What has been your best catch or save!

  1. Greetings All Nurses,

    I posted this to ask you what is your best service or save you have done for a clients welfare. It can be a case that always stand out in your mind as a positive thing you did for a client. I know I have several but there is this one that I recall like it was just yesterday. It was over a year and a half ago. I was doing a travel nursing assignment in a very rural community hospital in Nebraska. We had I think 1 surgeon (general), 1 ortho and 3 family Docs on staff at the hospital. That was it! A CRNA did all the surgeries and it was her who actually helped me find a resolution to a desprate situation I found myself in.

    In mid shift of a 12 hour shift I got assigned a new admit. She actually was passed to me at 3PM during one of the shift changes. She had severe abdominal pain difuse in nature. Her abdomin was firm and she wanted something for pain. She had an order for regular tylenol and nothing else. So like the good nure I am I contacted her family Doc (a female) who had admitted her (at home). It had actually been her Doc's day off and she was being covered by some other Doc who I then called at the office. I talked with the office nurse and was told to contact the surgeon who had been consulted for this client. The surgeon was to have examined her in the AM but did not. He was now in surgery, just down the hall. I called back there to get someone to look at this client and hopefully get some orders. I was doing my very best to get someone down there STAT!

    My charge nurse was covering the ER and I was on my own! I finally got the CRNA to look at this girl, she started to do the normal pre-op questioning and exam, like nothing was out of the ordinary. When she palpated her abd. she (I could read her face) began to be very concerned got on the phone to the OR and told that Doc he had an emergent client! We preped her for surgery, like removing her tongue piercing, belly button piercing and finger nail polish, while the CRNA did the informed consent! We stripped her in nothing flat and put her into a hospital gown.

    The next day the surgeon stopped me in the hallway to tell me I had saved this girls life. He had not planned to see her till about 45 minutes d/t the fact he was doing a surgery that had been planned and it would have taken him that long to get to her in the hospital room. He told me she had an eptopic pregnancy that was the size of a grapefriut and ready to rupture. This will be the one I recall when I am old and gray!

    "I remember when I had a good day at work"! When I can say I actually saved a life! I did nothing that anyone else would have done but GOD it is a good feeling to have such a catch in my belt! I will take this one to my grave, gosh though for the life of me I can not recall her name, LOL!

    I have other experiences when I can say I did the extra mile for a patient. But none that so readily impacted a person's life as this. I have never worked ER or any units where this type of thing occurs freaquantly, so for me a lonely LPN this is as good as it gets!

    Peace,
    Have a Blessed Day,
    James (Jami) Ullman, LPN, Doula

    Visit my web site at
    http://www.geocities.com/4birthing
    or the club I founded for Midwifes and Doulas at:
    http://clubs.yahoo.com/clubs/columbusmidwifesanddoulas

    "During Childbirth pain is recognized as physiological and not pathological and therefore pain may not be a bad thing." - unknown

    "I am grateful to be connected to my inner sense of the 'rightness' of natural homebirth, but I find it totally bizarre that I have to become a modern-day Joan of Arc to accomplish that goal."
    - Piper Allan Severns
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  2. Poll: Have you ever had a life saving catch?

    • Yes, I think so

      10.00% 6
    • Yes, Absolutately

      70.00% 42
    • Not yet

      15.00% 9
    • not sure

      5.00% 3
    60 Votes
  3. 13 Comments

  4. by   CEN35
    Toooooo many times.......can't even recall most of them now
  5. by   radnurse2001
    Picture it--- Night shift, Cardiac step-down unit. 50 yearold post cath 3VD including left main. C/o severe crushing chest pain. nitro gtt as high up as we could go 10 mg mso4 iv over 10 min time frame. EKG changes in anterior leads. (CCU nurse said not MI) Called physician (cardiologist--got earful on word of CCU nurse) Called again 5 min later when reached second nitro plateau---Not relieved. Called back up cardiologist, Prepped for stat cath---closing left main---to or. Appology from first cardiologist--CCU nurse---gone. I was six months out of school. LEARNED REAL QUICK!!!!!!!
    OK-abdomen ridgid, difference of 50mm/hg in blood pressure r-l arms. C/o severe worsening back pain. Called surgeon stat-dissecting aortic anyurism---BEST SAVE.
  6. by   oramar
    GI bleed admitted to med/surg because he had good H/H. Everything looks good until 6am. He gives one good gag and in the next 5 min he brings up 2 1/2 liters blood. I am there with LPN with 14 med/surg patients on night turn. The house officer has just left. ER doctor is tied up. I call GI MD who has knows this patient. Say, "your GI bleed is now GI hemorrahage." "COME IN NOW". Call nursing supervisor who is experienced ER and ICU nurse. We get two lines in and run fluids wide open just like ER would do and get him to GI lab in ten min. GI MD meets us there. He looses two more liters of blood at least. Hgh drops from 14 to 5 something in very short time. Bleeding stops because they run liter after liter of blood and GI MD cauterized bleeding esophgeal varicies. In big hospital I know surgery would have been best bet but in small community hospital is takes time to summon team. This guy should not of made it. He just squeaked by cause I knew what I was doing and so did everyone else involved. It is better to have a very small number of people who know there **** and do it when things go bad than a bunch of people who run around and flap there hands in the air helplessly. Notice it was team effort. The little bit of help I had support me well.
  7. by   hoolahan
    Working in MICU, had a pt rushed in to us with profound hypotension. I couldn't get a BP, could barely feel a pulse. two residents came with pt, and are trying to line the guy up, RT is ambu'ing him. Since I couldn't get a good pulse, I grabbed a doppler to get a BP by doppler, and clearly "heard" a pulsus paradoxus. I said to the resident, is this guy in tamponade? He went back and compared the CXR from admission to now, and sure enough, widened mediastinum. Turns out it was a rare instance of a cardiac cath turned tamponade, the wire must have made a small puncture that bled slowly until he couldn't compensate any more . Rushed him up to the cath lab and he had a pigtail catheter placed, after he was tapped. He improved immediately.

    The best was the look on the resident's face when he came back and asked me how did I figure that out? He couldn't believe that just good assessment can identify a problem.
  8. by   KARRN3
    FLOATED TO MEDICAL TELE FROM SURGICAL STEPDOWN,GOT A FLUFFY PT IN FOR SYNCOPE. PATIENT DIDN'T LOOK RIGHT TO ME SO I GOT A STAT H AND H,WHILE WAITING RESULTS UPDATED CARDIOLOGIST ON VS, PT NOT LOOKING WELL BUT NOTHING CONCRETE.MD ASKED WHO ORDERED H/H-WELL, THAT WOULD BE ME,THE NURSE-HE WASN'T AMUSED.BUT WHEN H/H CAME BACK 4 AND 13 FROM RETROPERITONEAL BLEED HE FORGAVE ME.
  9. by   night owl
    saved my husbands life one evening at dinner. he was choking on a piece of steak, and one evening when my daughter was 2 1/2 years old, she choked on a pierogie. to this day she still calls them "chokies." they were the two best "saves" of my life!
  10. by   Peeps Mcarthur
    NOC shift, as an RT. A quiet rehab hospital with no docs. The RN calls me to a patient room to observe and ask me what I think...........after I get up off the floor from the shock of actually being asked my opinnion.............I went to observe the patient, and although things seemed to be in order, "something" was not right about it. He seemed to be sleeping soundly, it was just that he never did sleep THAT well.
    Protocol indicated ABG's per rt P pulse ox spot check(I forget the exact perameters, it was ten years ago)...anyhooo, the RN asked me to proceed since she wanted to make sure before calling the doc. It was actually up to me ......I wrote the protocol order for ABG's ,drew it, ran it through the analyzer, and interpreted the results(like I said t was a small rehab hos). I determined from the results that the doc did indeed have to be called, and the pt was likely to require intubation .....The doc was as noncompliant to commands as the pt, and would not answer his pager(imagine that ), so guess who needed to intubate him .....It was a bit more difficult than it had been on Resusiannie in ACLS class(thank God for that training), but I had successfuly done all the things the doc would have done before he got there. All these procedures were called for, and my actions were protected, and certainly called for, under protocol. The patient would not have survived without my intervention.
    The doc, of course, changed all my initial vent settings, and scolded me that the tube was placed incorrectly(I had bilateral breath sounds, and blood gases to verify his ventillation, his pressures were not remarkable) I got scolded by everyone.....except for the RN that never showed her approval in front of others for fear of political incorrectness ..............I knew that my actions were on the very outside of my authority, and knew that because of that, any mistakes would be magnified many fold, but I also know, in my heart, if not for my actions the patient would have died..............So yea, it was a "save". It was also the defining reason I quit RT ironically enough. I guess it could be defined as bittersweet at best.
  11. by   Jenny P
    I tell my patients and co-workers that I'm not an "adrenaline junkie" (the term they use on "Truma" on The Learning Channel); so I plan to make sure that I have a "boring shift" every night! That means I find and fix the little things before they become big problems.
    Through the years I remember many different "saves;" but like Rick, they are too numerous to count. Nowadays, I find I'll have an interesting night when I come in and am told "I asked for you to be assigned to this patient; he/she really needs your care."
  12. by   P_RN
    I'll add mine to the "more than I can mention."

    Probably a dozen or more PEs, a couple of MIs, one tamponade....guy had AIDS and didn't make it.....I always wondered if he had been negative if the team would have tried harder.....I'll never know...not a save that time.

    Two Heimlichs with another nurse in the cafeteria......A witnessed MVC where another driver and I got a gal out when her car had run into a swampy area and started to sink......


    And a Partridge in a Pear Tree.......

    Gosh goodness......there has been a lot of adrenaline rushing .
  13. by   moonchild20002000
    Too many to even remember!!!!!
  14. by   Iam46yearsold
    My first save was a young woman came in c/o anxiety. She was a little tachycardic and diaphoretic. The doctor was thinking strange and or drug use initially. I got him to order a CT Angiogram. Sure enough there she was with almost a complete saddle bock pulmonary embolus. They used Streptokinase on her and she walked out of the hospital 2 weeks later. That was back when I was a young RN
  15. by   ElvishDNP
    I used to work at a community health center, which pretty much did primary medical care for a lot of un- or underinsured people. Wednesday mornings usually got started slow, as the docs/PAs/NPs had weekly meetings at a different site. So it was just the nurses and office staff that morning when a guy shows up with a bellyache. He was febrile, n/v...and he just didn't look right. I sent him to the ER and he ended up having a gangrenous appendix. Ick.

    Have had a good number of babies go bad, and it pays to be johnny-on-the-spot with that. A couple that have gone from in-room-with-mom to doing poorly with NEC in a matter of hours, but we caught it in time and babies were ok.

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