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?
Specializes in Trauma,ER,CCU/OHU/Nsg Ed/Nsg Research.
Originally posted by Big Bab's
I have never heard of milk and mosasses enemas, what would this be for??
I have only done this once, and it was at another hospital where I picked up an agency shift or 2. The patient was elderly and constipated. The Doc was also elderly, so maybe that's why he ordered it. The other nurses that worked there said he ordered it a lot, after trying Dulcolax because he felt it was gentler than a Fleets. Apparently, this Doc was also known to order coffee enemas at times.
All I know is that the "results" from this enema were gooey and sickly sweet. It almost makes me gag thinking about it.
Just the other night I had an order for "MILK & MOLASSES ENEMAS-----GIVE UNTIL CLEAR!!!!!! They just don't pay us enough sometimes!
AMEN, sister!
One of our GI docs told a story about how he was awakened at 3 a.m. by a new nurse who wanted orders for a constipated patient. He ordered a milk and molasses enema and told the hapless nurse to make SURE that she used "Brer Rabbit" brand molasses ONLY. I wonder what the night shift nursing supervisor said to the nurse when she called to ask if she could go to the grocery store to get the correct brand of molasses. :)
You know, people in Californis pay big bucks for colon cleansing. I just saw an HBO special with margaret Cho, and she was making fun of it, but really, people are INTO it!
We just had a pt. admitted with the dx of FOS! Do you believe that?:chuckle
We used to give our patients a pink enema that was called "Pink Lady Enema" and that's how the MD's would order it. The pharmacy would make it up with a mixture of things, like mineral oil, but I don't know what made it pink!
I would have to agree with the ones above, especially q 1 hour accuchecks with sliding scale. Another one I don't like is a dopamine (renal dose) or cardizem drip on a non-ICU patient.
well the worst so far in my 3 years as an ER nurse, went to say more on a Doctor's failure to missed out an order for one important prescription. For a very long time reporting to a graveyard shift schedules. One patient male over a fifty yrs. old come behind ER doors for a not less than 10 times a month except for some few scattered months wherein he is admitted.Due to an often midnight execerbation of his asthma condition resulting to a much difficulty and labored breathing.As for none any other, he responds very well to a combivent nebulization 3 times Q15 minutes together with an asap order of a 300 mg of hydrocortisone intradermal. he is sent home after.
None of the resident doctors remembered and went to order an antiulcer that possibly might develop from steroid medications.
well the worst so far in my 3 years as an ER nurse, went to say more on a Doctor's failure to missed out an order for one important prescription. For a very long time reporting to a graveyard shift schedules. One patient male over a fifty yrs. old come behind ER doors for a not less than 10 times a month except for some few scattered months wherein he is admitted.Due to an often midnight execerbation of his asthma condition resulting to a much difficulty and labored breathing.As for none any other, he responds very well to a combivent nebulization 3 times Q15 minutes together with an asap order of a 300 mg of hydrocortisone intradermal. he is sent home after.
None of the resident doctors remembered and went to order an antiulcer that possibly might develop from steroid medications.
He passed away last month on my usual shift, as he came behind my door, on boardlike abdomen, thrashing out fresh blood and at the same time spills out fresh blood ooozing from behind.
). 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?
Big Bab's
161 Posts
I have never heard of milk and mosasses enemas, what would this be for??