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've got a doc that orders 25 mg Benadryl for everything. She once told me to give a guy 25 of Benadryl for a headache. She also considers NS @ 100 ml/hr a bolus.
Had a doc (GE resident) come in on our ICU telling a us he is going to shock patient X. So we ask him why he wants to punish poor Mr. X. He goes well obviously he is in atrial fibrillation. So my fellow nurse kindly points out that in her humble opinion it's sinustachy. He walks up to the monitor (7 lead) and goes well it isn't sinustachy I don't see the P-waves. So she tells him trust us we've been doing this for years it's sinustachy. He goes well the patient has no reason to be in sinustachy, so she points at the epi drip and the fact this is a very septic patient so he's got every reason to.
So this doc still convinced he is right comes up to me and asks my opinion on the rhythm so I tell him I think my colleague is very capable of reading rhythms herself but that I wonder how many atrial fibrillations he knows to have a steady regular ventricular response of 127 bpm for the entire 5 minutes that he has been arguing. So to please him we suggest to do a 12 lead. (FYI on the monitor the P-waves were clearly visible but pushed back into the T-waves). Ofc the 12 lead shows sinustachy and even states it as the "diagnosis". So we show him the EKG and he goes I'll be back.
So he comes back in with the cardiology fellow and hands over the EKG. The cardiologist takes a literal half second look and goes sinustachy. My colleague shows up looking very angelic in her white uniform, going sinustachy really??? Well good thing you didn't shock mr X now is it... The doc just up and left and has never returned since :)
order of 20mg DILAUDID prior to reduction... when I asked the doc for clarification he didn't even glance at the order and said I calculated it, that is the correct dose. I pointed out that he had written Dilaudid and had the pleasure of seeing him go pale. He stammered Demerol, I meant Demerol... did you give it!?!
order of 20mg DILAUDID prior to reduction... when I asked the doc for clarification he didn't even glance at the order and said I calculated it, that is the correct dose. I pointed out that he had written Dilaudid and had the pleasure of seeing him go pale. He stammered Demerol, I meant Demerol... did you give it!?!
Did I give it! Heck no!
What scares me most about this is that there are nurses out there that wouldn't have the common sense to catch that mistake like you did.
brainkandy87
321 Posts
We've got a doc that orders 25 mg Benadryl for everything. She once told me to give a guy 25 of Benadryl for a headache. She also considers NS @ 100 ml/hr a bolus.