I Just REALLY Need To Vent.... - page 3

OK... how to do this and maintain confidentiality?? screw it.... got a patient from ER... the report was pretty benign, post partum a couple weeks, c/o pain for a week, n/v past few days. No... Read More

  1. by   darius000
    Hi Lori,
    As an ED Nurse in Australia, (or ER over there), I used to hate having to escort patients to ICU mainly because thay wouldn't listen and more often than not they would just totally ignore you. So I think that the ICU Manager thing is probably a worldwide phenominum.

    As for ED, I wonder how the patient was looking both physically and haemodynamically prior to them transferring her to your unit? The last ED that I worked at would never have transferred a patient to a ward that looked as though they were going to crash. I don't think you mentioned her age and general level of fitness and health but younger, fitter and generally healthy patients can compensate, haemodynamically, for longer periods.

    Another thing that I have noted in ED is that you can triage a patient, and even if you send them straight into ED, their history will be completely different from what they told you less than 1 minute ago.

    Anyway, sounds to me like you were doing all of the right things at the time, and can now look back and feel great about your actions.
    regards
    Patrick
  2. by   darius000
    Hi Lori,
    As an ED Nurse in Australia, (or ER over there), I used to hate having to escort patients to ICU mainly because thay wouldn't listen and more often than not they would just totally ignore you. So I think that the ICU Manager thing is probably a worldwide phenominum.

    As for ED, I wonder how the patient was looking both physically and haemodynamically prior to them transferring her to your unit? The last ED that I worked at would never have transferred a patient to a ward that looked as though they were going to crash. I don't think you mentioned her age and general level of fitness and health but younger, fitter and generally healthy patients can compensate, haemodynamically, for longer periods.

    Another thing that I have noted in ED is that you can triage a patient, and even if you send them straight into ED, their history will be completely different from what they told you less than 1 minute ago.

    Anyway, sounds to me like you were doing all of the right things at the time, and can now look back and feel great about your actions.
    regards
    Patrick
  3. by   susanmary
    And ... by the way Lori ... who took care of your other patients while you spent so much time on this admission/assessment/transfer? We all know/feel your pain.
    Good for you for following through. You ultimately saved her life.
  4. by   Fgr8Out
    Originally posted by susanmary
    And ... by the way Lori ... who took care of your other patients while you spent so much time on this admission/assessment/transfer? We all know/feel your pain.
    Good for you for following through. You ultimately saved her life.
    There were several factors that were in this patient's favor. First, I'm an experienced Med-Surg nurse of 7 years... I've had *some* ICU experience and can handle just about anything a patient can toss my way (except certain drips, i suppose)...I'm ACLS and have been an instructor for many years in CPR... and I had just discharged a couple patient's. so my load at the time of this 23 year old's arrival was 3. (It was a VERY slow day).

    I had 3 other RN's on the floor as well, one a Traveler orienting her very first day on our floor. She was a godsend and answered lights, changed IV bags, gave pain meds, etc... while the other 2 RN's assisted me with bolusing, monitoring the patients sats, set her up for cardiac monitoring with the one on our crash cart. (I've already written up one of our Hospitals "Thank you" cards for all of them, to let management know how truly amazing the group of people I work with ARE!!

    Mom is doing fine... she was (as i suspected) septic and shocky at the time of her arrival to my floor. After multiple antibiotics, fluids and some rest, she is up and about, caring for her adorable newborn. I was close to tears as I left her room, thinking about how much better her initial admission should have been... but also thankful that it hadn't turned in the other direction, which could have been even worse.

    Thank you, everyone, for your kind words, anecdotes and encouragement.
  5. by   susanmary
    Lori, glad to hear she's doing well. She was lucky to have had you as a nurse -- even if for only a few minutes.
  6. by   fedupnurse
    Lori, As an ICU nurse for 10 years now, I can tell you that this patient screamed ICU. Tele wouldn't have been enough for what she was going thru. You did the right thing. That is one thing I like about where I work. We get the occassional OB patient in ICU and occassionally the OB patient goes bad while still in OB and we and our OB nurses support each other very well. Sure there are some prima donnas who don't help anyone and that sounds like the charge nurse you were dealing with, but we have had good experiences. I know zippo about fundi and I'd assume the OB crew knows zippo about treating a hr of 170 and a falling BP. This is why we have different specialties. You did good Lori. Keep on advocating and I hope someday you get to deal with some of the ICU nurses like myself who would have gladly took this patient in a heartbeat. Now, inappropriate admissions I will fight to the death over because they take up the beds that patients like yours need!
    Hope she did well and hope if I ever have a kid I have a nurse like you looking out for me!

close