What is the dumbest order you ever read? - page 19
I thought I had seen some AH orders but yesterday took the all time win! I had a 97 year old man admitted from ER with impaction and the order said---- "Give oil retention enema and have pt. hold ... Read More
Jan 12, '08Specialty: ltc ; Joined: Aug '07; Posts: 48; Likes: 12i work ltc and the only standing order we have it for treatments it is
clean c n/s, apply TAO, cover c 4x4 and tape qday and prn
one of our experienced nurses wrote the oder to read
clean c n/s, apply new skin.
sadly enough this wasnt caught till about 1 week later....
a few days ago we found out there is actually something called "new skin" bowlers use it lol
Jan 12, '08Occupation: ER RN Specialty: ER ; Joined: Jan '08; Posts: 230; Likes: 329So this patient has had their ER workup, is perfectly stable (DX of HTN or some-such), and is being admitted to the tele floor. One of the nurses is putting in the morning admit orders and there, buried amongst the morning orders for labs, meds, etc...is an order that states "Intubate". For a patient that was breathing better than I, and was fully alert. Great fun when he called the intern that wrote the order (on speaker phone) and asked if that was a STAT order or if it could wait till in the AM. Even better when she denied she had ordered it. Gotta love doclings.
Jan 12, '08Occupation: RN med-surg Joined: Dec '07; Posts: 628; Likes: 463Doc got in a hurry and wrote and order for:
Ancef IV Q8 hours prn pain
Jan 12, '08Occupation: Medically retired ex-nurse with a BSN Specialty: 18 year(s) of experience in ER, ICU, Infection Control ; Joined: Jun '06; Posts: 79; Likes: 40Rehydrate the patient who is bleeding copiously (and has a falling BP) with Sprite - now I guess this doesn't really count as it was a verbal order which we refused to carry out and insisted on an IV instead.
Jan 12, '08Occupation: RN, waitress, housekeeper, bed maker Specialty: 3 year(s) of experience in LTC, med-surg, critial care ; Joined: Sep '04; Posts: 497; Likes: 85Quote from tvccrnWe have a doctor that writes a sliding scale for potassium on every patient he has regardless of diagnosis.I've seen sliding scale potassium before. It was for a patient that was chronically low.
Jan 12, '08Joined: Jun '02; Posts: 14,165; Likes: 59,214Quote from not nowi work cardiac surgery -- the only patients who don't have an order for sliding scale potassium are those with renal failure.we have a doctor that writes a sliding scale for potassium on every patient he has regardless of diagnosis.
Jan 12, '08Occupation: Obs Unit Specialty: Telemetry & Obs ; From: US ; Joined: Oct '03; Posts: 2,412; Likes: 1,820Quote from EnrightSorry, just can't resist:On a rehab unit I worked, The day charge wrote we should document "nature of flatus" on all patients.
A fart it is a pleasant thing,
It gives the belly ease,
It warms the bed in winter,
And suffocates the fleas.
A fart can be quiet,
A fart can be loud,
Some leave a powerful,
A fart can be short,
Or a fart can be long,
Some farts have been known
To sound like a song......
A fart can create
A most curious medley,
A fart can be harmless,
Or silent , and deadly.
A fart might not smell,
While others are vile,
A fart may pass quickly,
Or linger a while......
A fart can occur
In a number of places,
And leave everyone there,
With strange looks on their faces.
From wide-open prairie,
To small elevators,
A fart will find all of
Us sooner or later.
But farts are all bad,
Is simply not true-
We must never forget.......
Good old farts like you!
Jan 12, '08Joined: Dec '04; Posts: 330; Likes: 143"Boost, one bottle tid chilled but not over ice, shaken not stirred" PS Chocolate only
Apr 5, '08Occupation: Neuro/tele LPN Specialty: 6 year(s) of experience in neuro,renal,tele ; Joined: Apr '08; Posts: 12; Likes: 3We have a new hospitalist who has a smart mouth, she constantly writes, "albuterol and atrovent PO q4hrs". Open wide, I have some albuterol and atrovent for your cough!Last edit by ElvishDNP on Apr 14, '08 : Reason: TOS - language
Apr 5, '08Occupation: Neuro/tele LPN Specialty: 6 year(s) of experience in neuro,renal,tele ; Joined: Apr '08; Posts: 12; Likes: 3:rollLOL, imma sing this to my husband!!
Apr 5, '08Joined: Jan '04; Posts: 999; Likes: 1,019I finally have something to add to this thread. This is one of my favorite threads by the way.
Last week I had a patient that wasn't doing so hot. His urinary output was 100ccs the first day, then 50ccs the next day..bun/creatinine slowly rising...got himself an ARF diagnosis. A resident came through, didn't even bother going in to assess the pt, and wrote something along the lines of, "Bladder training, clamp foley 2 hours then unclamp 2 hours"
I dutifully carried the order out (I was in the patient's room every hour or so anyways...so why not). Total output on my shift? 30ccs...I'm sure the 3 or 4ccs that came out each time I unclamped the foley worked wonders for his bladder training. The next day the attending wrote, "Leave foley in." Sometimes I wonder if some of the residents even bother reading through the progress notes/labs/VS/I+O/etc.Last edit by november17 on Apr 5, '08
Jun 25, '08Occupation: 4 yrs Med Surge, 13 years Critical Care, now lovin Specialty: 20 year(s) of experience in Med surg, Critical Care, LTC ; From: US ; Joined: May '08; Posts: 1,641; Likes: 1,649Novolin 70/30 NPH insulin 40 units q a.m.
Two totally different insulins. This order got by the charge nurse, the pharmacist and 3 days of nurses before I found it. I called the primary physician and explained the problem with the order, so he said "Well, which insulin has she been getting?" I said "I couldn't tell you sir, I just started as her nurse this a.m."
I had to write this up, hated to do it, but it got by two many people. The failsafe's in the system totally failed in this instance.
Another order I received was Morphine, 20 mg Iv q 15 minutes prn. I called the physician and said "This can't be right" he said "It's what I ordered" I said, sir, the patient is a 1 y/o with pneumonia, do you really think this order is appropriate? He hemmend and hawed, and realized that he was thinking about another patient - and d/c the order on the child. I suggested that without knowing the other patient, the 20 mg Morphine might be appropriate, but he really should put a max dosage in for safety's sake, also dropped a PCA hint as well. Don't know if he ever did.
Jun 30, '08Occupation: RN Specialty: 5 year(s) of experience in Med/Surg, Oncology ; Joined: Nov '06; Posts: 16; Likes: 11Lobster for dinner tonight....
Lobster?? This aint Red Lobster!!! Laughed about that for a few weeks!! :chuckle