[MadisonsMomRN]

WOW.

I found out the he had an ulcer that perforated! Very serious condition. I don't understand... he denied pain when I asked him. I did read however that some people do not have pain just the nausea and vomiting. He had a pretty involved surgery, repairs etc and a lot of antibiotics.

No wonder he was in ICU...

He is doing better though. They aren't sure when he will be discharged.

I will find out more when he's actually discharged back to us and I see his paperwork from the hospital.

All I can say is **whew**. It really does feel good to make a good judgement call without seeing all of the symptoms involved... and just based on the assessment.

It makes nursing so worthwhile to see that I played a part in him getting the proper care he needed in an emergent time of need (obviously when no one else agreed.) SO SO glad it was a positive outcome.

[JailRN]

Good for you!!! We nurses need to trust our 'gut' feelings and not back down just becaues the detention satff doesn't like it or is inconvenienced by our decisions!

[JailRN]

Again, good for you...the nurses are the ones with the license to loose, not the security staff..they need to learn about liability, liability, liability.............you trust your judgement and your gut.....

[MadisonsMomRN]

Security tries to be intimidating... I hate that. Your right. We are the one with the license. I wont risk that for anyone!!

[sirI]

Threads merged for continuity.

[pattilpn2]

Originally Posted by MadisonsMomRN

WOW.

I found out the he had an ulcer that perforated! Very serious condition. I don't understand... he denied pain when I asked him. I did read however that some people do not have pain just the nausea and vomiting. He had a pretty involved surgery, repairs etc and a lot of antibiotics.

No wonder he was in ICU...

He is doing better though. They aren't sure when he will be discharged.

I will find out more when he's actually discharged back to us and I see his paperwork from the hospital.

All I can say is **whew**. It really does feel good to make a good judgement call without seeing all of the symptoms involved... and just based on the assessment.

It makes nursing so worthwhile to see that I played a part in him getting the proper care he needed in an emergent time of need (obviously when no one else agreed.) SO SO glad it was a positive outcome.

YES!! that is what makes our day, when we can see/feel "something's up" and act upon it regardless of what others say/do. I'm sure the "other side" is realizing (or i hope they do) that we are there to do just that.I'm still in orientation for my 1st "jail time"( lol!!) and i'm sure loving it compared to the war..oops...i mean work zone's i've been in (med surg/ltc). I sure do appreciate you writing in to tell about his symptoms/progress.Last time i took care of a perf. ulcer pt i felt he was going to go into DT"S, warned everyone, nurses and doc-i asked for librium for him and was told to "watch and wait", well lo and behold i come in one night and catch this guy up standing, stretching his central line across the room as well as his NGT. I go in to check him out and he tells me that he is up because "the urinal that you gave me has a hole in it", says "there it is, go look for your self", i look down at his chair and there is his incentive spirometer leaking with urine so there i go calling the md for that librium and some ativan at 2am. gee i felt sooooo bad for calling at that time of the morning. Please keep us posted, i'm sure he will thank you when he gets back to you. Keep up the good work!!!!

[CookieCritter]

Originally Posted by MadisonsMomRN

Security tries to be intimidating... I hate that. Your right. We are the one with the license. I wont risk that for anyone!!

Bingo! I am with you on that. You have everything to lose and the public will put on a trial of public opinion first like they did in the case of the Florida boot camp death if something went wrong and you didn't demand further care.

Those guards turned on the nurse right away after the teenager died and the public felt the nurse should have known better then the guards. I in fact couldn't even find one nurse who would defend her either.


Sounds like some of your officers need a little more training or a refresher course before they end up in some huge lawsuit. They should know that if they are jail deputies for a county then the local sherrifs will always choose to defend and hire attornies for patrol deputies over detention ones. The brass will always give the least amount of energy and funds to the detention side.

They are fooling themselves if they think even their own agency is going to bail them out of certain liabilties like an inmate dying because they refused to transport even though you and the other nurses suggested that. They need to remember the line that they are using in some areas that have been through this "whatever the nurse says is what we're doing next"

You stay safe and continue to make the decisions that are correct for you and your patients.

[MadisonsMomRN]

Thank you! When the officers questioned his "needing" to go to the hospital, I told them he HAD to go. Then I said "Should I call 911?" They said "no, we will transport." I can still see that half wit officer looking at his watch saying "you want him to go now?" Ugh... yes moron. Now. He cannot be allowed to wait. LOL I didn't say that but was surely thinking it.

Assessment question here... why do you think his temp was low; at 95.5? I took it three times and it was about the same. Was it due to bleeding? Or maybe didn't have anything to do with it. My thinking cap isn't on and wasn't on then either because I didn't understand why is was low.

[MadisonsMomRN]

Where did that LOL come from...

[Angie O'Plasty, RN]

Originally Posted by MadisonsMomRN

Thank you! When the officers questioned his "needing" to go to the hospital, I told them he HAD to go. Then I said "Should I call 911?" They said "no, we will transport." I can still see that half wit officer looking at his watch saying "you want him to go now?" Ugh... yes moron. Now. He cannot be allowed to wait. LOL I didn't say that but was surely thinking it.

Assessment question here... why do you think his temp was low; at 95.5? I took it three times and it was about the same. Was it due to bleeding? Or maybe didn't have anything to do with it. My thinking cap isn't on and wasn't on then either because I didn't understand why is was low.

Sounds like he was in shock.

http://0-medlineplus.nlm.nih.gov.cat...7.htm#Symptoms

An examination indicates the presence of shock. There is usually low blood pressure, rapid pulse, and low body temperature.