Things you'd LOVE to tell the doc and get away with it....

[nerdtonurse?]

Since the patient version is so popular, and I had a bad weekend (and no hope for a better one this weekend....)

You've been giving this schizophrenic Alzheimer's pt 10 mg Ambien, plus 50mg Benedryl, plus 100mg Seroquel every night at their NH for years. Could you please, PLEASE explain why you stopped giving it to them when you put them in the hospital? Do I look like a lion tamer?

Yes, I am going to report you when you take the packing out of an abdominal wound with your bare hands, despite me waving gloves in front of your face. That's what the risk management software's for. BTW, did you not see the big isolation gear on the door? Pt. has hx. of MRSA in the wound, and you just stirred in it barehanded....

When I call you at 3 am and tell you your pt's BP is 212 over 179, resp are 32, and O2 sats are 78, could you please say something other than "So what do you want me to do?" Because, one night, I'm going to tell you what to do, and it's going to be something that only a hermaphrodite can physically do.

We all know this pt's a junkie; could you please, PLEASE, not admit everyone who comes to the ER with a pulse tonight? I've got two evolving CVA's and an acute MI, along with my OOB q5minutes Alzheimer's pt, my drama queen post lap chole, and one in restraints that the NH sent simple to get a break from him trying to bite them. I don't need a "demerol, phenergan and diet soda" q4h, too.

[hollymckenziern]

PLEASE take a few moments to sign the q24 hour restraint form (Yeah right-like they're really doing their own evaluation every day). Please remember to sign the med reconciliation form when transferring out patients. (I know I'll never get you to write out the med list yourself. Forget that. Just sign it?) And most of all-don't go home at the end of the day without going back to all your charts and co-signing the verbal and telephone orders. Nurses are the ones who are scolded and counseled when these aren't done. Thank you.

[debragan]

If you dont want me to call and wake you in the middle of the night, so that you can scream at me and call me an idiot for waking you, for god's sake don't d/c his ativan unless you want to sit up all night with him to stop him from pulling out his peg tube and or his foley!

[gracedRN, BSN, RN]

Loving this!!

"OK This is the NURSE'S Station! Don't walk in here and take my seat, my computer, and interrupt report because you DON'T belong here."

"Yes, I'll be calling with critical values. Regardless of the time."

"Do NOT tell me (over the phone) that pt is 'not allowed to leave AMA', then say you're 'NOT coming in to sign the EOD.' I'll pull out the AMA paper faster than you can pull your perfectly coiffed head out of your a@$!!"

[gracedRN, BSN, RN]

"Put on your big boy panties and deal with it"

ROFLMAO!!

[netglow, ASN, RN]

GracedRN...

I once witnessed a physician pistol-whipping where the nurse told him, "Your head is so far up your (rear), you better write new orders for yourself if you want me to help get it out!" -- I ran for cover so I could fully laugh MAO, when I finished and came back that nurse asked if I had been crying, and I said "you bet I was" and gave her a big thumbs up.

[hollymckenziern]

More, more, MORE!!! Never had so much fun on my day off!

[Spiker, ASN, RN, EMT-P]

amen to that, ruby! a lot of us have been doing this since these docs were little kids, & we have a lot of information/common sense to share with them. they'll go far in life if they realize they can learn from us!

[ec2703]

Funneeeeeeee!!!!

[nurselindah, BSN, RN]

Pull your own freaking charts. Can't you see I am passing medications for 45 ALZHEIMERS patients(half of which are yours. Ever tried balancing 20 charts on a desk the size of a bedside tray?), trying to finish before dinner trays come at 5pm. Otherwise I will have to wait until after 6:30pm when it's a mad race by CNAs to get them ready for bed. Like being in the Kentucky Derby. That gives me NO time before the 9pm med pass and sundowners sets in, when the game turns into hide and seek. Sheesh.

[WYDiceDancer]

GracedRN...

I once witnessed a physician pistol-whipping where the nurse told him, "Your head is so far up your (rear), you better write new orders for yourself if you want me to help get it out!" -- I ran for cover so I could fully laugh MAO, when I finished and came back that nurse asked if I had been crying, and I said "you bet I was" and gave her a big thumbs up.

On the same thread, I have a friend tell the administrator (when he ATTEMPTED to write her up for an imagined infraction)"You can take that and shove it up your @$$, and maybe on the way up it will lance the hemorroid that is keeping the blood from reaching your brain!" Ten years later it STILL cracks me up.

[hollymckenziern]

So you expect me to transfuse 4 PRBC's and 4 FFPs stat? When you won't do the transfusion consent?

[RetiredTooSoon]

I may know what he needs, but after being a surgeon for 10 years you should know that nurses are not allowed to write their own orders.

Yes, I know this is a fun thread. One thing that may save a few grey hairs, though...

When I was working OR and preop clinic, I was allowed to write orders-I also ordered labwork. The doctors told us what special orders they wanted for certain types of patients and the RNs could write the order, knowing that the doc would sign them off when the patient got to them-I guess it was like a verbal order, given days or weeks ahead of time. Since we were a small centre and only had two ORs open at most and on Fridays had no surgeries or in-house anaesthesia coverage, we couldn't just call a doctor to get orders for non-urgent reasons.

My cousin was a diabetes instructor/RN and she was given a pad of signed prescriptions so she could write routine insulin orders. We didn't have nurse practitioners at that time, but apparently someone in the clinic checked with the nurses' professional association and got clearance for the nurses in diabetes education to write the insulin orders.

It may be useful to get universal standing orders for such cases so that if there is a GI bleed or other relatively 'routine' complication, you can act first, get the data and then call the doctor with the results.