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"
We have a computerized system, and all orders (with a couple of exceptions) are supposed to be written as mg/kg with total dose. I had someone try to write an order recently that was "x dose, please give twice" and then they didn't understand why I couldn't accept the order as written. I had to walk them through rewriting the order with a completely straight face.
Specializes in ER, Cardiac, Hospice, Hyperbaric, Float.
"Elevate patient's scrotum while lying in bed"
ACTUALLY, funny as that sounds, it is a legit order when someone has severe scrotal edema. There is even a contraption (can't remember what it is called, sorry) sort of like a "sling" for the scrotum to elevate it. Seriously!
We have an MD that frequently orders urine Hcg's to R/O pregnancy on abd pains and before getting back or abd. films. That's fine, but on our hysterectomy patients??
We have a doc in our ER that still does urine HCGs on hysterectomy patients. When she was in her residency she had a patient who had had a hysterectomy but was pregnant with an abdominal pregnancy. Ridiculously rare, but now all of her patients get checked regardless!
We have a doc in our ER that still does urine HCGs on hysterectomy patients. When she was in her residency she had a patient who had had a hysterectomy but was pregnant with an abdominal pregnancy. Ridiculously rare, but now all of her patients get checked regardless!
This doesn't seem like a candidate for "worst orders" at all ... considering that patients get their medical histories wrong, frequently.
This doesn't seem like a candidate for "worst orders" at all ... considering that patients get their medical histories wrong, frequently.
Very true. Had a patient who claimed to have had a hysterectomy, but on her CT scan, guess what? She still had a uterus! Thankfully without a fetus present. That was a fun conversation later: "Ma'am, just for your information, your uterus is still resident in your body..." LOL
Very true. Had a patient who claimed to have had a hysterectomy, but on her CT scan, guess what? She still had a uterus! Thankfully without a fetus present. That was a fun conversation later: "Ma'am, just for your information, your uterus is still resident in your body..." LOL
Sounds like a girl I would have dated back in the day. "I've had a hysterectomy"..."I'm on birth control"...
This doesn't seem like a candidate for "worst orders" at all ... considering that patients get their medical histories wrong, frequently.
I wasn't saying it was:) I was replying to someone else to explain why a doc might want an HCG on a hysterectomy patient. Sorry, I thought that was clear.
Specializes in Emergency/Trauma/Critical Care Nursing.
Give Tylenol rectal suppository PO , pt was walky/talky, fully capable AND able to be given PO meds... when said order was questioned the resident became argumentative and insisted there was nothing wrong w/this order and that it was totally fine to give patient's rectal suppositories orally! Luckily this resident did not end up passing his residency... eeek!
That was a fun conversation later: "Ma'am, just for your information, your uterus is still resident in your body..." LOL
, pt was walky/talky, fully capable AND able to be given PO meds... when said order was questioned the resident became argumentative and insisted there was nothing wrong w/this order and that it was totally fine to give patient's rectal suppositories orally! 
Luckily this resident did not end up passing his residency... eeek!
hiddencatRN, BSN, RN
3,408 Posts
We have a computerized system, and all orders (with a couple of exceptions) are supposed to be written as mg/kg with total dose. I had someone try to write an order recently that was "x dose, please give twice" and then they didn't understand why I couldn't accept the order as written. I had to walk them through rewriting the order with a completely straight face.