[peanuts75]

I work in a Community clinic for elderly (PACE program) and yesterday came to work and found a fax from a Board & Care home on my desk stating a patient of mine had vomited on Christmas eve w/vital signs scrawled at the bottom. (Proper protocol when someone gets sick after hours is to call the on call doctor. Which this B&C did not do) I quickly glanced at the vitals 114 systolic was reassuring. This person usually runs in the 170s or higher. I called the B&C to check on the patient and they said she was OK and had no further episodes of vomiting. I stressed not to fax the clinic after hours because no one is there and that they needed to call the urgent care # next time.
At the end of my day, as I was looking over the fax again and the diastolic taken at the B&C was 101! I called our HC nurse, and left a message for her to check on the patient, but it was late in the day yesterday. I'm assuming she is OK since I haven't heard anything from B&C. I am planning to talk to my manager about this and filling out an incident report. IS THERE ANYTHING ELSE I SHOULD DO TO COVER MYSELF? I FEEL LIKE SUCH A BAD NURSE

[Roseyposey]

The b/p was 114/101?

[GrumpyRN63]

I don't understand how this works ... Is this a wellness clinic ?? or is this an actual community health care center. If so Was the pt seen in the clinic for feeling ill? , Is there no medical person ( NP or MD) to evaluate these pts? It seems they failed to notify a medical person, you just received a fax re :the events for your file? How can you feel responsible 2 DAYS after the fact. Is it not a nurse who saw her initially? Additionally BP 114/101 doesn't make any sense, is it possible you miss read the DBP, just some thoughts.... I think the incident report goes to whoever dropped the ball, the 'person' who evaluated her... was the pt given a follow up apt, sometimes nothing will be done at that moment in time for a DBP of 101, pts get referred, not necessarily immediately treatment esp, w/ apparent hx of HTN"she usually runs in the 170's"Also, The BP may have been transiently high 2/2 the vomitting, I think your getting too worked up over this, more info needed JMHO

[PsychRN03]

Originally Posted by JKCMom

The b/p was 114/101?

that's not possible...is it? sound like the individual who too the BP incorrectly reported the systolic...maybe the 114 is actually 174 and the OP misread or the recorder incorrectly wrote the number or the fax copy is not clear

sorry for not really staying on topic

[TheCommuter]

Originally Posted by peanuts75

IS THERE ANYTHING ELSE I SHOULD DO TO COVER MYSELF?

Instead of worrying about covering your behind, it's now the time to be fully honest and forthcoming regarding this situation to whomever requests information. When all else fails, honesty is the best policy. Hopefully, the patient is okay, and this issue should fade from peoples' consciousness.

[peanuts75]

Thanks to all the ppl who replied. No, There are no nurses there... That's why they should have notified the on call doctor. I talked to my NM today and told her the whole situation. (I never intended to conceal anything from my NMs...I was just thinking about legal aspects and how to document this.) NM said I don't have to fill out an incident report, just document when I realized the bp was high and what I did about it....Notified NP, asked HC RN to assess her. Her bp could have very well been elevated 2ndary to vomiting. Yes, I believe her blood pressure was 114/101. Her diastolic normally runs in the 90s.

[fultzymom]

I would say there is nothing that can be done now to fix things. But take it as a lesson to read carefully and throughly next time and be thankful that the patient is ok.

Leslie