Inquiring Minds Want To Know: Outrageous Orders!

Nurses General Nursing

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IVE RECENTLY HEARD SOME FUNNY AND SOMETIMES DISTURBING STORIES IN REGARDS TO PHYSICIANS ORDERS.SO I WAS JUST WONDERING:

WHATS THE MOST OUTRAGEOUS MD ORDER YOU EVER HAD TO TAKE OFF OR WERE EXPECTED TO IMPLEMENT? AND WHEN YOU REFUSED TO IMPLEMENT OR TAKE THESE ORDERS OFF,WHAT WERE THE CONSEQUENCES?

INQUIRING MINDS WANT TO KNOW,THANK YOU.

I would have written a progress note on the care given to the flowers! I would have also put a yellow sticky in the chart requesting an H&P on the flowers before I provided care.

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Specializes in Oncology/Haemetology/HIV.

Not to mention, accurate I&O, and vital signs on the flowers.

If the root intake of fluids was too low, at 0200 AM be sure to call and inquire as to the need to start IV fluids.

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I can't believe I nearly forgot this one because I had an absolute cow when I found out about it during report. The medical Resident involved is about to become a 3rd year now and she was a first year at the time. We had a brittle and I mean brittle diabetic in the unit. He also had a problem holding onto his potassium. Many ICU patients do. We order K+ supplements. Not this doctor (the attending did the ordering the resident didn't see a problem with it). This attending and resident decided it would be a wise thing to hold his insulin. Day shift did!!! I stopped getting report mid sentence and did a finger stick. I also brought in stuff to draw a tube of blood because I knew his sugars would be way to high to register on the accucheck. His sugar was 900 something and yes folks there was acetone. These 3 had put the man into DKA!! Scary thing was this nurse (Agency and never was allowed back after this) took his sugars all day and didn't report the high numbers and never sent a sepcimen when the accucheck said too high to read. The family came in and saw the insulin drip hanging and hit the roof. Cannot say that I blame them!!!!

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I worked in a Military Teaching Hospital where our stellar physicians (not) would want all sedation stopped cold turkey at 2400 for intubated, ventilated patients. They also refused to apply restraints on 90% of the intubated patients. The truth of the matter was that they did not start vent weaning until they grand rounded the following morning at 0800. The patient, after fighting with the nursing staff that was lying across them all night to prevent extubation and bucking the vent for 8 hours, were then too tired to pull good negative inspiratory force and vital capacities. Essentillay they would fail weaning parameters. Needless to say this was a repeated vicious cycle. The point of the story is that the physicians and residents would accuse the nursing staff delivering unordered sedation thus causing the wean failures. So they started writing in the orders: DO NOT ADMINISTER SEDATION FOR NURSING CONVEINANCE! This used to make my blood boil!

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"May eat anything he wants including raw fish." (Intubated patient with an NG tube, no reason to suspect he was a sushi lover...)

Love the thread!

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I hear you on that one Okihusker! I have worked nights for all but 2 years of my 10 as a nurse. I am so sick of docs who either don't order sedation and wonder why their patients are still vented after a month or who think we snow these poor slobs so we can sit at the desk and eat BonBons all night! Make the patient a 1:1 and you can forget about restraints. If the patient is calm minus sedation, fine. But if they are agitated and anxious, they will fail weaning. Perhaps they should use Diprivan and wean it to off starting at 6 or 7 am. I have frequently offered to intubate these types of docs to see how they like breathing thru a straw!!! None have taken me up on the offer yet...go figure!

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:rolleyes:

Well....what do you think we should do?

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We have a pulmonologist who never listens to lung sounds. He will read the nurse's notes or other physicians' notes and write what they wrote. Or he will ask what the patient's lungs sound like, and write what you tell him verbatim in his note. If he can't do that he just writes "distant breath sounds." I guess they all sound distant if you listen from six feet away. Some day I'm going to tell him I hear Beethoven's Fifth in the patient's lungs and see if he writes that. Another MD, an internist, uses our nursing assessment to do his H&P, never even examines the patient himself.

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Had a doc once that came to see a post partum patient, but she was visiting her infant in NICU. Doc wrote in notes "nurse states pt. doing well."

I paged him and asked him to come back and change his note or see his pt.

Heather

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I worked with one doctor who was a sweetheart by day, but when the sun went down, his "dark side" definitely came out! When I called in the middle of the night to tell him that his cirrhosis patient was coding, he growled, "Give her a liver transplant!" and hung up on me. I asked around, but couldn't find any volunteers to donate. Can't think why...:rolleyes:

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Specializes in NICU, PICU, PACU.

"Take Dwayne into a quiet room away from others to feed....he possibly has ADD" this was an order for a 2 month old preeme :lol

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Specializes in Neuro Critical Care.

Pt is NPO including meds, then the MD orders about 20 PO meds. First year resident...early morning...need I say more? :rolleyes:

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