I feel so stupid. What should I have done?

You absolutely did the right thing. Elderly can quickly become septic with a UTI. If they are unable to communicate what hurts and when, how would you know! I worked LTC for a very long time, and the son is just being a jerk, he doesn't like spending Mom's money for her. I've seen it time and time again.... We even had one man who's brother was his POA and he would come to our meetings and say.... "why does he need this or that, there should be something left over to give his nieces and nephews..." What about the residents quality of life, he isn't dead yet?? Good job you probably saved a hospitalization with sepsis and further grumbling from the son....

You absolutely did the right thing. I think some family members will complain, no matter what. Why were they so upset that she was sent to the ED? If it was my mother, I would be happy that they were pro-active, checking everything out.

I had sepsis twice before. Both times I was admitted with IV antibiotics. The last time that I had sepsis, I had no warning signs. I was totally asymptomatic, and woke up in extreme abdominal pain, had shortness of breath, nausea, vomiting, and was in so much pain that I could barely walk. So, I can see how it can just sneak up on you. Again, I reiterate that you did the right thing.

Just tell the son you didn't bring your Superman Xray Vision Googles to work that day so you weren't sure if it was her hip or not!

You were in the right , sent her to the ED to get evualated you can't diagnos her because thats not in your scope of practice ..... sometimes the patients family are clueless on how everything works and demand things that are out of our control in many situations !!! don't feel bad or stupid everything you could have done you did .

Sounds like you did the right thing, UTI's in elderly can be so tricky! I am a new grad, so I don't have much nursing experience to share with you, but my first degree is in psychology and this is where I can add my 2 pennies!

You can actually use one of those textbook phrases on the son; "It must be so difficult for you to see your mother in so much pain."

Unless this is his everyday attitude, the son isn't a jerk nor does he really think it is 'all your fault'. He's scared and angry that his mother is deteriorating and he has zero control over it. He feels powerless and is projecting that fear and anger onto the closest person, you.

Try the above phrase and see if he is able to open up. We meet people in the most vulnerable states and often take the brunt of outbursts. You did a great job at critical thinking, don't let the incident take that from you.

I agree with everyone else. You did the right thing. Who knows she could have been having flank pain that felt like hip pain. I have found with the elderly that for some reason UTI's lead to confusion or more confusion in pt. As said before they can become septic very quickly. The right thing to do is send them to the ED, which you do. Also do thank you CNA for catching something. She will be more likely to come to you with things.

I also think you did the right thing.

Better safe than sorry.

Every patient experience provides us a learning opportunity-we learn and grow and may do the same or different next time.

otessa