So new nurses..share some of your duh moments so far! Here is one I did last week:
It was the end of a 12 hr night shift. Pt having weird fecal type residual out of PEG. Ended up hooking it to suction to see how much she had. So we took it off suction per MD orders. Preceptor gave me a big thick strip of tape and said "go use this to mark the canister with the time and amount so the next shift will know how much." I thought "huh why did she give me this LONG strip of tape"
I tore it in half and lined it up ---- this way with the suction drainage, wrote the amt and time.
A few minutes later I'm charting and my preceptor says "um come here I need to show you something"
Well DUH..I was supposed to put the tape like this | to mark it...oops lol. She said she got a chuckle out of it. Made perfect sense once she said it. Scary sometimes that they give us a license huh? lol
So what have you done that you felt like DUH...what was I thinking?
Specializes in Labor and Delivery, Surgical/ Ortho.
Here a good one:
I am sitting down to chart at about midnight and the tech comes to me and tells me that one of my patients is satting in the 60's. I go immediately to check on her and the highest I could get was low 80's. So I ask her to please go get my preceptor. She comes in and gets the same thing. We have the patient wake and take some deep breaths to no avail. She tells me she is not too concerned since she is a COPD pt. Right before we leave the room, she notices that the O2 connector on the wall looks weird. Someone had got the patient up and rehooked her to AIR, not O2!! No wonder!
Ok, here is mine. I work on an ortho/neuro unit and we had a patient come from surgery from a spinal cord untethering and was going to be on bedrest for like 5-6 days. She had no foley catheter and in report from PACU I was told that she has a colostomy. So, I see the neurosurgeon in the hall checking on her shortly after she comes up and so I am thinking about this fact that she will eventually have to go to the bathroom. I ask him..."Would you like us to insert a foley catheter?" He replied, "Well, I think she has a urostomy" I reply, "Recovery told me she has a colostomy, but didn't mention a urostomy" He says, "Well, let's go look" Turns out the patient has a urostomy NOT a colostomy! She straight caths herself through the urostomy every few hours. I felt like a complete moron!!!!!!
We're all gonna have "duh" moments, and I have a feeling I'll be having them now and then for a long, long time.
I learned the other morning, while emergently helping with suctioning a vent patient (the suction type that is automatically connected to the vent wasn't set up yet) that it only works if you turn the suction ON. Luckily it took very little time to learn this. I've done a fair bit of vent suctioning, really... even the kind where you take it apart, bag, stick the sterile tube in, etc... but I guarantee you I will never, ever forget to turn the suction on again.
I'm slowly having less...but the other night my pt was a bit anxious. She kept taking off her 02 and I put it back on and reminded her she needed it. She was fairly young CHF/COPD (lifelong smoker) My preceptor walked in and said "what is all this extra tubing" She got to looking and the 02 hooked to the patient wasn't plugged into the wall. Someone in the prior shift (or RT) hooked up another set of tubing to the wall and it was lying on the floor behind the bed.
I'm glad she discovered this so I could switch it and get my pt actually ON the O2. Her sats were ok thankfully but still. I didn't mix it up but I wish I'd have been the one to catch it. So many little things to always be checking!
I had a patient that was having normal output all day of at least 150 mL and suddenly for the hour it was 2mL, then 1 mL! the next I was like what the heck, so I asked the nurse about it and she was like 'Look, his tubing is kinked in the bed rail". So the next hour he put out 679 mL! I had been doing q 2 hr assessments on him and he didn't have any bladder distention nor was he in pain.
I had a couple of "duh" moments this week, as well...
1) I was assessing my pt at the beginning of my shift.after listening to lungs,heart,etc. I told her I needed to look at her feet...wouldn't have been a big deal if she wasn't a double amputee...DUH! She got a kick out of it...I didn't find it to be as funny, though.
2) Pt came in new onset a fib. Was titrating Cardizem drip all night to get HR below 100. Hr had been consistently in 120's-160's. RT informed me that they put CPAP on...about 3 minutes later I look at the monitor and see hr of 30's. Pt was difficult to arouse (had given 0.5mg ativan about 1 hour prior). I called md to notify of pt hr and difficulty to arouse after being on cpap. Turned cardizem off, of course. MD came in from home to evaluate pt at midnight only to review ekg strips to see that the tracing wasn't picking up and pt had a hr in 120's not 30's the whole time.Unfortunately I was so busy with another pt, I wasn't told by charge rn that the monitor tech had been calling about poor tracing and inaccurate heart reading.Oh, well...better to error on side of caution, I guess. I just feel bad for the doctor having to come in to see her pt when it ended up being unnecessary.
PB&J - guess it would have been good to listened apically ... but being new sometimes we forget those simple things huh? Hence the name of this thread lol
Pt had DL PICC w/ three pumps. I hung an IV antibiotic, only to come back later and find the med was all over the floor. I never did hook tubing to the pt (just assumed it was going to her). DUH!!
Specializes in NICU, PICU, PCVICU and peds oncology.
PB&J - guess it would have been good to listened apically ... but being new sometimes we forget those simple things huh?
In the climate of short-staffing and mandatory overtime, it's no wonder people come to rely on technology to be their eyes and ears. We can't physically be in two places at once but monitors are supposed to allow us to multitask/multi-nurse to cover the shortfall. I'm sure PB&J learned a valuable lesson about believing a machine over her own assessment. And I bet the physician wasn't that upset about being called in... truly better safe than sorry.
I work in L&D... I had just layed the pt back to do her foley... everything went fine. Sat her back up a little and realized I wasn't tracing her baby anymore... so I grabbed the u/s and started trying to reposition it.... still nothing.... I'm not even hearing the baby move like I had been..... Looked down... I had the u/s upside down... I felt so dumb... just then my preceptor comes into the room to see why we're not tracing the baby... she just smiled and told me I'm supposed to do funny things like that right now :)
Not to undo the "duhness" of my "duh" moment, I did happen to check my pts radial pulse prior to calling the MD (which I found to be faint to nonexistant. Not to mentions, she barely aroused to my sternal rub.) It would have been a great idea to have listened apically, though. Unfortunately I wasn't thinking nursing 101. Maybe I couldn't find her radial pulse because my pulse was bounding so hard? Anyways, we learn from our experiences. I definately won't forget this one. "Treat the patient and not the monitor"!
Hey PB&J! You are NEVER gonna guess what happened last night on my shift! You will get a kick out of this and how we have LEARNED from each other's duh! moments.
Ok so pt has HR in 60's early in shift. After clearing it with preceptor I gave her lopressor. Well she does fine, several hours later still 60s.
But about 6 hrs later...we are standing by the monitors and preceptor goes "hey...your ladies HR is 50" then the next minute "oh gosh now it's 80!" So I go in to check her and because of this thread thought to immediately check apical lol.
Sure enough, she was 52. Checked her BP...stable. Checked her O2 and it was in the 80s (I was impressed with myself I remembered that a drop in HR can = drop in O2 due to dec. CO lol). Asked her to breathe deeply..still 80s. Grabbed some O2 and put it on her. So while I'm checking her sat the pulse ox reads like HR of 82. I check again apically and immediately could tell yes it was going faster than the few minutes prior and yes now it was in the 80s.
Anyway, she did this bit off and on the rest of the shift but remained asymptomatic so we left a note for the cardiologist and informed oncoming shift. May end up needing pacemaker. Preceptor said no way was it due to Lopressor as it had been 6 hours and she was bradying AND going up above baseline.
But anyway - I thought about you and it helped me to learn to respond better to a change in status! :)
I don't think I had any major duh moments last night. Except the first few hours EVERYONE wanted pain meds, sleeping pills, or anxiety/antidepressants. Just trying to get all the VS and assessments and get out all the narcs, hang TPN, all my pt were diabetic it seemed and trying to get accuchecks before the CNA passed snacks... was BUSY! Then my little confused lady kept getting more confused after her family left for the night and her bed alarm was going off every 15 min as she would once again get up. One time the bed wasn't paging up to the desk when it alarmed and I was up checking out my brady pt so didn't hear it and she made it all the way to the nurses station..thank GOODNESS she didn't fall. We decided to contact family this morning as she severely needs someone at the bedside.
FUN night! But it went SO fast. And I had another pt I cried with who was getting surgery today and was scared who really was thankful for my care and said how much it meant to him. Was so sweet I cried with him and gave him a hug! This job is so crazy and great all in one! lol
smrfett76
22 Posts
Here a good one:
I am sitting down to chart at about midnight and the tech comes to me and tells me that one of my patients is satting in the 60's. I go immediately to check on her and the highest I could get was low 80's. So I ask her to please go get my preceptor. She comes in and gets the same thing. We have the patient wake and take some deep breaths to no avail. She tells me she is not too concerned since she is a COPD pt. Right before we leave the room, she notices that the O2 connector on the wall looks weird. Someone had got the patient up and rehooked her to AIR, not O2!! No wonder!