Radiology tech: "this patient has q0600 portable chest X-rays part of his old ICU order set. They normally DC these but they didn't DC his. Do I really need to do this?"
#2:
Me, to a different radiology tech: "we just discovered he might have foot fractures and I'm putting in orders right this exact second. Do you mind grabbing images of his feet while you're here?"
Rad tech: "the order wasn't already in so your, have to get that later."
Me: "the order is in right now."
Rad tech: "no."
Two seconds later, does the images anyway, because she realized it meant she'd have to come all the way upstairs again.
#3:
Respiratory: "Earlier MD asked for a different patient to have ABGs done at 0800" (after RT's shift would be over) "so we can just do this patient's in a few hours, too, right?"
#4:
Lab, after walking the whole unit to find me: "that patient has a PICC, why can't you draw her?"
Me: "I don't have orders saying I can."
Lab: "I saw her get drawn off that line last week, you need to draw her."
Me: "her line isn't being used for labs. I don't have an order saying it can be. I CAN'T use it. You need to draw her."
If it weren't the same people trying to get out of their orders every time, I'd figure they were just confirming things, but I am absolutely convinced they're trying to get out of doing their job, and they're trying to get the RN's "okay" so they can pass the buck to us, I am so done with this! If they want to questions orders, they should call the people writing them. :\
I saw a rad tech calling me in a room, hanging me an X-ray cassette and saying that he's all ready, just please position that right under the patient and let him know where to push the button. When I told him in his face that I am not going to do his job, he scowled something about me being so nice that he was just 100% sure that I wanted to "help". Nope, cookie, it's yours. Likewise responce for a lab girl who was so nice as to leave empty blood culture bottles in the patient's room thinking that I will be a sweetie and draw them... later on she made a point that she EVEN labeled them!
Some people take lazy to a whole new level.
It would be hard not to laugh at that Xray tech.
I would have to say "it's your responsibility to position that plate."
The lab person who left a set of labeled culture bottles is getting a call from me wanting to know when she is coming back. I might let her know that we can't start the antibiotics until both sets are drawn and that the policy says that the label is applied after the specimen is drawn not before.
I would light a fire under her by politely saying " If you don't fix this it will require an incident report for delay in treatment and/or potential lab specimen error. "
Pharmacy will regularly reschedule a stat order for an hour or two later, so they don't have to rush and bring me a medication that we don't keep on the unit.
Specializes in Psych, Corrections, Med-Surg, Ambulatory.
I can so relate to this. I don't know how many similar calls I got from pharmacy: "The doctor ordered 300 mg. This drug comes in 350 mg." RN: "Then you'll have to call him and clarify that." Pharmacy "I don't have time to call him." Well, I'll just put down my novel and see to it, shall I? The problem is, if I don't, they just won't bother to address it or fill the order.
My other un-favourite thing: Transporter: "We don't have to move him. He can just scoot himself onto the bed. He did it in PACU." RN: "No he didn't. He got wheeled in there on this gurney that he is still on. Now we are going to use this nice slidey thing to move him." If I wasn't in the room the instant the transporter brought a fresh postop, I would always come in to find the poor patient struggling to get himself moved, while the transporter stood by uselessly. I so wanted to rip their faces off for being so lazy and callous.
When I request a missing dose from pharmacy for insulin and they send me a note via the tube system saying "this med is already in stock in the refrigerator". No it's not or I wouldn't be sending a missing dose request! In the time it takes to for them to send the note and then field the call from me to request it personally, they could have sent it in the first place. Happens a bunch when the Pyxis is out of something, too.
I can so relate to this. I don't know how many similar calls I got from pharmacy: "The doctor ordered 300 mg. This drug comes in 350 mg." RN: "Then you'll have to call him and clarify that." Pharmacy "I don't have time to call him." Well, I'll just put down my novel and see to it, shall I? The problem is, if I don't, they just won't bother to address it or fill the order
.
I would be seriously tempted to tell that pharmacist that asking me to order a therapeutic equivalent is asking me to practice beyond the scope of a nursing license and that he needs to be having this conversation with the doctor.
Ditto for neurologists and radiologists who try to call me with abnormal CT and EEG results.
I say "Since this is a medical management issue, wouldn't it be better to talk to the doctor? Dr. Hodad (hands of death and destruction) is on call and I will get you his number."
It is not okay for these people to dump their responsibilities on the bedside nurse.
Our phlebotomists get overwhelmed and start canceling labs without telling anyone. I don't think any of our nurses would be put off if a phlebotomist was really in a crisis and asked them to get a blood draw on their patient. If they tell me they're running behind on CBGs, I have no problem getting my own. But you can't DC the orders and hope no one notices. I promise, we aren't just putting those orders in for kicks and giggles because we think it's fun to overwhelm the lab. We actually did need the results of those silly troponins.
Ditto for neurologists and radiologists who try to call me with abnormal results.
I say "Since this is a medical management issue, wouldn't it be better to talk to the doctor? Dr. Hodad (hands of death and destruction) is on call and I will get you his number."
It is not okay for these people to dump their responsibilities on the nurse.
Yeah, happens all the time and if nursing, God forbid, stops to control it, the famous stuff of "but we ALWAYS do it this way here" and blah about teamwork, cooperation and "we're all one family here" will grow up like weed in no time. And there will be claims that "we never call providers, it's nursing job!"
I saw a rad tech calling me in a room, hanging me an X-ray cassette and saying that he's all ready, just please position that right under the patient and let him know where to push the button. When I told him in his face that I am not going to do his job, he scowled something about me being so nice that he was just 100% sure that I wanted to "help". Nope, cookie, it's yours. Likewise responce for a lab girl who was so nice as to leave empty blood culture bottles in the patient's room thinking that I will be a sweetie and draw them... later on she made a point that she EVEN labeled them!
Nice and polite but absolute refusal to do one's job usually works as a miracle... but meanwhile I know that patient is suffering and that d*** thing just got to be done. We are blessed by having a nursing leader who will not hesitate to call that department and get a little chat with their NM. This solves the problem for a while.
The rad techs always pull pillows out from behind patients and never replace them, so the other day I made 2 techs help me reposition the patient before they left the room because we had just turned him 2 minutes before they showed up and I would have to hunt down people to help. They tried to say ohh we dont do that... well too bad!
I had the great misfortune to have a new wound care nurse see my patient. She freaked out because there were no supplies in the room for a VAC change and tried to command me to get this this and this. It just rubbed me the wrong way. I gave her the number for central supply and said call me when you're ready.
We have an RT who is too lazy to restock the intubation box. He will stay in the room and call out for the stylet, a MAC or Miller blade, a yankauer, ETT, ETC02, 10cc syringe. It's ridiculous. Next time I am going to bring him the tackle box and break the lock..
I also can't stand this rule that insists that housekeeping can't clean up any body fluids. Nursing staff has to scrub everything off before they will come into the room.
Stupid.
Oh this one. One time my homeless pt missed the toilet and then tried to take a bath in the sink. I had to stop caring for my other three ED patients because the housekeeper refused to clean the bathroom. I am certainly not above cleaning and have done it many times but when I have to stop giving care (which is my job) to clean (which is your job) that's when we have a situation.
Seen that, done that. The suggestions to turf to doc are spot on.
Wondering if you are equally as culpable.. Why would you NOT get an order to draw from the PICC? The patient has been in critical care for days.... central line access for blood draws is standard care.
Oh this one. One time my homeless pt missed the toilet and then tried to take a bath in the sink. I had to stop caring for my other three ED patients because the housekeeper refused to clean the bathroom. I am certainly not above cleaning and have done it many times but when I have to stop giving care (which is my job) to clean (which is your job) that's when we have a situation.
I would put an out order sign on the door with one of those yellow piso mojado/wet floor signs.
icuRNmaggie, BSN, RN
1,970 Posts
Some people take lazy to a whole new level.
It would be hard not to laugh at that Xray tech.
I would have to say "it's your responsibility to position that plate."
The lab person who left a set of labeled culture bottles is getting a call from me wanting to know when she is coming back. I might let her know that we can't start the antibiotics until both sets are drawn and that the policy says that the label is applied after the specimen is drawn not before.
I would light a fire under her by politely saying " If you don't fix this it will require an incident report for delay in treatment and/or potential lab specimen error. "