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!!!
Sure they were sterile. We had either sterile glass medicine cups, or after we got plastic syringes we could pop the top off (Monoject-I think). You'd tip the MS pill from the sterile supply into the cap or cup , squirt the NS diluent and then draw up the dose. The pills came in a small bottle like Ntg does. I dont think anyone could poke a finger in.
You would also make sure that it was absolutely dissolved--absolutely, positively no particulate matter left. If need be, you could crush the pill with a sterile mortar and pestle--but that was rarely necessary--all that was needed was patience. The tablets dissolved fairly rapidly in sterile injectable NS. Yes, we had sterile glass and metal med cups, as well. Still do, in the OR--they look like shot glasses.
In any case, there is no reason to do it any more, so it should never be an issue here in America, where injectable MSO4 is readily available now.
Nurse with 23 years experience had patient swallow Motrin 800 mg with a nasogastric tube in place!
I don't see how this wrong unless there was an order to administer all meds via NGT. I have had many a GI patient with NG tubes to LIS take meds PO (after clamping the NGT). If someone has difficulty swallowing or isn't concious enough to take meds PO and they have a NGT with orders to crush meds and admin them through the tube, then by all means give through the tube, however it is not intrisically wrong to give a patient PO meds just because they have a NGT IMHO. Anyone else have input on this?
I don't see how this wrong unless there was an order to administer all meds via NGT. I have had many a GI patient with NG tubes to LIS take meds PO (after clamping the NGT). If someone has difficulty swallowing or isn't concious enough to take meds PO and they have a NGT with orders to crush meds and admin them through the tube, then by all means give through the tube, however it is not intrisically wrong to give a patient PO meds just because they have a NGT IMHO. Anyone else have input on this?
Yes, that it what I was saying. A pt is not NPO simply by virtue of having an NG in place. I just don't understand why anyone would think a pill HAS to go down the NG.
Also, Hey, guess what? Sometimes patients get dobhoff tubes-- small bore NG tubes for supplemental feedings. The key word here is "supplemental". Of course, sometimes DHTs are in place because nothing can be swallowed. .
You have to know what the purpose of the NG is for, and if it needs to be hooked up to suction all the time before you decide whether you are going to crush that pill and dump it down the NG tube, withhold the pill, or give it to the patient to swallow.
Ngs are common enough on my floor that I've seen all types of dietary orders with them.
A nurse on shift with me, years ago had a diabetic patient who was a hard IV stick. The IV abx ran in very very slow, so this nurse decided to fill the IV bag with air, and place a B/P cuff around it. You know, pressure bag. Well it worked, and the patient got an air embolus. I found out because I answered the call bell. The patient made it, and this nurse was placed on admin duty, never to touch a patient again. This happened when I was in the navy.
I don't see how this wrong unless there was an order to administer all meds via NGT. I have had many a GI patient with NG tubes to LIS take meds PO (after clamping the NGT). If someone has difficulty swallowing or isn't concious enough to take meds PO and they have a NGT with orders to crush meds and admin them through the tube, then by all means give through the tube, however it is not intrisically wrong to give a patient PO meds just because they have a NGT IMHO. Anyone else have input on this?
every facility that I have worked in there was an NPO order or po as tolerated leaving it up to the nurse to decide
I have read all of these and I can't even imagine........
sometimes I joke and say that its a wonder we function as nurses, with the little bit of knowledge we walk away from nursing school with.
but my god, I pray for my safety one day when I am a patient. I hope I have a nurse like me......ANAL, VERY CAUTIOUS, TAKE MY JOB SERIOUSLY, & ANAL RETENTIVE SOME MORE.
KUDOS....to all of the nurses who CARE enough to seek/learned/do the proper way of nursing practice. :)
A nurse on shift with me, years ago had a diabetic patient who was a hard IV stick. The IV abx ran in very very slow, so this nurse decided to fill the IV bag with air, and place a B/P cuff around it. You know, pressure bag. Well it worked, and the patient got an air embolus.
Filled the IV bag with air and placed a BP cuff around it??!!
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
well, i've made a number of mistakes in my life as i'm sure everyone else here has. some of them i catch, others get written up, and i'm sure that there are some i never do hear about. i don't think the purpose of this thread is to ridicule others, but merely to provide an outlet. laughter is a good medicine -- for us as well as for our patients!:)
years ago, i was taking care of a sickle cell patient who required morphine injections about every 60-75 minutes. he was sitting up at the bedside, begging for morphine and the lpn i was working with came in to give him his shot. as she was going for the thigh, though, the tubex slipped out of her hand and fell, hitting the patient's big toe where it stuck, flapping in the breeze. without missing a beat, the lpn went ahead and injected the morphine. he must've gotten pain relief, because for the rest of his stay, he asked to get his shot "in the toe, just like that night nurse did.":chuckle
my biggest mistake (or one of them, i guess!) was dislocating a resident's shoulder. we had a luekemia patient decompensating and although she was on his service, he didn't feel qualified to deal with her particular problem. we were paging a consult service, but he was absolutely refusing to help and this patient was going down the tubes. i was walking him down the hall toward the patient's room, giving him an update. when we got to the patient's room, he put on the brakes. i took his arm, intending, i guess, to drag him into the room. but at that moment, he had a grand mal seizure and fell to the ground. in my infinite wisdom, i was trying to hold him up rather than follow him down to the ground, and his shoulder got dislocated on the way down. when all was said and done, the resident was admitted to our floor as a patient for a seizure workup, and i had to take care of him. the whole time, he was telling everyone "there's the b*tch that dislocated my shoulder!" :uhoh21:
my biggest mistake (or one of them, i guess!) was dislocating a resident's shoulder. we had a luekemia patient decompensating and although she was on his service, he didn't feel qualified to deal with her particular problem. we were paging a consult service, but he was absolutely refusing to help and this patient was going down the tubes. i was walking him down the hall toward the patient's room, giving him an update. when we got to the patient's room, he put on the brakes. i took his arm, intending, i guess, to drag him into the room. but at that moment, he had a grand mal seizure and fell to the ground. in my infinite wisdom, i was trying to hold him up rather than follow him down to the ground, and his shoulder got dislocated on the way down. when all was said and done, the resident was admitted to our floor as a patient for a seizure workup, and i had to take care of him. the whole time, he was telling everyone "there's the b*tch that dislocated my shoulder!" :uhoh21:
never heard of that and would be afraid to try it... i'd be afraid that i'd inject some sort of particle into the patient. you know the only clear things by IV rule?
:rotfl: :rotfl: Nurses give something by IV???? :rotfl: :rotfl: . Back when this was practice (early 60s) nurses didn't even start IV's. The supervisor would sometimes take a nurse aside and show them how on the QT, but a nurse admit it---NEVER. It was gluteus maximus 99% of the time. Oh temps were by glass thermometer and only DOCTORS took BPs.
when all was said and done, the resident was admitted to our floor as a patient for a seizure workup, and i had to take care of him. the whole time, he was telling everyone "there's the b*tch that dislocated my shoulder!" :uhoh21: 
stevierae
1,085 Posts
You would also make sure that it was absolutely dissolved--absolutely, positively no particulate matter left. If need be, you could crush the pill with a sterile mortar and pestle--but that was rarely necessary--all that was needed was patience. The tablets dissolved fairly rapidly in sterile injectable NS. Yes, we had sterile glass and metal med cups, as well. Still do, in the OR--they look like shot glasses.
In any case, there is no reason to do it any more, so it should never be an issue here in America, where injectable MSO4 is readily available now.