Quote from camiluvsNURSING
I have a question, this happened on my last shift.
I am a new nurse and this is my 4th week in the Emergency. I have had a full load since i started. My preceptor will go help in the Trauma rooms when an ambulance comes in or help the female nurses he has a crush on and usually i'm by myself.
A pt comes in through triage with numbness/tingling in his right hand has a hx of a TIA a month ago, no c/o pain and the triage nurse brings him to the room. I hook him up to the cardiac monitor, do a NIH stroke scale and swallow screen (no signs of a stroke and he passed the swallow screen) and do an EKG. I walk the EKG to the Dr.'s ask which one has this pt one of them took the EKG (which showed a 1st degree AV block) and signed it and gave it back to me. The Dr. (another Dr. not the one that signed the EKG) took an hour to come assess the pt. Then he calls a code stroke and i get questioned about the pt by my preceptor because he hasn't been around and he didn't know anything. He says i should have made the Dr. come sooner. He then says you better be glad the pt did not have a stroke (it was another TIA) or you would have been in trouble. Was i at fault? If so, how?
Whay was the patient triaged as. CTAS 2 ( or emergent) and the patient should have been seen by the ER Doc a hll of a lot sooner than an hour later.
Having been both the preceptor and the preceptee (you get it... both sides of the table) this guys sounds like a bit of a lame ass preceptor. Sounds like he isn't doing his job and is trying to cover his ass by laying blame on you.
From the sounds of it, the doc decided to assess further for stroke, but from you description of minimal "defecits" TPA woudn't be in the patients near future unless they had deteriorated in that hour.
Our version of "code stroke" order set covers all of hte bases (labs, CT, consults, etc.), but doesn't immediately indicate the patient is up for thrombolytics.