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.
When I recently renewed ACLS, as I was running through my mega code scenario and I got pulseless Vtach, I said to shock the patient, and the entire class, including the instructor, all said, "no it's PEA because there's no pulse." Never mind how I explained it and showed them the algorithm card, I kept getting push back. I thought I had gone crazy and lost the ability to read until the instructor later came back to me and admitted he was wrong. So maybe the concept of PEA is sticking a little too well!
I observed a CRNA who was attempting to place an arterial line in a patient drop the catheter ON THE FLOOR and then proceed to reach down, pick it up and AGAIN try to insert it into the patient!!!! I was dumbfounded and couldn't believe what I just saw!! This is the one and only time I have written someone up/reported them. It's one thing to make a mistake, but this person made a conscious decision to place the patient in harm's way.
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
I observed a CRNA who was attempting to place an arterial line in a patient drop the catheter ON THE FLOOR and then proceed to reach down, pick it up and AGAIN try to insert it into the patient!!!! I was dumbfounded and couldn't believe what I just saw!! This is the one and only time I have written someone up/reported them. It's one thing to make a mistake, but this person made a conscious decision to place the patient in harm's way.
I observed a CRNA who was attempting to place an arterial line in a patient drop the catheter ON THE FLOOR and then proceed to reach down, pick it up and AGAIN try to insert it into the patient!!!! I was dumbfounded and couldn't believe what I just saw!! This is the one and only time I have written someone up/reported them. It's one thing to make a mistake, but this person made a conscious decision to place the patient in harm's way.
Looking back, I wish I would have said to the CRNA, "Excuse me, but let me go get you a NEW catheter before you proceed" but it just happened so fast and I was kind of in shock, I guess!
When I was still precepting at my first job, one of the other ICU nurses had a patient who was due to be extubated that morning, but absolutely freaked out with sedation turned down. The physician wanted sedation off from 5 AM on, so the guy was just in agony, thrashing around for three hours until 8 AM, when the physician finally showed up and decided the patient was too "unstable" to extubate because of his BP in the 200s and HR in the 150s+. Gee, doc, I wonder why that is?!
Anyway, because the physician decided to give the guy another day on the ventilator, and the nurse was mad about it, she decided not to turn the patient's sedation back on all day long out of spite. Every time I'd walk past the room, the guy was flailing around and thrashing, tears running down his face... finally, when night shift got there, the first thing the night shift nurse taking over that guy's care did was turn his propofol back on. In retrospect, I wish I had said/done something... but I was a brand new nurse fresh out of school, I was still on orientation, my preceptor was best buds with this nurse and I felt like I'd be making big time waves in a bad way if I questioned her, and this nurse had more than 10 years of experience and I honestly just didn't know whether it was any of my business what she did to her patients. I would say something if I saw that happening now.
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When I recently renewed ACLS, as I was running through my mega code scenario and I got pulseless Vtach, I said to shock the patient, and the entire class, including the instructor, all said, "no it's PEA because there's no pulse." Never mind how I explained it and showed them the algorithm card, I kept getting push back. I thought I had gone crazy and lost the ability to read until the instructor later came back to me and admitted he was wrong. So maybe the concept of PEA is sticking a little too well!