

Years ago, I worked with a brand new nurse, first job out of nursing school. She was a very sweet girl, however, seemed basically clueless about many nursing tasks. She had been orienting for a few weeks, when she came running up to me, frantic. She was crying and saying she was trying to give meds to a pt. thru the G-tube and now she couldn't flush the tube at all. I assured her we could unstop the tube, thought I would just show her some old tips on how to take care of this. When I got to the pt.'s bedside, I was completely amazed at what I saw. The G-tube had some thick, purple gunk all over it and in the tube. I asked the young nurse to tell me exactly what she did. She said, "First I crushed all the meds up, I flushed the tube, then I mixed the meds with grape jelly, and used the syringe to push it through the G-tube." "Whoa", I said, "Why did you mix the meds with grape jelly?" She then told me how she had seen all of us do that with crushed meds. I explained that you only mixed them that way to give meds po. :uhoh21:

Needless to say it took a while and a lot of work to clear that tube. This is also the same nurse that I once told to use a filter needle to draw up meds from a glass vial to avoid glass particles. Well, she did that, and then proceeded to give an IM injection with the filter needle! Ouch. :eek:

Limik

NancyJo · Oct 17, 2004

Several years ago I was working with a new LPN. At the start of our shift we would each take a hall and make a quick run through to make sure all were breathing and start tube feedings. One particular pt. had orders to bolus 2 cans + 520mls water at the start of each shift. Rather than just push the feeding through we would hang a bag and let the feeding run wide open by gravity., which was ok with the doc. The problem was for some reason, and i still to this day can not figure out how he done it, he connected the feeding bag into this pt.'s foley and didn't realize until the feeding was done and he went to unhook it. So he comes to tell me what he has done and asks if I think he will be ok. I just started irrigating the foley and started running water through the g-tube. Fortunately he was not CHF. By the time the doc called back he was returning urine again and the doc said we had done what we needed to do. Forunatley the guy suffered no ill effects and did fine.

Shotzie · Oct 17, 2004

This is not the worst clinical mistake I've seen but it was a doozie:

Long ago, I worked in a big city ICU that was working hard to upgrade the qualityof nursing care in the whole hospital. Over the course of about 3 years they made the ICUs RN staffing only. I worked on the night shift with an older LVN who was the last LVN working critical care. The sad thing is that there had been some great LVN's they had moved out and "Amanda" was the one they kept because she would work weekends and holidays that no one else wanted to work.

One weekend we had just been killed with new admits and codes. We had 4 codes, back to back, and I was the charge nurse on the unit who had to handle and supervise each and every one of those codes. By the 4th one I was physically exhaused from all the chest compressions (uh, excuse me Mr. Intern, wouldn't you like to take over now???), but still working mentally in high gear. When number 4 went V-tach to asystole in less than 2 minutes I told Amanda to call the patient's family and let them know. The patient ("Harry")was very frail and our chances of bringing him out were like slim and none. She goes to the nursing station makes a couple of calls and comes back saying the family was hysterical and surprised but was coming in. I did wonder for about half a second why they were surprised, they knew what kind of shape Harry was in and they had left the request to be called if there was a code but then I went back to the business at hand.

About 15 minutes later, just as we were calling the code I hear screeching and crying coming from the hallway. I step outside to see this fairly young family loudly crying and falling all over each other. They wanted me to tell them details about how "Susie" died...how could that have happened? she was so young, and she was only in the ICU because of a complication from her medicine...how could she have died??? I looked at them in absolute amazement and puzzlement. I asked them "what makes you think "Susie" died? Then it hit me. Amanda had called the WRONG family and told them to come in quick because their loved one was not going to make it!!!!

They told me about the nurse who woke them up and gave them the news. I was absolutely horrified and had no idea how to explain how this kind of an error had happened. They were thrilled to find "Susie" sleeping peacefully through all the commotion but were ready to fight every one of the nurses working that night. I had to bail out (thank God!!) and call the house supervisor because we had another patient with dysrhythmia and the next thing we knew, "Amanda" was working postpartum nursery.

claire_au · Oct 17, 2004

when i was working at the the paediatric hospital here, there was a tragic incident involving a tiny baby,an iv splint and tape, and a pair of very sharp nurses scissors. the digit was reattached sucessfully. scissors and small children just do not mix and i make sure it is only my fingers in peril when i have to cut tape to remove an iv splint

saskrn · Oct 17, 2004

All of us at one time or another have seen or heard of a nurse doing the most idiotic or blatantly stupid thing that goes against our grain of "good nursing". What's the worst you've ever heard? Here's one for you:
At a LTC where I worked, (this was LONG ago...) we had one nurse on 3-11 shift that all the other nurses kept complaining about because it was "common knowledge" that she always gave her 4 pm meds with her 8 pm meds. Of course, I never actually saw this happen and rarely ever worked with this woman. However, no one else would dare to approach this nurse as she had worked there "forever", and always got her way with whatever she wanted. She would leave the building and not clock out for her breaks, and spend a couple of hours at Walmart then return to work. I was told once that a family member approached her about a resident who thought was having a heart attack and this nurse told them "I'm not her nurse, you need to inform someone else"....this while she sat at the nurses desk filing her nails. Anyhow, one evening our DON just "happened" to check this nurses med cart...and guess what. Supposedly, all the 8pm meds had already been given (or at least they weren't in the med cards) Needless to say, she doesn't work there anymore. Actually, I believe she retired!!!
I don't understand how some nurses can be so PLAINLY unprofessional - not even attempt to hide it! EDIT: Just a reminder, this is what I had heard, not what I had witnessed. Had I witnessed anything close to this you better believe I would be on the phone with someone...and fast!!!

I don't know if this really qualifies, but I have run into nurses that are unable to read IV bags. For example, Jane Doe RN walks up to me, shoves an IV bag in my face, and asks if this is normal saline, because apparently she can't tell. Another nurse asked if she had D5 1/2, I said "yes", and she didn't believe me and started yelling at me! What fluids have these nurses been hanging on their patients? :uhoh21: