The worst or strangest orders you have seen...

angel337, MSN, RN · Jul 17, 2007

Stat banana
does 500mg of caffeine exist? If so please can I have some?
Yea, I like the float heels too...

i have given caffeine IV in the ER several times for people with headaches following a lumbar puncture or epidural. some docs even use it to treat severe migraines.

MadisonsMomRN, BSN, RN · Jul 17, 2007

This was written by a very tired, but competant ER doc....we both had a good laugh about it when I pointed it out to him. (It was on a discharge Rx).
Vicodin 1 gram IV Q4-6 hours as needed for pain
Dispense 20
Not really sure what he was thinking.....but he was thankful I caught it...we all write stupid stuff. Today near the end of a very busy shift, I was charting off on a patient and the time I wrote was 1899. I guess that means one minute before 1900, right????

Oh believe me I have done some crazy things too... of course not intentional. I just think its funny... BUT our medical director is really a QUACK.

As a nurse I know we are human and make mistakes but you have to admit some of them are funny!! (of course if they cause NO harm to our patients!)

MadisonsMomRN, BSN, RN · Jul 17, 2007

i have given caffeine IV in the ER several times for people with headaches following a lumbar puncture or epidural. some docs even use it to treat severe migraines.

That make sense... I didn't know that. I haven't worked in an ER before. I know that when I have a bad headache caffeine does help.

Learn something new everyday.

purple1953reading · Jul 17, 2007

We once had a dr. order Malox, and the RN, (from out of country original) gave it IV> actually drew it up in a syringe, and put it in an IV, and it was dripping when I found it.

TheCommuter, BSN, RN · Jul 17, 2007

1. 70/40 insulin, 15 units, SQ BID @ 0630 and 1630 (70/40 insulin doesn't exist...)

2. Dulcolax 10mg, po Q 6 hours, PRN for fever (Dulcolax is a laxative...)

icuwant2rn · Jul 17, 2007

I had to chuckle on this one. I have not seen a patient desire a foley...

I work med/surg (mostly surg with med overflow) and you would not believe the # of pts that want a foley placed! Usually they want it "just for the night" because they've been up with PT that day now they are sore and don't want to be assisted up to go to the BR. :trout:

I just tell them the doc will not give them a foley just because they want it, but I can give them some pain meds to help ease the pain and a bsc. :rolleyes:

TiffyRN, BSN, PhD · Jul 17, 2007

Average type med/surg patient, not on major narcs, not hospice had a MD that tended to write very very detailed orders that included many things that were standard practice. Such as. . .

Call for RR

Really? You bet your pretty &%$ I'll be calling for RR

And I have heard of patients that want foleys, beg the nursing staff for them; mostly older ladies that know that they don't have good mobility and that they are in to get majorly diuresed.

And I did see a few orders for IV caffeine for adult migraines. And it's a routine med for premature infants, IV and PO, though in doses much smaller than 500mg, the standard daily dose is 5mg/kg.

NursingAgainstdaOdds · Jul 17, 2007

I work med/surg (mostly surg with med overflow) and you would not believe the # of pts that want a foley placed! Usually they want it "just for the night" because they've been up with PT that day now they are sore and don't want to be assisted up to go to the BR. :trout:
I just tell them the doc will not give them a foley just because they want it, but I can give them some pain meds to help ease the pain and a bsc.

Yep I had a pt last week who requested a Foley (and got it :rolleyes: ). She DC'ed it herself on my shift (it "fell out" with the balloon intact), but it didn't go back.

EmmaG, RN · Jul 17, 2007

I still love the coumadin PRN order!

Our hospital policy was that all coumadin orders were to be written as daily, one-time orders after the results of the daily PT/INR were seen by or called to the doc (except for patients who were on therapeutic/maintenance dosage at home and the doc had to make note that he knew of this). Otherwise, "Coumadin Xmg po daily" was not allowed.

The initial order was written as 'prn', so that pharmacy could enter it into the electronic MAR and it would show up on the patient's record. After a while, they adjusted the system so that it would appear on the MAR as "reminder" and a time to be given, with a space to enter in the daily dosage.

I'm not saying that is what happened in your case, but I've seen it written as prn for that reason.

nrsang97, BSN, RN · Jul 17, 2007

I had a pt that had a NGT that was clogged and I took it out and tried to replace it. Couldn't get the tube back in between 3 RN's (come to find out after endoscopy pt tube feed solidified in her esophogus and stomach). I called the Doc and said that the NGT was out and I was unable to get back in along with 2 other nurses. He said "Does she really need it?" Nope she dosen't doc I just wanted to talk to you and hear your voice. Later I called him again and told him that pt sodium level was in the 150's and if he wanted to change from 0.9ns to 0.45ns. He told me to give her a "Water bolus" I think he ment free water through the NGT. I asked him how to do this and he said "Oh yeah her NGT is out" No duh doc why did you think I asked for the IV fluid changes. He said to leave the IV fluid. I was wondering did he want me to squirt her with a garden hose or something??

Hoozdo, ADN · Jul 17, 2007

Infuse 2 units PRBC

written on the WRONG patient :trout:

residents are so much fun, NOT!

ZippyGBR, BSN, RN · Jul 17, 2007

mouthcares prn. Thanks for the tip, doctor.

given recent discussion about how "nurses can't do anything without a valid medical order (for billing purposes) " does this perhaps not indiciate the level of bureaucratic idiocy that has been reached in some systems due to the way in which their finances work?