What are your most dreaded Dr.'s orders to hear- you know, the ones that tell you that you're in for one heck of a night? For the past couple of nights, I had a patient with ammonia levels in the 260s, who had an order for a Lactulose drip (at first, it was full-strength via DHT- yeah, THAT worked out well ). Needless to say, it went how I had envisioned it: the DHT kept occluding, until I finally got new orders for 1/2 strength via NGT, the pt was out of it, and was code-browning the whole time. Man, I hope I never see orders like that again! What are some of your dreaded orders?
I just KNEW I shouldn't have mentioned the dreaded Kayexalate order... Got one tonight for a patient with potassium of 6.2. It was PO, fortunately, and before I left, had to call the doc near midnight because there were still no results four hours after administering.
i probably should not have read that as a nursing student, and let me just say, i can see you need a sick sense of humor to survive nursing.. im gonna go take a shower after reading all that!
The nurse on second shift got this order for a 219 lb woman post-op fem/pop bypass who refused to bear weight...Please remove foley and give 40 of lasix now!!!!! Im a fairly new nurse but when she told me that in report I said, dont you know that with that order you give the lasix but wait and let me d/c the foley in am!! I finally called doc at 3 am and asked for orders to re-insert foley at patients request!
Those were some great examples of crappy (!) orders. This is not really a dreaded order, just an annoying/insulting one: "accurate I & o's and record". As opposed to what? Made up ones that I keep to myself???
Ambulate patient q1 hour! This on a 450 pound man with gastric bypass and in one of those "big boy beds" with a special airmattress. Pt. kept almost sliding out of bed when we would get him up. He also had a decubitus ulcer on his coccyx and the Alevyn dressing covering it kept coming off when he would get up!
4 units FFP, 2 units blood and irrigate colostomy x2 with tap water!!!! And that was just one of my 7 patients today!!!
Oh you poor thing!!!
Originally posted by gettingmymsn
This is not really a dreaded order, just an annoying/insulting one: "accurate I & o's and record". As opposed to what? Made up ones that I keep to myself???
Ya know, I've also felt insulted by that order when I've gotten it!
I used to dread getting this one surgeon's gastric bypass patients who he'd send to our med-surg floor, fresh post-op, with continuous epidural fentanyl (which was rarely adequate for pain relief and we'd spend half our time paging Anesthesia for orders) and he'd send them WITHOUT FOLEY CATHETERS!!! and orders to insert a foley if no void in 8 hours. Well, invariably they couldn't void due to the epidural fentanyl's tendency to cause urinary retention. And because of their extreme obesity it would be painful and extremely difficult to try to get female patients on one of our tiny fracture bedpans, and then it would be really challenging to cath them due also to the obesity.
Fortunately, his gastric bypass patients now spend their first night in ICU and come to med-surg the 2nd day, and usually have a foley in, or, were able to somehow void in ICU.
). Needless to say, it went how I had envisioned it: the DHT kept occluding, until I finally got new orders for 1/2 strength via NGT, the pt was out of it, and was code-browning the whole time. Man, I hope I never see orders like that again! What are some of your dreaded orders?
RN-PA, RN
626 Posts
I just KNEW I shouldn't have mentioned the dreaded Kayexalate order... Got one tonight for a patient with potassium of 6.2. It was PO, fortunately, and before I left, had to call the doc near midnight because there were still no results four hours after administering.