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"
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...
Did he mend his approach after that? I applaud your courage and sense of humor. How did your boss take it? And what did that jerk doctor have to say? :argue:
Specializes in Emergency/Trauma/Critical Care Nursing.
This doctor should be reprimanded and he should apologize to the nurses. Furthermore, a guy who is capable of all you say does not need to be bathed. Maybe his feet or back, depending on his condition, but that's it. What did you do?
wow vito, u sure are a party pooper!!!! we're sharing these stories because we DID do the right things to resolve them, we're just looking back now at how stupid they were that they are now funny. must you really read so much into each and every comment? you're killing my giggle buzz i had going on!!
you did report this to your boss, right? And she took it to the doc's boss, right? This stuff isn't funny, guys, it's dangerous and a waste of the nurse's time. What does the other doctor have to say about the original doctor?
Manager was very aware and I let everyone know. The young pt was very close to the nursing staff and worked healthcare too. He knew and also talked to other docs about it.
The doc that corrected the order did not say anything. It is well known how much of a jerk he is. As a matter of fact I have not seen him around lately.
The new admission for the ER who was unresponsive.... I am surprised the ER nurse did not notice.
Usually they do. But the doc is such a jerk that they probably did not want to approach him.
Specializes in ER, Trauma, ICU/CCU/NICU, EMS, Transport.
SADDLE embolous....
...follow up question. WHY would they ever to a Chest CT with that HR normal like that?
had a funny one reciently. We had a patient who had been in the ed twice in the last two days for dizzyness. No chest pain, sats were 97% on RA, HR was well into the 70's. The doc decided to send him for a pulmonary angio to rule out PE. When he came back I placed him back on a monitor and was explaining to the family that this is a precaution and we want to make sure its not something dangerous. Right then the doc practically runs back in the room and said we have found our answer. CT showed straddle embolis. Me only being in the ED for one year I have never seen one of these before and hopefully will not again. He showed me the ct and pointed it out. Just about completely occluding the pulmunary arteries. So my next question quickly...
"how much heparin do you want on him"
"well, go ahead and titrate it till he bleeds from his eyes and then back it down a bit" as he laughs.
...follow up question. WHY would they ever to a Chest CT with that HR normal like that?
Sorry, I thought he said straddle, hadn't heard the term before that day. Thank you.
About the CT, I just remembered the D-Dimer came back abnormal and I think they were checking that to just cover the bases. We so weren't looking at this guy and saying "PE".
Patient had low grade fever with an allergy to aspirin. Resident ordered aspirin. I asked the resident if she wanted to change it, she replied "no, put in the MAR the patient refused. She only has nausea and vomiting as a reaction to aspirin. I will put in for zofran too.". Are you kidding me? There are other medications to give for a fever! The attending fixed it, thankfully.
Ok, so most of these are about ridiculous orders actually related to diagnostics or interventions. How about just plain ridiculous? Here's one for you..."feed pt". An actual order I saw for a pt that was homeless and really only came in because it was cold outside and he didn't have anywhere to go. Not because he was diabetic and hadn't eaten or had taken too much insulin or meds or blah blah blah. I'm all about taking care of people, but seriously???
Ok, so most of these are about ridiculous orders actually related to diagnostics or interventions. How about just plain ridiculous? Here's one for you..."feed pt". An actual order I saw for a pt that was homeless and really only came in because it was cold outside and he didn't have anywhere to go. Not because he was diabetic and hadn't eaten or had taken too much insulin or meds or blah blah blah. I'm all about taking care of people, but seriously???
I've had a homeless person come in just like the one you describe above. I have fed them and will continue to do so. After I order a tray, I tell the doc I did so and have them sign the order. I've even offered the shower room to the homeless before. One time one of the docs discharged a homeless person during a Tornado Warning. When I told him I refuse to allow him to go out there, this particular doc gave me an attitude. So I spun around and told him how wrong he was. Then I proceeded to tell him, if he didn't back me up, I could easily become that "lazy nurse" on the team he talks nasty about and relys on ME to pick up her slack.....You rub my back I'll rub yours. Once the warning was disontinued, I personally gave this homeless man my umbrella.....It might be selfish but I sure did feel better that day ....and thought of this gentleman the whole night when I was home safely under my roof. Poor guy.
I was holding an ICU pt in our ED one day. She was doing badly and it was almost noon and I hadn't left her bedside since I came on that morning. Titrating, dripping, vitalizing, etc. She was high maintenace. Finally ICU rounded and the attending wanted an order written to bath the pt. The ED resident was rotating through ICU this day and told me about it but also said he wasn't going to write it as an order and he was very sorry. I lost my stuff. Like if the pt was stable enough for me to stop managing her meds and vitals and etc., I would wash her butt. Uh, no. I still have 4 other pts that I haven't laid eyes on. Chances are good at least one of them are very sick as this is the ED. She came straight to us from a NH. If there's a problem with her general hygiene then take it up with the MD who cares for all the NH pts. Today, this morning, here in this ED, her grooming WILL NOT BE ADDRESSED!! Some people are soooo out of touch!
:loveya:
I'm all about taking care of people, but seriously???
Vito Andolini
1,451 Posts
Did he mend his approach after that? I applaud your courage and sense of humor. How did your boss take it? And what did that jerk doctor have to say? :argue: