Just For Fun

[Brenda K Hutson]

Well, along the lines of "scary" scenarios: RN sent for unit on patient (pick-up slip was a duplicate; 1 copy went back with unit and 1 stayed in BB). We received a call a little later for the Nurse, complaining that we sent her blood on the wrong patient (now the fact that she had hung the blood, obviously without checking it with another RN and/or the patient armband, was besides the point). We told her we sent the blood for the patient requested (and we had 1 slip to prove it). So she said, "well that is not the patient I asked the clerk to send for;" still not taking responsibility for her actions. On the good side, the unit was group O so no reaction. On the bad side, the patient's children found out about it; Oh, and did I mention that 1 daughter who was a doctor and a 2nd who was a lawyer?

Moral of the story: If you are going to ***** up, check the family history first!

Brenda Hutson, CLS(ASCP)SBB

Hmmmm...not sure how my ***** up turned into ***** I did not say anything like that?? That is a little disconcerting.

Brenda

[Brenda K Hutson]

Hmmmm...not sure how my ***** up turned into ***** I did not say anything like that?? That is a little disconcerting.

Brenda

Ah, so it looks like certain words automatically turn into ****. Sorry, I don't think the word I used was bad so not sure what is up with that (maybe it depends on the context in which that word might be used; not sure). Honest, it is not what one would think of when seeing the ***. Ok, reworded: "If you are going to make a mistake like that, check out the family first."

Brenda

[Marilyn Plett]

During the middle of a surgeon's tirade on inadequate inventory, I calmly interrupted to ask when he had last donated blood. He paused and stuttered a little. I had his blood donation within 24 hours.

There's always at least one doctor who's confused as to why the antibody screen was negative last week but positive this week following transfusion. Must be error on our part rather than textbook-perfect primary immune response!

[lef5501]

Scary situation:

An OR doc decided our plt pheresis were taking too long to arrive so he himself called another area hospital and told them to send him their plts. Only way we found out was because the other hopitals tech couldn't remember which hospital had called and was checking before sending them. So much for that units final disposition.

Same OR doc and same patient also decided our PRBC's were taking too long and "hijacked" our units when the courier delivered them. The OR tech grabbed them from the courier and was bringing the ARC box into the OR. Didn't matter to the OR team that their patient was an A Pos with an antibody and that box also had some B units in it, as well as the A units.(not antigen typed yet, mind you)

[tricore]

Favorite diagnosis: fawn willow bronze disease

[KKidd]

Love all these replies! My 2 funniest and scariest (do to wondering where the knowedge levels of RNS and MDs are sometimes) was the nurse that came down in the middle of the night to pick up blood on a B pos patient. We crossmatched B Neg as the units were shortdated and we wanted to not waste them as there is many less B neg that B pos patients. She questioned up and down the "wrong blood type" I explained to her the whole its perfectly fine to transfuse Rh neg blood to an Rh pos patient just dont do it the other way. Showed her a blurb in the technical manual stating such as well. She took the blood and returned in about 15 minutes saying there was no way she could give this blood to the patient. Ended up having to call the pathologist on call at like 2 am to explain it was perfectly fine to her and since it was a doctor explaining it she finally took it.

The other scenario is the patient they took to the OR and drew a crossmatch specimen while the patient was on the table that ended up with an antibody. The tech working it up kept trying to explain the delay and the doctor said "well just give me O negative".

How about the doctor who has to give Rh specific plasma? We had another hospital call and ask if we had O neg FFP. I said that I could send some O pos. The pathologist/med. director would not accept it. I hope they found the O neg plasma for the patient

[BenchTech]

Scary situation:

An OR doc decided our plt pheresis were taking too long to arrive so he himself called another area hospital and told them to send him their plts. Only way we found out was because the other hopitals tech couldn't remember which hospital had called and was checking before sending them. So much for that units final disposition.

Same OR doc and same patient also decided our PRBC's were taking too long and "hijacked" our units when the courier delivered them. The OR tech grabbed them from the courier and was bringing the ARC box into the OR. Didn't matter to the OR team that their patient was an A Pos with an antibody and that box also had some B units in it, as well as the A units.(not antigen typed yet, mind you)

I can't even imagine in what universe that someone would think that this is okay!! So what happened? Please tell me that there were repercussions for everyone involved....

[John C. Staley]

How many of you remember the first time you saw SOB as a diagnosis? I was an ER admission clerk at the time. I asked the doc if it meant what I thought it did and he said "probably" but not to tell anyone!

[Sheila]

LOL at these. The bit about nurses being unwilling to give Rh Neg blood to Rh Pos patients occurs so frequently here that I purchased some neon-green stickers that read, SAFE ALTERNATE BLOOD TYPE and I plaster the bag and the form with them. This has helped a lot, although there are still a few that don't believe the sticker, either.

One of our patients has four antibodies, and of course his providers never remember to order his blood in advance. The last time he was in, the doc called to ask what the hold up was and I explained (I thought) about the antibodies, and the doc then says,

WELL JUST SEND UP SOME O NEGATIVE. They think O Negative solves every BB problem in the world.

Lastly, the funniest thing I've heard a doc say was uttered by one for whom English was a second language. His patient was bleeding and he came down himself to sign out blood. We asked how the patient was doing (wanting to get an idea of how many more units to set up), and while looking at the floor and shaking his head slowly back and forth, he says:

"This patient is probably very terrible".

Since then, anytime there is a patient circling the drain, so to speak, we refer to the patient as "probably very terrible".

[tbostock]

Couple of my favorites:

From a nurse: "Could you spell WBC?"

From a nurse: "I just ordered a urinalysis test...are you gonna want us to send a urine with that?"

From a nurse, after I tried three times to spell potassium to her, and told her to just put down "K". She didn't understand that, and I said..."um, the chemical symbol for potassium?"...she said "what is a chemical symbol?"

From an MD (hematologist), just the other day, when asked he ordered irradiated products for a GI bleed: "I thought that if you irradiate blood, they never make antibodies"

From a patient, after being in the bathroom for an hour to collect a semen analysis: "I'm sorry, I just couldn't get it to the fill line"

[L106]

Terri -

I'm glad it is late afternoon here and no one is around my office. (Otherwise people would be coming in and asking me what I'm laughing so hard about!!)

Seriously, Everybody, this thread is a barrel of fun!

[donellda]

How many of you remember the first time you saw SOB as a diagnosis? I was an ER admission clerk at the time. I asked the doc if it meant what I thought it did and he said "probably" but not to tell anyone!

I've always gotten a kick out of that one. The diagnosis that got my attention one night was "boil on ****":eek:

I got bleeped!! BUT you get my drift.

[swede]

We received a phone call one lovely morning from a nurse stating that she had just figured out that she hung a unit of blood on the wrong patient ( Apos to Opos, her nurse manager's father!) and she wondered if we needed to know that. Of course the response was WHAT...OH MY GOD! She said, "Well you don't need to make me feel bad.....besides, I gave him some Benadryl!" We were so thankful that he wouldn't be itching as he entered the pearly gates .

Amazingly, the patient did not die.....

[Brenda K Hutson]

Wow, I am really enjoying hearing "your" tales.

I saw some related to misspelled diagnosis; I wish I could remember some because I know I have seen that also.

This isn't nearly as funny as most of the former posts, but it is in relation to trying to get an accurate history on a patient; either because you got a positive antibody screen, or because they want to extend the specimen > 3 days (so you need to confirm no pregnancies and/or transfusions in the past 3 months):

1. At one place (where we still received paper reqs.), the history question for the sake of extending specimens was 2 separate questions with a box: Have you been pregnant in past 3 mos. and Have you been transfused in past 3 mos. We would get some that said NO transfusions in past 3 mos., even though they were being transfused weekly! So, I was threatening to take away the option to extend specimens if they were not more diligent. So the last straw was getting the req. that said YES, the patient has been pregnant in the past 3 mos. Problem?? It was a male! Upon calling the Nurse to complain, they just laughed. Didn't quite see the importance of the accuracy of the question.

2. With a positive Antibody Screen, I once called a Nurse on the floor and asked her to ask the patient if they had ever had any pregnancies and/or transfusions. The Nurse put me on hold; when she came back a few minutes later, she replied (quite indignantly I might add): Of course she isn't pregnant; she is 83 years old! NEWS FLASH; thanks for your help Nurse..

Brenda Hutson, CLS(ASCP)SBB

[Nicki]

I think it is how blind some people are.... a broken fridge with a very prominent label saying out of use, plus brown parcel tape around the door several times (old fashioned fridge with no lock), warm inside as its off, and someone took the tape off and put PLATELETS in it!!

[Mary**]

I once saw the diagnosis: "eats light bulbs".

[lateonenite]

I had a doctor query an automated diff result.

Dr: Can you tell me the automated diff result for ****?

Me: Let me just look that up....no I'm sorry, I can't, the automated diff is unreliable as the total white cell count is <0.1(x10^9).

Dr: Well, umm what does that mean?

Me: let me just have a look at the previous, well on the last FBC there was "1 neutrophil seen" on the film - there just simply aren't enough cells to get an accurate result from the analyser.

Dr: Does that mean I have to put more in the tube?

[kate murphy]

My favorite diagnosis: Dead battery.

I hoped they meant a pacemaker battery....

[skopti]

I was training few nurses on the use of a computer application, I said now right click the mouse when one of them said: I am left handed, how can I right click?..... I started teaching them the basics of using a mouse instead of what they were there to learn

[LAS]

My favorite was "right overrain sist"

I saw a warning sign in a research lab once that said "WARNING - DO NOT STARE AT LASER WITH REMAINING EYE."

Edited August 19, 2009 by LAS
more to add...

[KKidd]

ALthough I haven't heard it in awhile, nurses used to call for the bun results on **** in room xxx. I always wanted to ask if that was a hamburger or hot dog bun.

:imslow:

I also love the fact that I should know who is in room 432B. But I digress.....

One diagnosis I remember is "arm don't work". I've been told that the ER registration personnel have to enter it exactly as they hear it!

[Sheila]

Another good one is when the phone rings and the nurse asks, "You got any blood for this hip?" Or this colon, this heart, this lung, etc. Poor patients are only a body part sticking out of the drapes to the OR nurses.

Fave diagnosis: FBR (Foreign Body Rectum). Most recent was a LARGE home-grown cucumber. Patient had a perforated colon and ended up with a colostomy. Same patient had FBR five years ago; a "gourd" in that instance.

What do you want to be that "Veggie Tales" is his fave cartoon?

[swede]

The OR calls all the time to ask how many units we have available for Mr. XXXX. We do electronic crossmatching, so we usually ask them how many do they want. They of course keep saying well how many do you have. So we answer that currently we have 45 on the shelf! Then they say, "Well you don't have to be obnoxious!" Well, then how many do you want??????

We had a patient come in to ER with the diagnosis....."wants to be a witch"

We also had a panicked ER doctor call out one night (yes, I was a witness) "Hurry get me uncrossmatched blood. Get me the universal donor.....get me B pos!"

[L106]

Oh, Sheila...........Life around here just hasn't been the same since we no longer get the diagnoses printed with the pt's demographics!!

[Barb Thompson]

Most memorable diagnosis: "hard won't go down"

Scary scenario: Mom O pos, Anti-E, baby O Pos, positive DAT. Doctor (yes, the doctor!) calls and tells me I am wrong; the baby can't have a positive DAT because the mom and baby are the same type. I explain about the Anti-E, and he tells me that's just a minor antibody!

Had a mom with an anti-D titer>2000 at delivery, doc demanded RhoGam. It was the mom's 5th baby, 2 previous babies did not survive, and the docs did not know why. Her prenatal Anti-D titer was 16, and no one noticed. They never checked the baby's H&H, so at 5 days old, the baby was in PICU with a Hgb of 5. The pediatric hematologist thought the baby's positive DAT was due to an ABO incompatibility, but the mom was A neg and the baby was A pos.

Also, had a patient with Anti-c and 2 other antibodies. The tech did not complete the workup the night before surgery (I guess multiple antibodies confused him), so it didn't get sent to the ref lab until the next day (the day of the surgery). OR was notified, and they took the patient in anyway. Of course they needed blood super stat. I was already at home, when they called me. I told them not to emergency release any O negs....they didn't believe me and called the path. Guess what they gave? Yup, O negs!.

We also get calls about room numbers. I ask them to call back when their room number has a name.

Along the same line....I inspected a lab that had in their collection policy that the 2 independent patient identifiers were name and room number!