SNF. RN supervisor summoned (overhead, at about 0300) me to one of her rooms. She was attempting to insert an NG tube in an alert man, about 40, alcoholic, with varices. Told me she felt a 'blockage'. She was holding the tube as though it were a fork, and she was 'stabbing' something. She rammed the tube down, pulled back, then rammed it again- until blood exloded out the tube. I suctioned him really quick and the suction tubing, canister and filters became packed with blood. I ran out and called 911, came back told her "Get the **** away from him! What are you DOING"?. I was suspended, for allowing her, an RN, my supervisor, to be so incompetent. Was told I should have known she was incompetent, and should have 'taken the NG from her and inserted it yourself'. Oh, really. Yes, he died. She was 'asked to resign', because her son was the medical director of the place. The panic on that man's face is clear today, and that was 25 years ago. BTW- I don't think an LVN should insert NG tubes, it's as crazy as giving TPN. Out of bounds, my opinion.
Recently during a code the patient was in v-fib and resident was calling it PEA, wouldn't let us shock. The code leader told him it was v-fib but resident said, "He doesn't have a pulse so it's PEA." Then asked if anybody had any suggestions, we all shouted SHOCK. Someone tried to explain that you don't have a pulse with v-fib but the silly resident didn't believe us. Needless to say the patient died and the resident was reported. What is really frustrating about this is our policy changed about 2 months ago and the nurses can not administer medications or shock without an order from the resident if he/she is present. Why are we ACLS certified then? Exception is in ICU, we can shock prior to resident being present but cannot admin drugs. Can anybody say crazy.
Was he the only MD/DO in the room for the code????
Nooooooooooooooooooo! Oh my gosh. What is it with people and insulin? Read the order check the blood sugar, read the order again. If it seems like too much insulin, it just might be. Check check and triple check. Scarey.[/quote']
And it's one of the meds that require 2 RNs to check.
Some dialysis "nurses" are not nurses....they are technicians.
A technician torqued my fathers VAS cath in an attempt to get the cap off...after I warned her to NOT use two metal hemostats to get it off, AND told her I was a critical care RN....she fractured his catheter. I told them how to temporaily fix it..no one listened
It was a late Friday night and I was "assured he would be fine until Monday" and it wasn't "necessary to call the team in for this"......I told the MD (who I knew well) that I will hold him personally responsible if anything happened I had a bad feeling.....my Dad coded 13 hours later and died.
This is wrong on so many levels. CNA's don't insert rectal tubes for one. Two even if CNA's were allowed to peform this procedure, why would she think its okay to tie a plastic wlamart bag at the end to catch gas and fecal matter? Imagine what the family of that pt would be thinking when they walked in and saw a walmart bag and a tube hanging from their loved ones butt.....this is so wrong.[/quote']
BTW, can any nurses out there tell me what could cause a patient to suddenly die right after being hooked up to a dialysis machine? I'm thinking clot? Is it nurse error or just bad luck? Thanks.
Running the dialysis machine too fast can severely decrease the pts BP, they can go into cardiac arrest, also if the chemicals manage to mix with the blood it can quickly kill the pt. (this is what I remember from my dialysis training sevral years ago).
We don't have to have a 2nd nurse double check insulin, but we DO have to have them check the 5,000 unit SQ of heparin even though it is the ONLY dose of SQ heparin we use.
When I was in my final weeks of school, my preceptor walked into the room of a newly admitted patient and greeted him with "Oh, your last name is [smith]? We have another [smith] right down the hall! Are you related?"
A totally paralyzed vent pt lived in the downstairs of the house which had been converted into an apt for. him. The family had minimal involvement with him. Home health nurses came and went. On my first shift, there was no nurse for me to receive rpt from. I later was told, and saw from the documentation, that she left before my arrival, although her shift ended when I got there. I was told that she worked four hours of her eight hour shift, then went to another job, because she had a "mortgage to pay". I was supposed to keep my mouth shut. A totally paralyzed pt on a vent, left alone for several hours daily. When I reported all of this, I was made out to be the bad guy. Of course.
dudette10, MSN, RN
3,530 Posts
Was he the only MD/DO in the room for the code????