Orders from hell...

Nurses General Nursing

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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?

So he wrote an order "Please give one of Patient A's Miracluzamab pills to Patient B daily. We'll replace them when Patient B's supply comes in." Yep. So Patient A's name was actually in Patient B's chart.

Holy Cow!!

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Specializes in Ortho, CMSRN.

"Do not extubate member" (postop Foley)

Bahahaha! I guess the words are technically correct, a foley is a tube. Still funny though.

Impossible orders are funny, but I think my least favorite orders that I have received were

an enema on a bed bound patient

manual disimpaction

nit picking/combing a patient with headlice (Who even has time for that on a med-surg floor?! :no:)

I realize that they were all very necessary at the time. Still don't like them though.

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Oh, I just remembered a great one. We had a patient on an uncommon specialty drug for an off label indication that had to come from a far away pharmacy and was exorbitantly expensive. The patient was dying and made a miraculous turn around on said med. We'll call this guy Patient A. At the same time Patient A was admitted, Patient B came in with the same condition under the same service. The physician immediately began trying to get approval to get Miracluzamab for Patient B but it was looking like it would take awhile.

So he wrote an order "Please give one of Patient A's Miracluzamab pills to Patient B daily. We'll replace them when Patient B's supply comes in." Yep. So Patient A's name was actually in Patient B's chart.

Incidentally, this was the same physician as the aforementioned highly inclusive Ativan order.

Always amazing to me how quickly and casually doctors feel free to ask nurses to do things that are malpractice, will get them terminated, theft charges filed, and their nursing license removed. Just no, no to all of it.

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Specializes in Oncology.
Always amazing to me how quickly and casually doctors feel free to ask nurses to do things that are malpractice, will get them terminated, theft charges filed, and their nursing license removed. Just no, no to all of it.

Yep. Then he wanted to pick which nurses were assigned to make sure it was none of the "by the books" ones.

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Specializes in Travel, Home Health, Med-Surg.

...bathe patient...

really MD, no one would have figured that out without your order

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Specializes in Hospice, corrections, psychiatry, rehab, LTC.

We had a psychiatrist who wrote a Geodon order that was impossible to carry out. He wrote the order for a PO dose to be given with food. If the patient refused the PO, we were supposed to give an IM injection of Geodon before she ate. If we were presenting the PO medication with food, she was already eating...

Another physician who wrote an order for BP checks qd x5d, and record results. For whatever reason, he seemed to believe that we would take the BP but not record it unless he specifically ordered it.

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Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
I was working at a large teaching hospital and we had downtime one night. Well a lot of nights, but anyway the residents hated it because they had to use prescription pads and they weren't used to it. Well one of my residents hands me my patients prescription for DC. It was supposed to be a tapper steroid dose. He writes on the pad. Patients name and Prednisone tappered dose. That's it. I could not stop laughing and made him fix it. He didn't even understand what was wrong. They were so used to their little pre set boxes they just click. I showed everyone so he couldn't live it down. It was so funny.
I'm sorry, but what is a "tappered" dose?
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Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
...bathe patient...

really MD, no one would have figured that out without your order

When I started forty years ago, people could be admitted to Med/Surg for a week for "work-up". Among the standard orders for "work-up" patients: "Bathe patient before seen by MD" (because some of them seemed to be alergic to soap and water) and "Valium 10 mg. PO q 4 h prn." Those were the good old days.
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Specializes in CCU, SICU, CVSICU, Precepting & Teaching.

Here are my favorites:

"Dopamine 5 mcg/kg/min forever"

"Flower care every 24 hours." (Yes, water and deadhead the patient's flowers.)

"Yes I DO want ABGs q 1 hour JUST LIKE I'VE ORDERED THREE TIMES IN THE PAST FOUR HOURS AND I DON'T CARE THE THE PATIENT IS A DNR AND DOESN'T HAVE AN ART LINE." (Order took up two pages in the handwritten order section.)

"Ambulate patient at 0800, 1100, 1400, 1700 and 2000." The patient weighed 450 pounds, had part of one foot amputated and hadn't actually stood for three years. He had one of those scooter things -- came in on it and it was stored in the room. The patient ended up calling the doctor's office and telling him what a stupid order it was.

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I'm sorry, but what is a "tappered" dose?

I'm gonna go out on a limb and guess it was obviously a missspelling. I would have fixed it but I was unable to go back and edit the post once I realized it. I am about 99% positive though that I will have them again.

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Specializes in Neuro ICU and Med Surg.

Peri pads PRN for a patient who was obviously on her period. Oh yes dear resdient, being a woman I had no idea what could be possibly happening.

Insert NGT and place to LIS during MRI so pt can have his tumor volume MRI he is refusing due to nausea. I refused to carry out this order. I was not doing that to a paitent who had a right to refuse an MRI. Even the patient told the attending intensivest I was his hero for refusing to do this.

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Increase lasix and discontinue Foley. Naturally the pt is 400 lbs, uses a bedpan, and won't allow anyone to help her turn

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