I have a two nursing degrees, going for a third and have a whole lotta common sense. When I see stupid or hear stupid orders I may or may not carry them out..here are my all time favorites:
1) Male patient with active lower GI bleed...HGB of 5...Hypotensive and tachycardic..has 2 large bore IVs running with NS wide open as fast as it will go...blood bank working as fast as possible to get me my units of PRBCs ASAP...BP barely 90 systolic.
Order from resident: "We need orthostatic vitals on this patient"
Tramadol for a Pt. being treated with an SSRI (sertraline, if memory serves me correct.). If the pain is that bad, then give Tylenol #3 . Sorry, I just don't feel like dealing with Serotonin Syndrome tonight. (Can you tell i've worked psych lately?)
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
you're so right. i have never considered that term before but it was definitely an "uncode." the uncodes from hell are often far worse than when the pt actually just gets it over with and codes. i don't know if she is still alive, i never checked, but she did make it safely upstairs to icu. i felt bad for the icu nurse in report though because even when i am calm i have a huge potty mouth. all i can remember about the report i gave on this pt was the unusual high number of expletives i was tossing around like a drunken sailor..
and the icu nurse, who knows the icu resident far better than you do, was rolling her eyes and praying for the jesus bus to come rescue this poor woman sooner rather than later! lol!
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
actually, as an endocrine nurse that sees new onset's regularly, they need fluids, especially something with k in it. after the insulin drip is started, their k will start to drop, and to keep it from dropping to much they need k. also, these pt's are dehydrated, so fluids are always good.
i think the problem with the fluid order was the "kvo" in front of it.
i think the problem with the fluid order was the "kvo" in front of it.
i'm so glad someone caught the message there!
yep, the problem was indeed the "kvo" part of the order. not a good plan for hhnk patients! stupid doctor couldn't manage to tell the difference between dka and hhnk.
OMG!!! You have GOT to be kidding me!! We had a Physicians assistant who thought he could do NO wrong, but some of his orders were ridiculous!
Phenergan 100mg IVP, and then argued that that crazy dose could be given rapid, not diluted! And, yes through a peripheral iv access.
4o mEq KCl also rapid IVP, and it did not need to be diluted either! I aint giving THAT kind of bolus! I don't care WHAT the K level is!
That's just a few!
Anne[/
Obviously he skipped that pharm class during school.
This one caused me to quit on the spot:
3mg ativan ivp on a 100lb 14 year old who was complaining of arm pain after receiving a myers cocktail that was mixed without sterile proceedures and also learning she was positive for lymes (I did neither the iv and refused to do the ativan ivp)
floatRN
138 Posts
"Give patient a hard boiled egg."
"Neuro consult regarding headache" (patient had received nitro paste and then developed the headache)