What have other nurses done that have freaked you out?

[texas_lvn]

What have other peers done intentional/unintentional to freak you out? Good or bad. Happy or sad.

On my FIRST day as an LVN, (LTC) a res was screaming in her room as I was walking out to leave. I went in to see what was going on. She was having an anxiety attack and severe pain (post stroke). I pulled the call light, and no one came. Uggg.

So I peeked out the door and saw my CNA walking down the hall, and told him to come sit with res. I went down to get her a Xanax and a pain pill, well relief nurse was in the restroom, and relief CNA (with call light still going off) was sitting behind nurses station reading a newspaper. I told CNA to tell the nurse to get a Xanax and pain pill for res. She said OK. I go to relieve my CNA. Said goodbye to him, and stayed with res. after 10 minutes, CNA COMES INTO ROOM WITH XANAX AND MORPHINE PILL. She is soooooo shocked to see me still there, she hands me the pills and RUNS to the relief nurse. I could NOT BELIEVE WHAT I JUST SAW!!!!

(I did immediately call DON and tell what happened. Luckily, my CNA was still checking on another res, and saw the whole thing.--------they got a slap on the wrist! that was it!!!) :madface: :madface:

[CNL2B]

I just changed jobs...have been out of acute care for about 4 years...just got a job in a hospital.

An RN I work with told me that it is not necessary to clean the ports before hooking up meds or fluids to a saline lock. Apparently, they have some sort of anti-microbial properties that make this unnecessary. All of the other nurses clean the ports and there is nothing on the box or the package insert that indicates that cleansing is not needed. I've already mentioned this to the nurse manager, so hopefully I will get an accurate answer on this one.

Same RN dropped an NG tube on the floor...after the patient pulled it out. She picked it up and reinserted it...no gloves.

Same RN nicked the bag when she spiked an IV bag. She put a towel over the pump to catch the drips and let it infuse anyway. I found it when the pump beeped to let us know the infusion was done.

OK, all 3 of those things are disgusting and completely unsanitary and yes, I know that you know this even being out of practice for 4 years!! I hope she's not orienting you. None of that is good practice. I don't know of ANY IV tubing that has antimicrobial properties (although wouldn't that be a great invention!) If that is true (which I doubt) please make a post to the main board. We would all be thrilled to hear about this cutting edge technology ... LOL (!?!)

[gwafuh_rn, BSN, RN]

just want to share my story. I was orrienting this guy who in his mid 40s.He told me that the patient is getting 240 ml of glucerna bolus.I told him that 1 cup( the styro one) is already 240 ml.He told me that he didnt know that.He was putting the glucerna on a medicine cup(30 ml) and transfer it to the styro cup.He has to do it 8 times to get 240 ml.hehe!!!

[eriksoln, BSN, RN]

I can't determine which of these is worse!

The heparin drip is familiar to me; I once had an RN shut one of my heparin infusions off because the pump was beeping and she didn't have time to find me to let me know... Together, we determined that the patient went without for about an hour. The pump was beeping because it was unplugged and the battery was low...

From a personal perspective, the worst was the clueless charge nurse who didn't use the abduction pillow right on a hip repair pt.

Rather than lay it flat between the legs to promote abduction, she stood it upright between the legs and told the pt. to sit crossed legged/Indian style with the pillow between. Oh my. And during report I was getting the impression this pt. had a low tolerance for pain. Report was filled with "she is on a PCA, but we are giving her this/that PO med also. But she is still hurting so per the protocol we upped the PCA dose to this, but she still complained so we called the doctor..................".

Lucky for me, she was the first pt. I went to see. I walked in on her, up in a chair, abduction pillow standing up like a tower and her legs crossed around it. I had to go check my own pants for hershey swirls.

So I corrected the problem and SURPRISE, the pain is a little better:yeah:.

I called the doctor to inform him this pt. basically spent the day with legs crossed and all that, I suggested getting some new x-rays to see if it was OK, but he came in on his own to look at the pt. Took about an hour for him to get there.

In that hour before the doctor arrived, the charge nurse kept yapping in yapping about how I had the pillow in wrong. Even tried to go in the room and put it back the way they had it before. The pt. thankfully stopped her.

For an hour, "yap yap yap, we do things different, our policies are evidence based driven, thats how you guys do it out east but we are different". Then the doctor showed up, ordered some tests and wanted the name of every nurse who had been working the shift before me. All of a sudden the charge nurse was very busy with this very unhappy doctor...........no more yap yap yap at me.

[Kellyma]

wow those are some crazy stories!

[jesskidding, LPN]

During clinicals at a LTC facility. I was shadowing a RN and we went into a residents room who was known as a "digger". (I assume most of you know what this is) The resident was also wearing briefs. As soon as you walk into the room you can tell she needed to be changed. When I go help the RN, it is obvious from the dried feces that the previous shift had not bothered to change it. Most likely the CNA. The RN then told me there was an easy way to remove the dried feces. She told me all you have to do is rub shaving cream on it and it comes right off. She proceeded to pull out a travel size can of shaving cream like she uses it all the time. The whole time I was thinking why a nurse/caregiver would ever let it get to the point that you needed to use shaving cream! Why not change it right away? It made me so mad and I felt really bad for the resident. I hope someone was held responsible, but I doubt it. I was glad when our clinicals were finished in that facility!

[I_LOVE_TRAUMA, RN]

yeah it's so awful when resident's are left dirty for more than a few minutes...nothing upsets me more! I would like to make those caregivers sit in their mess all day.

But as far as the shaving cream thing goes...almost all of us "old" nurse use it every time a pt. Has a BM...NOTHING works better!! I love it.

[gwafuh_rn, BSN, RN]

I want to share another story that happened to me a while ago.My supervisor called me and told me that the patient that I handled last week died and she told me that she is gonna write me up.I worked day shift and the patient died that night.The patient's bp during my shift was kinda low.It was 90s/40s.There was an order to give lasix q 3 days.I hold the lasix because of the bp.I forgot to tell to my supervisor that the bp was kind of low.But I called the cardio consult of the pt and told him about my concerns.The dr told me that the bp is ok and to hold the lasix if the systolic is less than 100.During endorsement,I told the night nurse that the bp was kinda low so I need to hold the lasix.He told me that the pts bp was okay.The patient died that night.The primary doctor got upset because if she's the 1st one to be informed,she'll order a bolus of ns right away.I was really frustrated because that day,the family was thanking me for the care that I did to the patient.Anyways,my supervisor asked me why I didnt call the primary?Why do I need to call the cardio consult.I was speechless that time.

[CrazierThanYou]

During clinicals at a LTC facility. I was shadowing a RN and we went into a residents room who was known as a "digger". (I assume most of you know what this is) The resident was also wearing briefs. As soon as you walk into the room you can tell she needed to be changed. When I go help the RN, it is obvious from the dried feces that the previous shift had not bothered to change it. Most likely the CNA. The RN then told me there was an easy way to remove the dried feces. She told me all you have to do is rub shaving cream on it and it comes right off. She proceeded to pull out a travel size can of shaving cream like she uses it all the time. The whole time I was thinking why a nurse/caregiver would ever let it get to the point that you needed to use shaving cream! Why not change it right away? It made me so mad and I felt really bad for the resident. I hope someone was held responsible, but I doubt it. I was glad when our clinicals were finished in that facility!

When I worked at the nursing home, we used shaving cream on all the residents. That was about fifteen years ago. More recently, my instructor told us that shaving cream is really just canned foam soap.

[flashpoint]

During clinicals at a LTC facility. I was shadowing a RN and we went into a residents room who was known as a "digger". (I assume most of you know what this is) The resident was also wearing briefs. As soon as you walk into the room you can tell she needed to be changed. When I go help the RN, it is obvious from the dried feces that the previous shift had not bothered to change it. Most likely the CNA. The RN then told me there was an easy way to remove the dried feces. She told me all you have to do is rub shaving cream on it and it comes right off. She proceeded to pull out a travel size can of shaving cream like she uses it all the time. The whole time I was thinking why a nurse/caregiver would ever let it get to the point that you needed to use shaving cream! Why not change it right away? It made me so mad and I felt really bad for the resident. I hope someone was held responsible, but I doubt it. I was glad when our clinicals were finished in that facility!

Sometimes, no matter how soon you change someone, the BM can be really difficult to get off. I've changed someone and fifteen minutes later find them with dried BM again. A little bit of lotion or shaving cream or hair conditioner can really help.

[flashpoint]

I work in a very small community hospital...we only have two nurses on duty at night. Sometimes we don't have patients at all...most of the time we only have one or two. We're allowed to watch TV or movies or whatever it takes to stay awake during down time. One of the nurses I work with (the one who doesn't clean IV ports) is a TV addict! The minute everything is done, she is in an empty room glued to the TV. If she ends up going into a room to help a patient, the TV goes on as soon as she turns the call light off. Then, she leaves the TV on because she doesn't like the quiet...so she is certain that the patient doesn't like the quiet either. On really dull nights, she usually gets a nap in...and she snores...loud! I've brought concerns about her to the nurse manager, but she just says "that's just her" and "she is retiring in a few months." One of the other nurses refuses to work with her.

[MattiesMama]

Well, you could be right, and you could be wrong. There is NO truth to the rumor that every COPD pt. is a CO2 retainer, no matter WHAT you were taught in school. When in doubt, give the Os! orders are for the usual, and perhaps this nurse just might have known this pt. better than you did, and was walking away to arrange transport or to call the doctor. My point is, just because she did not discuss it with you does not mean that she was ignoring the situation. or, perhaps you are right and she was a total screwup. Either way, his death probably could not have been prevented. It was pneumonia, and COPD pt.s are at high risk. Not all deaths are causable, or preventable; as you will learn as you grow in this profession.

You know, it's interesting that you mentioned this because I just did a presentation for my class about how the theory of all COPDers being CO2 retaining/hypoxic drive is innaccurate, especially in acute situations. So now I know better. But it puzzles me-we had it pounded into our heads that giving a COPDer more than 2L would cause respiratory arrest. And it continues to be taught to this day. Kinda scary.

I still think his death could have been prevented though, because the pneumonia was so advanced before it was treated...he had orders to check lung sounds every shift, and no adventageous sounds were ever charted, right up to the shift before this incident occurred. Is it possible that he developed it that quickly?

[catlvr]

Not sure if this qualifies as the scariest, but maybe it does because it made me so angry, I was probably scary to be around: we had a respite hospice patient for two weeks; he had advanced dementia, contractures, parkinson's, h/o bone cancer. He was nonverbal, but able to squeeze your hand to answer questions. He had morphine ordered for pain. Pain was frequently written on his face, and the morphine really helped. I assessed him frequently during my shift and medicated him when needed. I realized that I (3-11) and the night nurse were giving him morphine, but the day nurse *never* did. I gently asked her how he was during the day, because his pain was evident during evenings and nights. She stated that "he never asked for pain medicine", so she was not going to give it to him. After counting to 10, I pointed out that he could not speak, and how the other nurses and I assessed him for pain, and hoped that she would help him. NO - she never once gave him pain medication. Still makes me tear up with rage.

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