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"
Specializes in ER, Trauma, ICU/CCU/NICU, EMS, Transport.
If I have a chronically ill patient, dialysis or not, who presents with any indication of infection I obtain a straight cath...unless I believe that the patient is capable of walking to the bathroom and clearly understands the meaning of clean collection technique.
How many of those towelette wipes are necessary for a standard clean catch urine?
Ok, I'm not an ER nurse...but thought I'd toss in my two cents.
Brand new patient comes to floor, ED orders were all screwed up (the doc's fault, not the nurses), I call hospitalist for clarification. I mean, there were some MAJOR issues. Like to continue Coumadin with an INR>5, and start on Lovenox also.
Anyway, I call doc, he FINALLY calls back, and cuts me off..."Just write whatever orders you want and don't call me back again"....then hangs up on me. Evil me, I actually wrote that as an order. I thought he was going to stroke out on me when he saw it there in the morning...
Yes, I had a very similar order...rectal temp on pt...well, the patient did not have a rectum. I wrote in the temp with "oral" next to it and gave it to the attending, who immediately began to rip me one. I said very quietly, "didn't the resident tell you the patient has no rectum?"
hehehe
Unfortunately, I have also seen "KCL 40meq IV push" waaaay too many times. I know I had to pass a test on medications to pass nursing school, that's all I'm saying folks!
Ok, I'm not an ER nurse...but thought I'd toss in my two cents.
Brand new patient comes to floor, ED orders were all screwed up (the doc's fault, not the nurses), I call hospitalist for clarification. I mean, there were some MAJOR issues. Like to continue Coumadin with an INR>5, and start on Lovenox also.
Anyway, I call doc, he FINALLY calls back, and cuts me off..."Just write whatever orders you want and don't call me back again"....then hangs up on me. Evil me, I actually wrote that as an order. I thought he was going to stroke out on me when he saw it there in the morning...
Oh, no! That reminds me of a physician that gave me a phone order that I just couldn't believe.
"Do not call me for abnormal labs. The next time you call me, he better be dead!" Then we started calling the nsg sup and she got the ER doc. But, the next time we spoke to the PCP on the phone, and, yep he was dead!"
And it was a man in his 60s, young and a full code. After the incident, we found out he was intoxicated (drunk as a skunk!), and he showed up later, after the ER doc cursed him out and he was still drunk. Needless to say he got a month or so off to go to rehab.
Even worse, he had his own plane, and he had been out flying after all his drinks. Talk about SCARY!!!
Specializes in ED, Tele, Med/surg, Psych, correctional.
How many of those towelette wipes are necessary for a standard clean catch urine?
Actually, research shows that it doesn't even have to be "those towelettes". Just because someone goes to the bathroom with said towelettes in their hand doesn't mean they use them. Our docs are not going to treat someone with ABX for a UTI who has trace leukes on their UA but +3 epithelial cells. Guess what? It's a dirty catch. But you know what? A lot of docs would treat it and that's why clean catch urine is so important. Here's a link to a study that was done with toilet trained children. They didn't use towelettes but liquid soap and gauze. Now if THEY can collect a clean catch then so can the entire walky-talky adult population, don't you think? (I'm sure they had help in the bathroom..lol)
Yes, I had a very similar order...rectal temp on pt...well, the patient did not have a rectum. I wrote in the temp with "oral" next to it and gave it to the attending, who immediately began to rip me one. I said very quietly, "didn't the resident tell you the patient has no rectum?"
hehehe
Unfortunately, I have also seen "KCL 40meq IV push" waaaay too many times. I know I had to pass a test on medications to pass nursing school, that's all I'm saying folks!
That's what I thought when I saw the order!! I was thinking, WHAT!???!! And where did he go to school?! And I got my butt chewed by him when I asked about it. The ER chief doc was standing behind him when I had asked about the order, and the guilty party that messed up and wrote the order got a good tongue lashing.
I was working night turn on med/surg and got a"possible OD" from the ER...she had been Narcaned in the ER and we were told she was OK for admission. About 4 hours later (3am), she crashed and was a nice dusky shade of blue when we found her....I immediately grabbed more Narcan figuring that was what would be ordered while another RN called the Dr and explained what was going on.....the order we received....."Give D50 IVP, feed pt and get glucometers q 1 hour until blood sugar is > 125" and he hung up.
HELLO!!?? can we say...NEEDS NARCAN!??? Tried to call him back and he didn't answer so we ended up calling the ER doc to come up...FINALLY got the Narcan order, narrowly missing a full code and sure enough....she came right around for us.....
Psych patient going wild in the ER, multiple attempts of calming the patient failed secondary to his schizophrenia and paranoid delusions. Security was already in the room physically restraining him.
:banghead:
Dolce, RN
861 Posts
maybe his diploma was written with a crayon? :uhoh21: