I had to follow you-know-who again last night, and this time, it was personal.
She flat-out refused to give her overdue meds.
Oh no she didn't!
The patient needed anti-epilepsy meds and Insulin at HS (you know, 2200). Well, I come in at 2300. The meds hadn't been given because they weren't there yet...the missing dose request hadn't been filled. Okay, that's fine. Pharmacy can take its sweet time quite often. Well, during report, the PO meds were delivered. (Or maybe it was right before report, when I was preparing my papers. Whatever.) She informed me that the insulin hadn't arrived. I told her that they couldn't send that through the tube system, so someone would need to hand deliver it, and that might be the hold up.
Fast forward to right after report. It was 2320, so I told Nurse Lazy McDumbass to give the PO meds and I would call pharmacy to ask if I could go and get the insulin pen. She agreed, and I called. The pharmacy tech told me it would be hand delivered to me shortly (after being on hold for a bit). I hung up the phone, and Nurse L.M. was standing there, med cup in hand.
"Oh," she pontificated. "What did they tell you?"
I explained it to her, and then she said, "well, you can do everything at once, then. He's sleeping, and I hate to wake him up."
"Uhh, I'll have to wake him up anyway."
"Yeah, you'll wake him up in five minutes, so what's the point in waking him up now and again in five minutes?" (gee...ya think meds to prevent seizures might be a good reason???)
"Actually, he'll be last, because he has a dressing change, so I'm going to see everyone else first."
She handed me the fucking cup. And got the hell out of dodge.
Now let's rewind for a tick.
Right after report, but before her refusal of cleaning up her shit, she went to clear her pump. (Saints be praised! This was truly a miracle!) And guess what...she realized she'd never scanned the damn IV bag in the first place, so she went in to scan it and learned...guess what...it was the wrong IV solution. And it had been infusing for five hours.
So, what did our wonderful healthcare professional do?
She told me what she did.
And attempted to leave the floor.
She didn't stop the IV pump. She didn't run to get a bag of the right stuff. She didn't apologize. She, of course, didn't complete a Safety First report. She told me "you'll have to put the right solution up." So she can not only make mistakes like a pro, she can give orders like one as well.
Praise the Lord, praise the Lord...praise the LORD that she is not in tonight. I'd most likely be a news item: "Nurse murdered in cold blood by oncoming shift...strangled by IV tubing."
Until next time...
Tuesday, February 24, 2009
Monday, February 23, 2009
The Curious Case of Lazy McDumbass
The title character of this story is a nurse on my floor. She works straight evenings, I work straight midnights, so naturally I oftentimes follow her (especially due to the plethora of 7p-7a/7a-7p'rs). I'm all for continuity of care, but I do NOT enjoy following this woman.
First of all, she watches me like a hawk as I prepare my report sheets. Perhaps she thinks I'm going to drop one of my nice pens or something. Who knows. All I know is that it disturbs me, mostly because the first words out of her mouth during report are "I didn't get to..." It never fails. No matter what the patient load, no matter what the acuity, she "didn't get to..." many things.
I'm not stupid. I know evenings are busy. I worked straight evenings myself for the better part of a year. I also know the things she is referring to, when combined, take less than five minutes. Which is, interestingly enough, the amount of time it takes for me to prepare my report sheets. Menial shit like emptying foleys and hanging up IV bags. Disconnecting patients from antibiotics. Checking to see if bed exit alarms are engaged.
Yet she has time to write long, weird progress notes. You won't find a note about a patient's fever, or a note about new onset slurred speech. No, you'll find a note about how the patient didn't want to eat his fucking dinner because dietary screwed up his order. That's not something for a damn progress note. Page dietary for a different tray. Lord knows they have plenty. Oh yeah, and she adds that the patient appears depressed because he didn't want to eat what he didn't order in the first place. No, slow one, he's not wanting to eat that. And if he's depressed, it's because you're his nurse.
My favorite thing last night, though, was "the doctor ordered 10mg and the pills are 20mg. That means you have to halve them." No shit! Really? I was going to have the patient bite the pill in half. Or maybe have her take one and then skip the next dose to even out the miligrams.
Speaking of that patient, apparently she "needs an HIV test." No, not because she has engaged in risky behavior, or because the physicians have ordered one or are thinking about it. Because Nurse Lazy McDumbass says so. I can't believe in this day and age that anyone, much less health care professionals, believe that there is a face of AIDS. Just because a patient has dental caries and a history of oral herpes...well, that just means the patient has poor oral hygeine and may or may not have a sexually transimitted virus.
I'm excited to experience round two of (ugh) perhaps five tonight.
First of all, she watches me like a hawk as I prepare my report sheets. Perhaps she thinks I'm going to drop one of my nice pens or something. Who knows. All I know is that it disturbs me, mostly because the first words out of her mouth during report are "I didn't get to..." It never fails. No matter what the patient load, no matter what the acuity, she "didn't get to..." many things.
I'm not stupid. I know evenings are busy. I worked straight evenings myself for the better part of a year. I also know the things she is referring to, when combined, take less than five minutes. Which is, interestingly enough, the amount of time it takes for me to prepare my report sheets. Menial shit like emptying foleys and hanging up IV bags. Disconnecting patients from antibiotics. Checking to see if bed exit alarms are engaged.
Yet she has time to write long, weird progress notes. You won't find a note about a patient's fever, or a note about new onset slurred speech. No, you'll find a note about how the patient didn't want to eat his fucking dinner because dietary screwed up his order. That's not something for a damn progress note. Page dietary for a different tray. Lord knows they have plenty. Oh yeah, and she adds that the patient appears depressed because he didn't want to eat what he didn't order in the first place. No, slow one, he's not wanting to eat that. And if he's depressed, it's because you're his nurse.
My favorite thing last night, though, was "the doctor ordered 10mg and the pills are 20mg. That means you have to halve them." No shit! Really? I was going to have the patient bite the pill in half. Or maybe have her take one and then skip the next dose to even out the miligrams.
Speaking of that patient, apparently she "needs an HIV test." No, not because she has engaged in risky behavior, or because the physicians have ordered one or are thinking about it. Because Nurse Lazy McDumbass says so. I can't believe in this day and age that anyone, much less health care professionals, believe that there is a face of AIDS. Just because a patient has dental caries and a history of oral herpes...well, that just means the patient has poor oral hygeine and may or may not have a sexually transimitted virus.
I'm excited to experience round two of (ugh) perhaps five tonight.
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