My embarassing moment re: doc and TO


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nursemike, ASN, RN

1 Article; 2,362 Posts

Specializes in Rodeo Nursing (Neuro). Has 12 years experience.

Oh, Lord.

Called a doctor one night for a pt in our epilepsy unit with a severe headache. She told me to give "4mg morphine, if not contraindicated."

4 of morphine for an HA? But it was 8/10. So, how do I decide if it's contraindicated? Checked chart for allergies. OK. Decided to just ask the patient--have you ever taken morphine? He had, with no problems.

So I put in the order and gave the med. Pt got some rest, HA was now 2/10 and tolerable. Pt loves me.

Neighbor gets HA. Call the doc. "Give 400 morphine, p.o., if not contraindicated." Doctor has a bit of a southern Asian accent, our phones are not real hi-fidelity sound systems, and my ears are 51 years old--well, 49, at the time, but still.

New as I was, 400mg of morphine didn't sound quite right by any route, so I said, "Pardon me?" and she repeated, "400mg of Motrin, po, if not contraindicated."

And I thought to myself, "Oh, crap."

I should have told her about the other pt's morphine right then, but didn't think of it in time. Did tell her when she came around. No great harm, but in the interim the EEG tech explained that morphine changes the EEG and might suppress or conceal a seizure. We want the pt to seize, so we can record it for diagnosis. I knew that, but didn't know about the problem with morphine.

Couple nights later, called for an order and same doctor told me to give 20 of lasix--l-a-s-i-x. But she never was nasty about it, and I now always remember to read back my orders.

PS Oh, if I'd only thought of it in time, I could have asked about the lasix, "Now, is that 20 milligrams?"

EmmaG, RN

2,999 Posts

Doc calls back at the same time that this thing they drive around the hospital halls to clean the floors - like a frickin' ZAMBONI is drivin' by the nursing station.

I hate those things :lol2:


699 Posts

Specializes in RN- Med/surg.

We have a Dr. with a heavy accent. Luckily he knows he's hard to understand...and very approachable. One day he was trying to dictate a note...and the computer would NOT recognize what he was saying. He finally looked at me in frustration and asked how to properly say "deviled up" I must have looked confused...because he gave me an example...."the pt deviled up a skin condition".... ohh..developed. I've had him spell out orders before.

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