What have other nurses done that have freaked you out? - page 56

What have other peers done intentional/unintentional to freak you out? Good or bad. Happy or sad. On my FIRST day as an LVN, (LTC) a res was screaming in her room as I was walking out to leave. I... Read More

  1. by   hecallsmeDuchess
    As someone preparing to start a career as a nurse, after reading all these stories, I guess the most important thing I gleaned from these stories is that I have to be very careful as nurse and never become complacent or think there's ever a stage I get to that I'll automatically know it all.
  2. by   shiccy
    Quote from NurseyTee
    These stories are TERRIFYING!! How did some of these people get their licenses?????????

    I have a few... One new RN on our subacute floor had a new admit that was a post-surgical pt. He had lovenox ordered but it wasn't in from Pharmacy. I told her to get on the phone to pharmacy and get it ordered and sent out stat. He hadn't had the lovenox in 18 hrs. I assumed she had done it as she said she was on it. (HER pt. btw, not mine.) Next night I come in and again NO lovenox. She didn't bother to do anything!
    I don't want to sound like a complete jerk, but I used to work at Cedar Point and they sent us all through a particular training, so I thought I'd pass this training along to you...

    When you page someone, request something, etc. and you need it sooner rather than later, you use the acronym ASAP. This means it's not something that is life or death. If the patient will not die or lose a limb NOW, then you will need this drug ASAP.

    If a patient is literally getting ready to crump, they have low compensatory ability and are dyspnic and/or Vitals are crashing, AND the med will hopefully will remedy this problem, then you definitely need the order STAT.

    STAT will get it sent to the front of EVERYTHING. EVERYBODY'S meds will get postponed b/c pharmacy has to stop their well oiled machine to take care of your request. ASAP will be put in front of the "regular" orders, which will have more pharmacy techs and pharmacists available to fulfill your request.

    If a patient is in acute and severe fluid overload and you need a dose of bumex, resp neb tx, and possibly some ativan, then you need these meds STAT. A patient will not die from not having lovenox RIGHT THIS MINUTE. (I'm assuming probably for DVT prophylaxis in a post-surgical patient). This means that ASAP should be used, and should be administered as soon as possible, but should not be confused w/ a patient that is bleeding uncontrollably, a patient that can't breathe, a patient that is having chest pain, etc.

    Final thought... 9/10 times you do NOT need a medication STAT. It took me a long time to get that through my skull. Almost EVERYTHING that you need is "ASAP" (and if you've looked ahead far enough, you will need the med "In 2hrs" (which the pharmacy like the most, and will probably send up faster sometimes ... especially if you order something like lovenox "stat")

    OTHER final note: Lovenox continues to work for 24+hrs depending on a patients renal function and creat clearance/GFR. Therefore the patient may have been slightly subtherapeutic more than usual, but they still at least have SOME of the med in their system.

    Again I'm sorry if I came off rude or obnoxious, it's just something I see people write all the time and think it's something that every hospital should address w/ their staff at some point in orientation.
  3. by   Simba&NalasMom
    Quote from shiccy
    I don't want to sound like a complete jerk, but I used to work at Cedar Point and they sent us all through a particular training, so I thought I'd pass this training along to you...

    When you page someone, request something, etc. and you need it sooner rather than later, you use the acronym ASAP. This means it's not something that is life or death. If the patient will not die or lose a limb NOW, then you will need this drug ASAP.

    If a patient is literally getting ready to crump, they have low compensatory ability and are dyspnic and/or Vitals are crashing, AND the med will hopefully will remedy this problem, then you definitely need the order STAT.

    STAT will get it sent to the front of EVERYTHING. EVERYBODY'S meds will get postponed b/c pharmacy has to stop their well oiled machine to take care of your request. ASAP will be put in front of the "regular" orders, which will have more pharmacy techs and pharmacists available to fulfill your request.

    If a patient is in acute and severe fluid overload and you need a dose of bumex, resp neb tx, and possibly some ativan, then you need these meds STAT. A patient will not die from not having lovenox RIGHT THIS MINUTE. (I'm assuming probably for DVT prophylaxis in a post-surgical patient). This means that ASAP should be used, and should be administered as soon as possible, but should not be confused w/ a patient that is bleeding uncontrollably, a patient that can't breathe, a patient that is having chest pain, etc.

    Final thought... 9/10 times you do NOT need a medication STAT. It took me a long time to get that through my skull. Almost EVERYTHING that you need is "ASAP" (and if you've looked ahead far enough, you will need the med "In 2hrs" (which the pharmacy like the most, and will probably send up faster sometimes ... especially if you order something like lovenox "stat")

    OTHER final note: Lovenox continues to work for 24+hrs depending on a patients renal function and creat clearance/GFR. Therefore the patient may have been slightly subtherapeutic more than usual, but they still at least have SOME of the med in their system.

    Again I'm sorry if I came off rude or obnoxious, it's just something I see people write all the time and think it's something that every hospital should address w/ their staff at some point in orientation.
    I don't think your post was rude or obnoxious; however, there is a difference between how STAT is used in long-term/skilled nursing facilities and how it's used in hospitals. In LTC, when we order a med or x-ray STAT, it is generally understood that it will be done within four hours and it is understood that b/c it's not a hospital, it's not literally life or death. I'm assuming that the post you're addressing is referring to a skilled nursing facility that is more along the lines of a "nursing home" type setting (OP referred to is as sub-acute).
  4. by   jerenemarie
    The RN, who happened to be a nun, was orientating me when I noticed she emptied a urinal with no gloves, did not wash her hands...we then went on coffeebreak & she peeled & ate a hard boiled egg...still after not washing her hands, EWWWWWWWWW!
  5. by   Honeynurse
    Quote from Tweety
    A nurse crushed Percocets, mixed with water, and gave it through a central line IV.

    Wow!!! That's freaky..
  6. by   LevitateMe
    i am an lvn in a rn mobility program and a few weeks ago i was helping another lvn with her blood draw, and right after she drew the blood she pulled the butterfly closed and dropped it right in the trash can!!! I was like uh whoa! don't do that, those go in the sharps... I think she was just a little freaked over the blood draw, having only done a couple in her carreer. she was pretty embarrassed.
  7. by   General E. Speaking, RN
    Found out a fellow nurse hung a 25,000 unit heparin/250 ml NS in 30 minutes. She thought is was an antibiotic!
  8. by   iNurseUK
    A newly-qualified nurse on my ward drew up 15 mls of insulin instead of 15 units. Thank God for our two-nurse checking policy and that she came trotting up to me to check the dose.

    No harm done and kudos to her for sticking to policy and having another nurse check it. Poor girl was mortified when I (gently) pointed out the mistake.
  9. by   GM2RN
    Heard about a nurse in my ED that recently had a pt on an insulin drip for several hours and never did a single glubed.
  10. by   sasha2lady
    I like this post hmm..let me see here...I saw a nurse give an IM ativan SLOWLY..i mean barely did get the needle in..made my skin crawl. I know of a nurse who doesnt give her ac meal insulins til we come in at around 7pm...along with her pm as in 1 and 2 pm...meds and narcs....yet signs off on it for the right times..has yet to have a narc count come out right, um....lets see...ive known of pts who had skin tears and falls without injury yet no charting or incident reports were done because "im prn, who cares im not doing that", ive seen nurses leave meds on top of carts..right out in the open. i saw a nurse light a cigarette in the dining room one time. i know of another nurse who writes all kinds of orders and has yet to document one single time on where and why that order came to be. I got a long list thats just too long to put on here....but....thats a few i know of
  11. by   shoegalRN
    I worked with a nurse who started a heparin gtt but NEVER drew a pTT. Seriously. I'm talking about prior to starting it, or for the time it ran until I got on shift to get report.
  12. by   shoegalRN
    Quote from Blackheartednurse
    1. A nurse running dopamine and dobutamine for unstable patient in the same IV line.
    If these meds are compatible via IV, they can be ran through the same IV lines. I used to work in ICU and seen lots of pressors ran into the same IV lines but labeled.
  13. by   Peds4LifeRN
    whoa.... speechless...

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