Send In The Clowns

fergus51 · May 21, 2002

I think if we want to improve patient safety we need to improve medical training. I mean we talk about new grad nurses being unprepared to work!!! Look at the residents and interns we get! Even the good ones can turn into complete idiots and kill a patient after they've been working 48 straight hours. It is absolutely terrifying and unsafe.

Editorial Team / Admin · May 21, 2002

A few years ago while being considered for jury duty, I was one of two RNs in "the box" for a med. mal. case: family sueing surgeon for wrongful death/negligence post AAA repair. Atty asked other nurse, "have you ever questioned a doctor's orders?" "No," sez she. (she was administrator of a SNF at the time; silk pants and blouse, coiffed to the nines . . .). I wanted to sling my arm in the air and shout, "Ask ME!!! Ask ME!!" They soon dismissed me w/out asking the question, when they found out I worked in Angio/Cath Lab. Didn't really want to be on case anyway.

Had 2nd yr res. one year approach one of our Rads for help interpreting a Nuc Med scan. "I have all the other modalities down, just Nuc med eludes me." I could have fainted on the spot. The Rads themselves consult ea. other on difficult cases; have spent 3-4+ years in fellowships, above what idiot resident would end up doing . . . Sheesh!!

Kudos to you all for your brains and guts! I want you to be MY nurses if/when . . .

--- Diana

"Why be normal?"

"I was normal once . . . . . . . . . I didn't like it."

caroladybelle, BSN, RN · May 21, 2002

I have never had to work w/residents yet, but I have seen enough screwups by the "Regular" docs.

I will be praying for ya'll

semstr · May 21, 2002

OMG, I feel for all of you!! Thank God, we have a different system here, although the greenhornes here have their first days too of course. But here it is spread over the year, so they don't get to the wards all at once!!

Take care of you (and them AND your patients), Renee

fedupnurse · May 21, 2002

I almost forgot the best story!! Last July, one of the absolute nicest resident (1st year) I think I have ever dealt with was on. We had a patient who was 10 years older than dirt who actuallt did need a blood transfusion. So I called the Resident as he was On Call (ROC) and said Mr. ___'s hgb is 6. He said ok let's give him a couple of units. I'll come out and put the order in the computer. After nearly fainting from not having to brow beat the guy to put the order in the computer, I arrive back from the blood bank with the first unit of packed cells in my hand. He comes running up to me and says "WAIT!!!! You didn't hang that blood yet, did you?????" I said no it's right here, why what's the matter? I thought the blood bank had called saying they gave me the wrong type or something. He says "OH THANK GOD you haven't given that blood yet! I was looking thru the chart and saw we have to call Dr. ROC before we transfuse. DO you know who this Dr. is?" I said ROC kind of Rock. He said "oh so you do know him." I said I'm looking at him right now. He said "No, I am ________." I said not tonight you're not, you are the Resident On Call. He said "oh I feel so stupid." Initially I told him his secret was safe with me but then told him it was just too good a story not to share. He is now about to become a second year and everyone I know calls him Dr. ROC! And he is still nice!

l.rae · May 21, 2002

Nancy LOL! thanks I needed that now....well back to the trenches LR

live4today, RN · May 21, 2002

Originally posted by fedupnurse
l.rae,
I have been an ICU nurse in a teaching hospital for 10 glorious years. Ya ready???
A few years ago we had this one new 1st year medical resident who thought he was all that and then some. SO it is July 1 and we had a DNR in the unit. She was vented. The patient died so I called him to come and pronounce the patient. He siad I've never done that. I said no $hit Sherlock it's July 1st. You haven't done anything you are about to do. Get on up here and I'll walk you thru it. 2 hours later!!!!! he walks in to the unit and we go into the room. She is purple, on a monitor still (Policy) and due to his slow pace rigomortis has definetly started in. She is also still on the vent. He says to me "how do I know if she is really dead?" I said "She's blue, flat line and STIFF! So listen to her chest for the absence of any sounds and then say dead. He goes to put his stethescope on her chest and the vent gives her a breath. He jumps so high he practically wen tthru the ceiling! He said "SHE'S ALIVE! What kind of game are you trying to play?" I said see that garden hose sticking out of her mouth? Yeah. See that tube connected to it? Yeah. Follow that tube to that gigantic piece of equipment called a ventilator and you will see that is what is breathing for her. He refused to pronounce her. I said you won't make it till next July. Sure enough he got canned about halfway thru the year.
Really nice resident named Brent. July 1st. Beeper goes off indicating a code. He stands there in front of me with this terrified look on his face. I said is it that you don't know where to go or you don't know what to do? He said both. I said we will have no problem with you my friend. He was one of the best residents we ever had.
It doesn't end on July 1st though. I had a 1st year last night that wanted us to hang Norcuron but no sedation because his pressure was too low. I said no way. Won't do it. No sedation in drip form, no paralytic in drip form either. She said how about 1 of Ativan q 6. I said how bout we end this converstion before someone gets hurt.
I could go on for hours....
July 1st is the scariest day of the year. And you all thpught it was Halloween!!!! Silly's!

Thanks for the laughs, Nancy! :rotfl: :chuckle