Wise Orders From Wise Doctors

[SilverBells, BSN]

So, this past week I’ve learned quite a bit at work.  I’ve really been impressed with how wise some of our doctors are.  
 

Some Words of Wisdom that they have offered:

1. If a patient is having loose stools, you should hold their bowel meds

2.  A patient with a skin tear on their arm should try not to bump their arm as this could lead to reopening of the wound

3.  A patient with a broken hip should avoid falling on that hip to prevent further injury 

4. Antihypertensives should be held for low blood pressures 

5.  Patients at risk for aspiration/choking should eat slowly, eat small bites and be supervised during meals

The intelligence and thought that went into each of these orders is incredible.  So insightful are these recommendations.

Who else has any Words of Wisdom to share from wise providers? 

[NICU Guy, BSN, RN]

Unfortunately, some nurses are born without the common sense gene and require those types of orders to keep their patients safe. They are also the same people that caused the myriad of warning labels on products, such as "Do not operate heavy machinery" after taking Nyquil. 

[aok7, NP]

I agree, you'd be surprised I am so sad to say

[Guest1144461]

NP here who works on the floors. I was a RN for years and didn't realize how many nurses lacked common sense until I was the one getting pages...

So yeah...this one falls flat.

[Sour Lemon]

1. Could be useful, as sometimes inducing is the goal, granted this one is usually not too difficult to figure out

2. Possible patient teaching suggestion? Assistive staff teaching suggestion?

3. Doesn't sound like an order, not sure what to make of it

4. Very useful with specific parameters

5. Somewhat useful, more for what it doesn't say ...puree, thick liquids, etc.

[Davey Do]

7 hours ago, SilverBells said:

Who else has any Words of Wisdom to share from wise providers? 

I overheard Dr. G, a psychiatrist on the phone with the intake center, say this regarding a possible admission:

"You can't admit someone for just being weird."

 

[Davey Do]

[TheMoonisMyLantern, ADN, LPN, RN]

32 minutes ago, Davey Do said:

I overheard Dr. G, a psychiatrist on the phone with the intake center, say this regarding a possible admission:

"You can't admit someone for just being weird."

 

OMG Davey, I love that.

 

[klone, MSN, RN]

[LovingLife123]

You actually wouldn’t believe what some people do.  I find some nurses just work on autopilot.  They get so focused on tasks that they don’t actually look at their patient.  
 

I've had patients with rectal tubes from stooling so much and the next shift administers all his laxatives.  Or I’ll have a patient now requiring Levo and the next shift administers their scheduled BP meds.  I always try to have the provider DC things but sometimes that one med gets missed.

It’s unfortunate.  But honestly, I’m sure this physicians have had to say those things a lot.

[Jedrnurse, BSN, RN]

2 minutes ago, LovingLife123 said:

You actually wouldn’t believe what some people do.  I find some nurses just work on autopilot.  They get so focused on tasks that they don’t actually look at their patient.  
 

I've had patients with rectal tubes from stooling so much and the next shift administers all his laxatives.  Or I’ll have a patient now requiring Levo and the next shift administers their scheduled BP meds.  I always try to have the provider DC things but sometimes that one med gets missed.

It’s unfortunate.  But honestly, I’m sure this physicians have had to say those things a lot.

So true. Merely passing the Boards does not ensure competence.

[Davey Do]

In my first few months at Wrongway Regional Medical Center, back in '03, working the male psych unit on days, I noted that some psychiatrists would admit anybody for just about anything, if the patient barely met criteria.

There was a man who threatened self harm to his wife, she called the police, and the patient was admitted through ER.

After talking with him during the admission assessment, it was easy to see that he had understandably exploded and threatened to kill himself out of anger at his wife's confession of infidelity. The patient was lucid, remorseful, committed to safety, and wanted to go home. I gave support and told him that I would advocate for him.

While I was off the unit, Dr. F saw the patient and was in the NS when I returned. I asked Dr. F what he thought about this patient and he said he was going to discharge him. I was pleasantly surprised and told Dr. F so.

"What?" Dr. F replied, "Did you think that I would admit him just because I could?"