Things Med students/residents have taught me

Geeg · Jan 22, 2004

That trying to titrate nipride and epi (I call it epipride) instead of using that wonderful drug called dobutamine.

Shotzie · Jan 23, 2004

That arrogance is not reserved for attendings.

Our intern was told not to touch the patient in the rotating bed until the resident came back. The nurse was involved in a lengthy dressing change that involved cleaning and packing a huge abdominal wound. She finished with him pacing and grumbling about how he needed to get his stuff done. After changing the bed and bed padding she rolled away the dressing cart. Somehow, God knows how!, while she was gone, he managed to unlock the bed, FLIPPING THE PATIENT ONTO THE FLOOR!!!

His response, "the nurse didn't relock the bed" luckily the RT had been by to draw ABG's and was able to report that she had leaned against the bed and it didn't move, just before he pulled the curtains around the bed to begin his exam.

And if that wasn't bad enough...it was during visiting hours and almost every bedin the unit had visitors!!!

Can you spell LAWSUIT!!!

NsgTiger · Jan 23, 2004

Use caution when inserting a chest tube or you just might end up in the opposite side of the chest cavity (and if your attending tells you this happened and shows you the xray, don't try to deny it - the films don't lie) Luckily for the pt, his initial injury ended up not being compatible with life

lsyorke, RN · Jan 23, 2004

Always check for the presence of an Advanced Directive before ordering an "NGT for medication administration" on a comatose patient whose family had confirmed NO TUBES.

When I questioned the order I was told "Just put it in anyway!". My not so professional response was "If you want a lawsuit your welcome to put it in yourself you idiot!"

NeuroICURN · Jan 23, 2004

When you pull out a chest tube, don't just put a dry, serile 4x4 guaze dressing on the site with a piece of transpore tape....this will require another chest tube!

Oh, and don't walk down the hall and do it to another patient less than five minutes later!

UGH!!! :eek:

Also, when your patient tries to get out of bed, thus snapping the EVD in their head... Do NOT try to just hook up a new drainage system to it. Then, when that doesn't work, pull it and tell your superiors that you just pulled it (leaving out the new system part). Because when your attending comes by and is discussing this with the nurses involved, and he finds out that you tried to just attach a new system, he is gonna be REALLY ticked off about it!!!

Ruby Vee, BSN · Jan 23, 2004

Medical students have taught me that:

It's possible to go through four years of college and 2.5 years of medical school without learning where a bedpan goes.

It's possible to believe that you are God without even graduating from medical school. (Trust me -- you're not!)

That even when the CT scan is really, REALLY interesting, you should pay attention to things like Airway, Breathing and Circulation. Otherwise, it ultimately doesn't matter that the CT scan showed no bleed.

There is always someone stupid enough to open the door to the stairwell for a confused patient in a wheelchair.

Things interns have taught me:

There really is no body cavity that cannot be reached with a good, strong arm and a 14 gauge needle. (With apologies to "House of God.")

It is possible to go through four years of medical school without learning where the Foley goes.

1 mg. of morphine is not going to do much for DTs.

40 mEq of KCl IV push has no good outcome.

Especially if given through a 22 gauge in the right hand.

A bicarb needle can go right through a nurse's hand like a hot knife through butter. Getting it out was somewhat painful, however. Trust me. It was my hand.

Defibrillating one's co-workers tends to annoy them. The first time. The second time, it makes them really, really MAD!

You can do a complete set of vital signs (including rectal temp!) on a sleep-deprived first year resident in an empty patient room without waking him.

Residents will eat anything . . . including your lunch if it's left unattended for more than 30 seconds.

Sometimes waking them up at 2AM to draw blood gases on a dead lady makes them better people.

When defibrillating a prisoner, take off the handcuffs and ankle bracelets first.

It is not wise to defibrillate a patient lying in a bathtub full of water even if your ACLS manual DOES say to defibrillate pulseless VT.

When calling to report bleeding, NEVER clean up the mess before the resident sees it. He'll always insist that you were either hysterical, exaggerating or both.

When pulling a balloon pump, always make sure it's not inflating and deflating first.

Always make sure you hold pressure on the site -- no peeking in the first minute.

No peeking in the second minute.

Blood really will hit the ceiling if it comes out of a really big artery in a patient with blood pressure. It will also hit your face if you're peeking.

Yes, Doctor. That balloon pump really WAS in an artery. The biggest damn artery in the human body.

And finally, I've learned that it's part of my job to keep the residents from killing the patients. But if a resident wants to wrestle one to the ground in order to stick a syringe in their arm -- make sure it's the PATIENT that gets the needle.

BarbPick · Jan 23, 2004

Ruby,

How is the new Job?

BarbPick · Jan 23, 2004

Real life lesson from an Intern

Never allow a resident sleep and give tylenol without an order. Turned out patient was on a fever watch with endocarditis and half of my as$ was chewed off, moral, never allow a residnet sleep, even through the small stuff.

Big Bab's · Jan 23, 2004

Originally posted by Shotzie
That arrogance is not reserved for attendings.
Our intern was told not to touch the patient in the rotating bed until the resident came back. The nurse was involved in a lengthy dressing change that involved cleaning and packing a huge abdominal wound. She finished with him pacing and grumbling about how he needed to get his stuff done. After changing the bed and bed padding she rolled away the dressing cart. Somehow, God knows how!, while she was gone, he managed to unlock the bed, FLIPPING THE PATIENT ONTO THE FLOOR!!!
His response, "the nurse didn't relock the bed" luckily the RT had been by to draw ABG's and was able to report that she had leaned against the bed and it didn't move, just before he pulled the curtains around the bed to begin his exam.
And if that wasn't bad enough...it was during visiting hours and almost every bedin the unit had visitors!!!
Can you spell LAWSUIT!!!

Oh my Shotzie!!!....so, what ended up happening to this idiot?!?!...Just curious.

Ruby Vee, BSN · Jan 23, 2004

Originally posted by BarbPick
Ruby,
How is the new Job?

The people here are unbelievably nice to us, so we're enjoying the people aspect. The job, however is both boring and frightening. Boring, because the majority of the patients ought to be in a skilled nursing home rather than in ICU. Frightening because -- the physicians complain that the nurses aren't doing their jobs correctly, the nurses complain that the physicians aren't doing their jobs -- and they're all right!!! Not only do they not do daily weights on CHF patients, not one person who is staff there even knows where the scales are kept. (Not that their is one, except a standing scale.) We're counting the weeks left in our contract, and are opting not to either renew or go on staff despite the generous monetary rewards for doing either! Anyone know of a teaching hospital in the Baltimore area that needs experienced ICU (CT ICU) nurses?

Ruby

USA987, MSN, RN, NP · Jan 23, 2004

Originally posted by Ruby Vee

40 mEq of KCl IV push has no good outcome.

Especially if given through a 22 gauge in the right hand.

When defibrillating a prisoner, take off the handcuffs and ankle bracelets first.

It is not wise to defibrillate a patient lying in a bathtub full of water even if your ACLS manual DOES say to defibrillate pulseless VT.

.

OMG....these 4 had me laughing so hard that I started having chest pain!!!!!!!!!!!!