aurora_borealis

Betadine then alcohol. And no fair blowing on the betadine to help it dry. Yes, I was actually told this.

I'll clarify: The nurse mixed up the patients and the doses, and the MD told her to stop the infusion on the patient who'd been receiving the double the prescribed amount, and yes, take the bag and infuse the remaining amount into the other patient, meaning switch the bag that had been given to patient A and give the rest to patient B. I did not "eat our young." The RN involved had more experience than I in that setting, it was just that I'm much more assertive and don't assume that whatever the MD says is necessarily right. I believe that nurses HAVE to be patient advocates, and to blindly follow a physician's order is not only stupid and a set up for a lawsuit, but unethical and immoral. This is what I ended up doing....I called the infectious disease nurse on call just to validate that I wasn't crazy, I called the supervisor for the hospital (it was a weekend) and finally, the pharmacist, where we worked out that the patient who still needed about half the dose would get a new bag, based solely on "guestimations", because it was impossible to judge just how much of the drug has actually infused. I had complete support from everyone involved, and nobody told me to do what the doctor ordered. Remember the doctor walked out in a snit and told me to handle it any way that I saw fit, so I did. He was notoriously difficult to deal with, which is why I think my co-worker didn't challenge him, and frankly I didn't want to either, especially since I wasn't even caring for these patients. But you do what you gotta do in order to sleep at night.

A co-worker was caring for 2 patients who were being treated with the same drug (cytoxin) but one of the doses was twice the amount of the other. She started both infusions within minutes of each other. About halfway through the infusions she realized she had mixed up the doses, so that patient A was receiving twice the ordered dosage, while patient B was getting about half the dose. She immediately told the physician what happened, and his resolution of the mistake was to stop the infusion on patient A and infuse the remaining amount into patient B. No, I am not kidding. I'm not sure which stunned me more, his idiocy or my co-worker who didn't bat an eye and actually started to do what he told her to do. WTF????? I went ballistic and told the doc no way, no how, was this going to happen under my watch. After 5 minutes of screaming at each other he finally walked away in a huff, mumbling that I could do whatever I wanted. Just as well, because I was ready to call in the calvary and I think he knew it. How would you have resolved this?

I used to work on a unit that playing "musical beds" was nearly a daily event. Our privates were for airborne or GI infections. More often than not we had to make room for a new patient who needed isolation, hence we had to move patients who were no longer infectious to a semi-private room. Oddly, most were pretty cool about it. We also told them in advance that this was always a possibility, so it came as no surprise. I must admit, I had nothing but contempt for people who demanded a private room. I judged them to be elitist snobs and they annoyed the hell out of me. Then Karma intervened. I had a severe case of peritionitis from a burst appendix (my fault, I sat on it for 24 hours before going to the ER.) Unfortunately I had recurrent bouts of obstruction from the adhesions, and each time they admitted me I demanded a private room. I had become one of "them" I must say though, why don't hospitals with semi privates provide 2 TV sets, one for each patient?

That's the policy for the CPD too. But I suspect the police officers involved decided to disobey policy, realizing basic humanity outweighs protocol. Too bad the ER staff did think that way.

I live in Chicago, and this case got massive media coverage. None of the staff involved ever mentioned an ongoing gun fight in the parking lot. If that was were case, then why didn't anybody mention that, as I doubt anyone would blame them for not being willing to put themselves in harm's way. Think about it, which would elicit more public support: fear for their lives, or flat out refusing to help some kid due to a hospital policy. Instead they call 911 rather than rendering immediate care. What I find stunning was the fact the the doctors and nurses were more interested in upholding policy than they were in a human life.

At least on ER they portray nurses as professionals who know what they're doing, and confront the docs when there is disagreement. I think this may be a first. No one EVER washed their hands. You see them, usually the docs, going from one bloody trauma to the next without washing their hands. YUCK! As far as meeting ambulances, a few years ago there was a case in Chicago where a 15 y.o. kid was shot, and somehow he made it to the steps outside the hospital, about 35 feet away from the ER door. The cops ran inside pleading for help, but the staff refused to go out there, as it was against hospital policy. After getting nowhere with them, the cops grabbed a wheelchair and managed to get the kid in the door themselves, wasting precious time. The staff was more than obliged to care for him. Only it was too late, he died. Needless to say the media got a hold of this story, and all hell broke loose. To this day I don't understand why the staff prioritized hospital policy over a person's life. I know, without a doubt, I would have said policy be damned. It was just so ****ing senseless.

If dietary screws up a pt's dinner, blame the nurse. If the pharmacy is late with med delivery, blame the nurse. If a physician is late and the family wants to speak with him/her, blame the nurse. If Xray is taking forever, blame the nurse. If transport is taking forever, blame the nurse. Can't get that private room with a view? Blame the nurse. Bad weather? Blame the nurse. Crappy golf game? Blame the nurse. Also, I didn't go to nursing school to teach manners.

Without even meeting this couple, I think they are likely candidates for the poster children for co-dependency. Weezie, has it occurred to you that your husband, who you claim isn't squeamish (and I'll take your word on that) still doesn't have the slightest clue as to what goes on in the OR? Do you honestly think he'll stand idly by with no questions, as in "why are you doing that, what's happening now?" etc. Do you really want the surgeon, srub and/or circulating nurse to stop and explain things to your husband, prolonging your anesthesia? You can't possibly think that the OR should assign personnel to babysit your husband, do you? What's the real agenda here? Do you or your husband not trust the surgeon, anesthesiologist or the OR team? Are one or both of you control freaks that have a hard time letting go? If your reasoning is that you want him there to say "goodbye" if you should die, it goes to follow that you shouldn't even consider driving anywhere without him on the off chance you're in a fatal accident and he won't be with you. Believe me, the odds of you dying in that OR are much slimmer than being killed in a car accident.

Okay, a few examples of nurses I worked with (briefly) as they were either counseled out or decided our unit wasn't for them. 1. Pt has trach and NG tube. RN asks another RN where to give the meds. 2. Pt. is on heparin. Pt has huge GI bleed, RN comes to me with a bedpan of about 400cc BRB and asks what she should do next. 3. Pt. is getting a unit of blood, blood finished infusing, RN switches over to NS, off the pump. Doesn't go back to check or tell oncoming RN, goes home. RN, doing her initial rounds, finds her 85 y.o. pt in acute pulmonary edema after receiving a liter of saline. 4. Pt. has central line, RN lets it go dry, doesn't tell anyone, hangs new bag, goes home, line has clotted off.

I know a woman who feels pretty much the same about her husband as you do about yours, only she is not leaving him because he supports her and she doesn't want to work. No, they don't have kids. They don't have sex, he's an internet Media junkie which is fine with her. She made her decision, and for some reason it works for both of them....personally I would find that situation a living hell, but to each his/her own. She basically describes her marriage as "it's like living alone only I can't date."

As she systematically uses every club to beat you with and then claims it was "an accident."

Are you a dialysis nurse? Frankly, there's not much difference between catheters, unless you have to work with them directly, i.e. doing dialysis. Some nurses and vascular surgeons prefer one brand over another, for various reasons, but in terms of assessing the site you don't really need to know the brand any more than you need to know the name brand of an IV catheter. Now, you should know the difference between and IJ and a SC placement, or, in some cases, a femoral.

After graduation a fellow student started dating a co-worker, so he transferred out to a different unit, mainly to avoid problems, it was his/their choice. They got married, all is well. I dated quite a few people from the workplace, but never, never, somebody from my unit. I could tell you stories, though, like the time a husband camped out at the CEO's door when he found out his wife was having an affair with a married doc. OOOh, that was good. Or the time a manager (married) was caught red handed with a married doc. And these people were not kids, they were well into their 40's. The worst time I had was after I broke up with an intern after a couple of years, (I should say he broke up with me, but at least we were both single) and a couple of months later he did a rotation on my unit....not a happy time, especially since he wasn't a very good doctor. Lots of tension all around, as my co-workers and I all tried to be professional, but they didn't like him either.

No, it's only the nurse's fault if s/he doesn't notice it, like I didn't, after a unit of blood infused. There are many reasons for an IV to infiltrate, usually has more to do with the pt's veins, the position of the catheter, and if the patient is combative or picking at it. You did the right thing by stopping the infusion, but you should also remove the IV and put cold packs on it to reduce swelling. And remember, when you pull an IV for a restart, ALWAYS remove the angiocath, better yet the extenstion set if your hospital uses them, and cap the tubing with a sterile plug. When I worked on the IV team, nothing irritated me more than being called for a restart and seeing the whole system flapping in the breeze, totally contaminated.