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Lately it's ice. I hate the stuff! Too many family members hovering asking for FRESH ice as my post op is tanking. Or family hovering in general lately. Or, "i don't eat hospital food."
Patient's relatives that won't touch or help their relative. Like a daughter that pushes the call light so that you can open her dad's milk. Literally. That happened.
when they ask that I will ask a really dumb question like "Oh, did something go wrong when you tried to open it?" Or I might say "Oh, you can go ahead and open it for him. we don't mind."
I have to chuckle at "dangerously low BPs" in the hospital... another nurse had a post-op patient last night with a SBP in the 90s, and the hospitalist came and saw the patient, ordered a bolus, wanted regular updates, etc. That's just another day in paradise for me... if I needed to be in the hospital under medical care every time my BP wasWell, I would have to just permanently move there then
On the other hand, someone dutifully followed protocol to the point and, doing things strictly according to it, had managed to bring blood sugar to normal. From 500 to 80, that is, within 90 min or so. The result was long and unsuccessful code and even longer explanation thereafter why CBG of 80 was not "normal", not a "goal" and why hospital policies ought to be not to confused with the Ten Commandments.
Well, I would have to just permanently move there thenOn the other hand, someone dutifully followed protocol to the point and, doing things strictly according to it, had managed to bring blood sugar to normal. From 500 to 80, that is, within 90 min or so. The result was long and unsuccessful code and even longer explanation thereafter why CBG of 80 was not "normal", not a "goal" and why hospital policies ought to be not to confused with the Ten Commandments.
I'm kind of floored that there's a protocol for blood glucose of 500. I've never seen treatment allowed for over 400 without a call to the doc for specific instructions.
-Patients who are "with it" yet still act like a**holes
-Pts who think I live and breathe to serve them and act accordingly
-Pts who are extremely overweight and yet the family brings them KFC, then they moan about how they're "not getting better"
-Nurses who don't accurately judge the amount of fluid left in an IV and/or let the line run dry JUST as report is ending and I take over.
I'm kind of floored that there's a protocol for blood glucose of 500. I've never seen treatment allowed for over 400 without a call to the doc for specific instructions.
"If 500 or over, give X units, call provider". Called AFTER giving that X units and not rechecking. Provider ordered 2X more units, which were immediately given. Rechecked in 15 min, it was still over 400, of course, called again, got order for 3X more insulin of another short preparation, the reason for that were neither asked, nor explained. Then it was an hour before getting that value of 80.
There were other details, but, at the baseline, when I deal with such situation, I check every 30 min and before each dose at the bare minimum. I also would dispute with provider changing short insulin preparation in the middle of it all. I would ask for larger dose being given in two increments 60 min apart if CBG allow.
People who tell the parents of a newborn not to hold it "too much" because that will make the child "spoiled." Just one of many pet peeves, but that is a BIG one. The kid JUST GOT HERE for crying out loud. I always jump in and say as kindly and sweetly as possible that you can spoil a child with too many video game systems or too many toys, but not too much love. It usually nips that in the bud and the parents are grateful to not to have to get into a fight over parenting techniques with grandma/auntie when the kid isn't even 1 hour old.
Preach. I get so aggravated by this in the NICU. Your baby hasn't been able to be held in weeks- hold that baby as long as possible and soak up the sweetness because no one will ever need you that much again. You will never regret snuggling your baby too much.
In the ER when the patients complain that nobody has been in their room to see them. Also they have been there for 20 min if thatAnd we have been in their room me the doc, medic. EKG labs done. And still. They say nobody came in to see them. Lol. Oh and to top it off they complain to a family member that JUST showed up. So then I'm dealing with them at the desk asking "why pt X has not been seen". [emoji33]🤔🙄
Preach. I get so aggravated by this in the NICU. Your baby hasn't been able to be held in weeks- hold that baby as long as possible and soak up the sweetness because no one will ever need you that much again. You will never regret snuggling your baby too much.
All I hear when people warn against spoiling BABIES is "Don't teach your child that you will meet their basic needs."
My pet peeve is poorly designed systems. The hard work should be done in designing a system where it is hard to do the wrong thing. People's lives are in my hands every day. I am cautious and thoughtful in my practice usually but mistakes happen. When you have to be very intelligent and use workarounds to prevent doing harm then administration is doing a bad job and deserves to be the patient that risks their life seeking help.
Jensmom7, BSN, RN
1,907 Posts
This is precisely why, when I'm at a facility, I don't just ask if everyone has enough meds.
I know who's getting stuff scheduled and fairly consistently PRN. I'll check the narc books and see for myself exactly how much is left.
However, when someone says "So and so needs more Dulcolax", I advise them to call the pharmacy used by the facility. As the School Nurse crowd says, "C'mon now!!"