What is the most incompetent thing you seen a fellow nurse do? - page 4
There were two patients in a double room on a 38 bed tele floor. One was an old fart with a sick heart an the other was a 35 year old male who was in an MVA being observed for a myocardial... Read More
Jun 4, '02Joined: Jan '02; Posts: 5,673; Likes: 159Lilgirl, I have had agency nurses too who have come in for a 4 hour orientation with claims of years of critical care experience. I take them at their word until they show zero recognition of an A line wave on the monitor, or don't know what to do with VTach (they think it's artifact), etc.
We have to be really careful with agency on their first visit to us, IMO,...I asess them very closely during their initial 4 hour orientation and DNR them right on the spot if they're coming in lying to me.
I've worked with some top notch agency nurses. I work agency myself on occasion. I do not misrepresent my skills, and I expect other agency staff to do the same. If they're gonna call themselves critical care nurses they better be able to demonstrate to me that they ARE critical care nurses.
::stepping off soapbox now::
Jun 4, '02Occupation: RN Joined: Feb '01; Posts: 519; Likes: 4Lots of errors, lots of mistakes but no one died. Guess that's the bottom lineLast edit by Hardknox on Jun 29, '02
Jun 4, '02Occupation: PNP, Director of Sim Lab, University of WA Specialty: 27 year(s) of experience in Pediatrics, Metabolic genetics, Neuro ; From: US ; Joined: Apr '01; Posts: 29thank god i'm no longer at the bedside....
When I was charge in the PICU, a fellow RN had one of our student NAs assist him with a bladder catheterization. The patient was in the ICU because he had an anaphylactic reaxn to latex while in the OR. There was an allergy sign above his bed clearly stating his allergy, and it was noted on his chart as well. This nurse went on to cath the boy with a red robinson catheter. When the student NA asked, "Isn't that latex?" the reply was, "I thought I'd test the diagnosis..." Good thing she had the cojones to stop him...
Luckily, no one was hurt, but the mess that ensued afterwards was horrible. This nurse was fined an incredible amount of money, made to go through orientation again, and no one wanted to work with him, because he tried to cover the whole thing up...Lesson learned-just tell the truth!
Jun 4, '02Occupation: ADN student/Obstetrics Tech Joined: Apr '01; Posts: 44; Likes: 5I am not an RN, but will be one soon...I work in L&D and have had to follow one increadably incompitent nurse for a long time before she got enough sense to resign...
I was given report on a delivered pt., RN told me that the patient was fine, she just hung a new bag of LR with 20 of pit, and fundus was U/U firm. I was to go in and wash her up, and tx her to PP. I go in, the room is a disaster, patient asks me about her IV, which is dripping all over the pumps, on the floor (which had a bath blanket, which was soaked.) worried about possible electrocution!!!! I imediately look at the line, which was tapped with transpore tape at the top port, pt tells me RN Incompitent had to tape it right around delivery because it was leaking, there was already 400 cc gone from this fresh bag and probably another 600 on the floor!! In stead of changing the line or d/c ing the IV this nurse decided that tape would do!!! I get the charge nurse in there, we assess her fundus which, mind you this is less than 5 min after report is 3/U, booggy, to the right with a palpable bladder...charge RN caths her for 1300cc, large clots, 1 dose of methergine later, fundus is finally firm at U/U. Changed tubing on the mainline, new bottle of pit up in D5LR, figure nothing else could go wrong, well, I am FINALLY washing this pt up and guess what, she is a disaster, there is blood up her back, the epidural line was never removed from her back (this is a RN responsibility)the bag was d/c'd but not the line taped up her back, she was never given a quick clean up before taken out of stirrups. I also find out when trying to get an extra hand to tx her, that her call light was never pluged in during her entire stay, pt states that she had mentioned this to RN incompitent, but that the RN said that was fine she was almost done!!!! This one of the many things done wrong by incompetant RN. SHe was given many chances to redeem herself, lots of support and help, but she just wasn't cut out for L&D. She was in Psych for 20 years, but had seem to have lost her basic nursing skills as well as common sence along the way. She didn't know where to find tones on a pre termer, charge nurse would send me in to help her out (I do usually put the pts on the fetal monitors, but they also should be able to do this them selves DUH!), didn't know how to do a clean catch, one time told the pt that the baby might be gone, because she couldn't find tones FREAKED OUT the pt who was 22 wks with spotting, charge RN and I go in, she was looking for tones above the umbilicus for 5 min., never asked for help, put the monitor on, and could hear the baby 150s and kicking!!! Had to do an US to reasure the pt. LAST Straw was giving report to the OB looking at the wrong monitor while giving HR and variability, the pt she was looking at was with great accels, her pt, was flat and contracting at 32 wks!! Well she realized it after she hung up, decided that she wouldn't call the OB back, and let it go, charge RN told her she had to give the OB a call let him know what happened and give him the correct report...Incompetant RN said she would do it later...NEVER DID, pt ended up delivering the next morning.
I don't know what ever happened to this RN...Hope she isn't working L&D....She set a good example for me of how not to practice when I graduate... I learned from her mistakes, too bad she didn't.
Jun 4, '02Occupation: CTICU Joined: May '02; Posts: 12; Likes: 2This was 20 years ago -- I was Charge, working with a new grad who wasn't even licensed yet. Her patient had a K+ of 3.8, and the H.O. wanted to replace K+ IV. Through a 20 G. in the back of the hand. (Did I mention that this was the first week of July?) Nancy New Grad said, "Oh, we have a policy, doctor, that if we (nurses) give it, we can only give it IVPB 20 mEq in 250cc over 2 - 4 hours. But if you want to push it yourself, you can give as much as you want." Dr. New Intern says "OK, we'll do that." She draws up 40 mEq and hands it to him, and he walks into the room to push IV KCL on this sweet little old lady with a normal K+! Both New Intern and New Grad were angry with me when I tried to intervene -- told me to MYOB! I called the R3, who thought I was joking. Finally the Pharmacist (who was male) stopped him.
Years ago, a post CABG patient goes into A Fib, and the doc orders Diltiazem, 5 mg IV bolus. The new nurse didn't know the drug, so she asked the charge nurse if that was an appropriate dose. The charge nurse said it was, so the New Grad went and drew up 5 mg. of Digoxin and pushed it. (They both start with D, right?) The patient didn't survive.
And then there was the LPN who was sent into the patient's room to give IM Morphine. She dropped the syringe (uncapped, and it fell, striking the patient in the great toe and sticking there. The patient is yelling about the pain in the toe, and the LPN figured "what the hell?" and injected it. In the toe.
There are many more . . .
Jun 4, '02Occupation: RN-Vent Unit Joined: Apr '02; Posts: 92; Likes: 6Its ICU that hard??
HI I graduated one year ago. I am working currently in an acute long term hospital with Vent-dependent patients. I just got an interview for an ICU position at a very busy and big hospital but as I am reading some messanges I am scared. any advice??
Jun 4, '02Occupation: med/surg noc Joined: Jul '01; Posts: 45; Likes: 6I was working in a nursing home in MN several years ago. I was making my rounds between the units checking in with the new nurses, asking if they needed help or had questions...all was well so I was told. On my last swing around the building one of the more experienced nurses flagged me down and wanted me upstairs NOW. I arrived to a family screaming at the new nurse, while the Residents daughter was onthe pay phone calling 911. Come to find out the Resident had been c/o N&V since 4pm. Coffee ground emisis since approx 5pm, it is now 10pm. Resident is grey, weak, thready pulse, no real B/P to speak off, ABD tender and rounded, gums pale pale pink. The waste basket by the bed is holding the most recent emisis...clots and red blood
By the time the Resident got out of there I was ready to kill this nurse. She thought the resident was faking sick for attention, gave her maalox for GI upset. Said she had identified the coffee ground emisis as partially digested lunch.
She still had a job after this event.
Another nurse did not know how to give ABX IVPB. So, she did not hang it. She dumped it in the med room trash can signed it off and told me she had run it without problems...the other nurse on the wing found it after she accidently threw her notes in the trash...
Still had a job.
Jun 4, '02Occupation: Nurse Educator: love those students! Specialty: Med/Surg,ER,L&D,ICU,OR,nrs. educator ; Joined: Apr '02; Posts: 968; Likes: 41Dilaudid IVP given rather than MS IVP (although in similar looking syringe) by an LPN not even allowed to give IVP meds! (Oh my goodness, ask if you don't know!)
Jun 5, '02Occupation: Clinical instructor Specialty: 13 year(s) of experience ; Joined: Dec '01; Posts: 781; Likes: 121an LPN mixing Toradol in the Demerol syringe, then giving it IM...
Jun 5, '02Occupation: Critical Care Nurse Joined: Jun '02; Posts: 2My, My, My! WHY do we so DELIGHT in our own mistakes while the doctors stick together and bury theirs? At least we nurses are more honest and forthright (Mostly) Should I begin with my coworker who hung a sandostatin gtt instead of NS on my blood tubing? Pt had a Minnisota Tube and died a few hours after her 300cc bolus. OR my coworker who didn't check placement on her NGT and fed glucerna to someone's lungs for 4 hrs? OR the time I was showing a nursing student how to dress a central line and while I trimmed the dressing I cut the line in two? (Thought my career was over on that one! But I was new in the Trauma ICU and untold nurses all had tales of shaving the cuff's on the ET Tubes and having to reintubate making me feel SO much better!)
Obviously these posts are all words to the wise. We know at anytime in our career it might happen to us. I tell all my friends and family "Stay OUT of the hospital, it's the most dangerous place you can go" All I wonder is who is going to be taking care of me in the next 30 years when I need to access some health care delivery?
Jun 5, '02Joined: Jan '02; Posts: 1,614; Likes: 2Originally posted by Teshiee
Well I have known nurses to infuse lipids in a preemie in one hour luckily that baby was fine but I can imagine what that little baby was feeling.
What do you think the baby felt? Would the baby feel all crazy, or would the baby's liver hurt really bad? I am curious what running too much lipid into an IV can cause a person to feel like. Thank you
Jun 5, '02Joined: Jan '02; Posts: 1,614; Likes: 2I've only worked in a hospital as a cna now for almost 2 months. I went two months before coming to the worst I've seen. My mouth activaed, and I started bad feelings on nurses part, and nurse wound up bad mouthing me and ??.
Pt is young guy recovering from rollover auto accident, head trauma+ body. I am a sitter, and the night before he pulled out his trach. Then his foley was removed. He's a nice young guy, his mom spent time with him, but the nurse rarely came in, said they just got back from vacation, and the sentences were broken when she spoke. by days end, the poor guy scratched his head wound (lil blood) and keeps trying to stand up to urinate (like a male would) after having the foley removed.
In CNA school, and in nursing school so far, the use of restraints is mentioned often as a last resort. They say you need a DR's order every time. So I am conditioned to believe yewd need a dr. to come in and say put them on. They really emphasize restraints are last resort.
Nurse makes a cameo appearance in the room, sees a little blood on his hand, and over reacts. She starts drilling me about not noticing it. Pt tried to stand up (he can't too well) and the nurse starts barking about putting him in restraints. Her voice and demenour were bad. I just said one word, "threat" and she left the room in a tizzy angry at me.
I think if your gonna use restraints, for a patients own good, you should just puttem on and not talk about it. And not threaten their use. The nurse had no empathy for this patient at all.
All these stories are very interesting, and I learn much from reading them. The vocabulary I reap is what I am thanking you for, and the introduction of various scenarios as well. I can not feign to understand all the drug names and proceedural descriptions, but I am loving to imagine.
Jun 5, '02Occupation: onc/heme rn Joined: Oct '01; Posts: 523; Likes: 37in the state that i work in, lpns are not allowed to give meds ivp. unfortunately, we had one that didn't feel it was necessary to ask a rn for help and decided to push all of her meds. pt had an order for 2-4mg ms ivp q2-4'. the lpn gave 10mg instead of 4mg twice. couldn't figure out why her once aox3 post op surg, was now lethargic?!! took us awhile to figure it out...after an intense review of her chart, the med sheet, the narc sheet, assessment....we found the med error. thankfully after some narcan she was fine.
do you guys report all of this on your risk report sheets? i just went to ed day today and they said that it isn't tattling, but providing them a way to review the system and see what can be done differently. what does everyone think of this?