One of the lousiest orders I ever got (and the doc was there, charting) was to give Insulin R- 100u IV.. The patient's blood sugar was in the mid 400s (high enough to treat ASAP, but not having symptoms) She had large ketones (don't remember if those were in the blood or urine)... I'd been a nurse for about 5-6 years at that point- NEVER gave that much IV.
I was in charge (no patients) and wasn't going to ask the patient's nurse to do something I wasn't comfortable with (though I told her, and she was glad I dealt with it). I got the insulin and showed the doc- he said yes, that's what he wanted. I drew up the 100units- showed him, and he said yes. I then said "OK, c'mon" and had him come with me while I gave the stuff (figured he could stand there when I had to run for the D50W).
On the way to the room, I asked him why so much.... he told me it was to deal with the ketones more than the blood sugar. We got to the room, and I gave the insulin IV. The patient did fine, and the doc informed me of why he ordered what he did.
Had a nursing home patient who was dying slowly. And not peacefully. I was the sup on W/Es, and they called me to look at the morphine orders...they were reasonable- don't remember exactly what. But, the lady's respirations were 12 (low, but not catastrophic) and labored. She was uncomfortable. And the nurses didn't want to give her something that would do her in- I called the doc, and got parameters for the MSO4...___mg q 4h IM (not so much IV back then) prn pain or respiratory distress; give if respirations >4. I was glad the patient got the relief; the nurses were glad for the parameters, and essentially permission to give the stuff...
