Orders from hell...

[Leonardo Del Toro]

From time to time I run into real gems of medical writing.

Levaquin 750 gm P.O. q. 48 hours for 2 more days

the trick is to find how many pills this will be

Can you?

[Boomer MS, RN]

"Do not call me again tonight unless the patient is actively coding!!" (pediatric patient no reason to believe they would code but had many changing medical needs throughout the shift that needed doctor's orders/intervention, and doctor just didn't want to deal with them anymore.) Yikes.

Boo Hoo for that doctor. I have no sympathy for him/her. Grow up and a pair.

[EKUGRAD, BSN, MSN, RN, CNS]

Perhaps you should have called the provider to ask, "So, just to clarify … you don't want me to use spit, or toilet water to clean this wound, right?".

I used to get these orders all the time in Home Health. The patient would go to the Wound Clinic weekly and we would get new orders for Home Health wound care. Almost always these were pre-printed boilerplate for patient and family use. They are very, very explicit and detailed for lay-folks.

[0.5GPA, ADN, CNA]

Best one yet. Very cool he did not forget your kindness.

[djh123]

I used to get these orders all the time in Home Health. The patient would go to the Wound Clinic weekly and we would get new orders for Home Health wound care. Almost always these were pre-printed boilerplate for patient and family use. They are very, very explicit and detailed for lay-folks.

Yeah, but they (the wound care clinic) know he's in a LTC facility, not at home with Aunt Gertrude doing his wound care.

[djh123]

I had an order from an intern one time that was something like "Tylenol 650 mg PO". What, continuously? Any ol' time I feel like it? Every Thursday?

[blondy2061h, MSN, RN]

Verbal order: "Give him however much Dilaudid you think is appropriate"

If you guessed this was from same doc who has gotten a few mentions here already you'd be correct. The other providers I work with just aren't nearly as fun!

[brillohead, ADN, RN]

Ativan 0.5-2mg IV or PO PRN nausea, vomiting, pain, anxiety, insomnia, patient request, RN discretion, or any other complaint

Oh, man, what I wouldn't give for this order most nights!!!!

[Ruby Vee, BSN]

Many years ago, we had a sweet little 90+ year old lady who was unfortunately badly constipated. Her doc made rounds and wrote the following order:

1. One quart cooking oil retention enema - get from dietary

2. If that doesn't work, try dynamite

We soon got a call from the pharmacy asking if we could get the order changed. Reason: dynamite was not on the formulary.

Beverage alert!

[Ruby Vee, BSN]

Re the pulmonologist in the stairwell: I NEED the rest of this story!

Security found him over 12 hours later when they made their midnight rounds. He did not make a full recovery. His family blamed the nursing staff for not taking him outside to smoke.

[notanumber]

Novorapid 10u SQ PRN for BGL>20.0

So . . . if I check the res 15 minutes later and they're still high, I can give it again? And every 15 minutes after that?

Asked multiple times, always refused to add a frequency for this very brittle diabetic.

[WVFNP, MSN, APRN]

This was actually a verbal order, and I need to set the scene a little bit...

We had a small child that had received burns to her face, nose, and mouth. With fear of the airway closing off, the ER doc decided to intubate...

Fast forward, the patient is put under and several intubation attempts are made and finally, success.

Just in time for the flight crew for transport. Upon moving the patient on to the flight crew's cot, the physician though the patient may have extubated herself... the physician and flight medic checked the CO2 detector, still color change, so we're good, right?

No, the physician asks for a new CO2 detector. OK. Placed on the ET tube, color change!! Good again, right? Wrong, the physician then asks the flight medic to take off the CO2 detector, place it in his own mouth, and blow through it... The medic loooed at him strangely of course, and he said "well, do it", and to everyone's horror, he actually did it!!

[3ringnursing, BSN]

EKUGRAD:

I used to get these orders all the time in Home Health. The patient would go to the Wound Clinic weekly and we would get new orders for Home Health wound care. Almost always these were pre-printed boilerplate for patient and family use. They are very, very explicit and detailed for lay-folks.

djh123:

Yeah, but they (the wound care clinic) know he's in a LTC facility, not at home with Aunt Gertrude doing his wound care.

I believe you took that reply right out of my typing finger …