Orders from hell...

Nurses General Nursing

Published

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?

Specializes in Crit Care; EOL; Pain/Symptom; Gero.

Dinosaur here. I remember orders like that. What it means is "Don't call me".

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Many moons ago I worked in a large teaching hospital. We all dreaded July 1 when the new crop of very green interns made their appearance. Second week of July, new intern writes orders for his new admission and remembers hearing his resident tell him to write prn orders for anything that could possibly come up so the night nurses won't call and wake him up. He was totally shocked and annoyed when I called him cause his patient wanted a sleeping pill. "Check my orders..... I already wrote for something to help him sleep" he says in his most annoyed voice." Yes, you did" I tell him "but are you sure you really meant to order MOM 300 cc po QHS prn sleep, cause if I gave that, sleeping would be the last thing the patient would be doing!!" Not to mention this is not the correct dose for this med! Of course he didn't believe me, the lowly nurse, and had to check with his resident before changing the order! Lol

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Specializes in OR.

My favorite is from nursing school, back in the 80's... Transderm Nitro p.o. Q am. Transferred to the MAR by staff for the last two weeks... they told me "just put it on him, we know that's not the way to give it." Great way to teach a student. I got bonus points for catching it, tho.

I can just see it... "here, mr. x, just chew on this for a while."

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Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
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.
DUH! Yes, I should have thought of that. It just zipped by me. I blame sleep deprivation.
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Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
One of my favorites when I was a hospitalist NP:

I'm sitting on a tele unit at end of the night shift finishing some documentation. Nurse doesn't realize I'm sitting there. Calls on-call hospitalist to report a death. Hospitalist orders: "EKG to make sure he's dead". Um....I could see on the tele monitor that the man was dead. I went in with the nurse and pronounced the patient after listening for a heart beat for one full minute and monitoring for respirations for that same full minute (by the way the patient was a DNR/DNI), called the on-call hospitalist who still insisted on an EKG. We ran it. Definitely asystole. I took it down to him and made him sign it off as "dead". Then we could release the body.

An ECG to diagnose death, eh. And he didn't make you prove that the leads hadn't fallen off?

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Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
Why stop there? Perhaps aerial spraying through the air vents for the whole unit?
You know, that sounds wonderful. Can we do that in the ICU visitor's lounge, too?
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Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
"NPO until extubated."

Um, yeah, because I was planning to push a cheeseburger down that ET tube.

I've seen family members trying to "share".

I took care of a man in the early 1980s who was waiting for a heart transplant in the CCU. He was big and a rare blood type, so the consensus was that he would never find a donor and was just waiting to die. He had no family and nobody every visited. One night when we were making popcorn on the unit, he said the smell was driving him crazy. He hadn't been able to eat solid food for weeks, but he really, REALLY wanted some popcorn. I figures what the heck, he was dying. Why not give him some popcorn? We took a coffee filter, filled it with hot, buttered popcorn and I sat and chatted with him as he ate it.

Barely an hour later, we got the call that they'd found him a heart. The heart was local, so the surgery was imminent. Everyone was thrilled for him, but what about that popcorn?

I told the intern, but he forgot to tell the surgeon or anesthesia . . . turns out the whole team was wondering how all that popcorn got down there when they placed the NG tube! Luckily he was already under anesthesia when they placed the big honking tube to suction it all out because the little bitty one got clogged.

That guy sent me a thankyou note for the popcorn every year for 17 years.

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Specializes in PICU, Pediatrics, Trauma.
OK, thanks for the explanation. I didn't know that, nor does anyone where I work. And no, we don't ever do a stat lab on it, but I'll keep that in mind for sure.

STAT serum glucose levels have always been in place where I have worked when the result is above the "hi" level.

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Specializes in PICU, Pediatrics, Trauma.
LOL. Actually, I can relate to this one. Many of the LTCs I've been based at I've actually had to write:

Vital signs (whatever timeframe): Oxygen saturation, blood pressure, temp, pulse, respirations. Record in the monitoring sections/vitals section of the EMR.

Wow! From where do they get their nurses and CNA's ?

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Specializes in PICU, Pediatrics, Trauma.
Why stop there? Perhaps aerial spraying through the air vents for the whole unit?

My unit could use this...BIG TIME....Adolescent psych. Gets sooooooooo loud. Then, the MHTs and Nurses start yelling to get them to settle down..It's nuts! It's crazy! Oops...Pardon the pun. Bahaha!

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Specializes in PICU, Pediatrics, Trauma.

Sounds good, but then everyone would get addicted to going to work....Literally!

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Specializes in Pediatrics.

When I get orders like this I ask for an order I can actually use....

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