Would You do the same thing I did? - page 3

would you do the same thing i did? was it really a crime and ground for termination? or i am missing something? i am a lvn here in san diego working in a small hospital which am employed for... Read More

  1. by   smk1
    I probably would have called 911. Maybe it would piss off the medics and ER staff, but if my kid has a temp of 104.2 with N/V and a severe headache and I can't get to him, 911 seems appropriate. He needs to be evaluated ASAP. If they decided he dosen't need to go by ambulance then they don't have to take him. In any case get a professional over there to decide. Maybe he would be fine going in a cab to the ER, but then again maybe not. I would have called and talked to him myself first though. In any case hope your child is doing fine. Maybe going in to talk to the supervisor could help smooth things over. Have a plan in place for how and why this will not happen again. Maybe it will help.
  2. by   oneLoneNurse
    Yes, I think calling 911, for a temp over 104 is prudent. Maybe its not as important in a child, BUT if you can't leave work, what are you supposed to do? I would want to ensure the child is OK. If the EMT has a child he/she might understand.

    Not an expert, BUT I think people in trouble of a certain generation or bent don't call 911 when they should and then there are others who call 911 too much. In this case, you either needed an adult with assessment skills there, or you did not. If it were my child I would have erred on the conservative side.
    Last edit by oneLoneNurse on Nov 15, '07
  3. by   ERRNTraveler
    Quote from TazziRN
    Ummm.........a fever is not a legitimate reason to call 911. A call to 911 for a teenager with a fever will result in a very ticked off paramedic and a disgusted ER nurse.

    Tazzi, I think you & I are the only ones who feel this way. *sigh*
  4. by   CyndieRN2007
    I'm very sorry. I have a young son, and I work nights too. Its very hard when they are sick. Again, Im so sorry. I can relate.
  5. by   CyndieRN2007
    Quote from TazziRN
    Ummm.........a fever is not a legitimate reason to call 911. A call to 911 for a teenager with a fever will result in a very ticked off paramedic and a disgusted ER nurse.
    Depends. Fever of 104 might be depending on accompanying s/sx.
  6. by   Daytonite
    no, i wouldn't have done the same thing you did. i think you overreacted. nursing treatment of a fever is taught in fundamentals of nursing. it is only an emergency if the person is having difficulty breathing, swallowing, has a stiff neck, severe headache, is confused, drowsy or has gone on to have seizures. the home treatment is lukewarm bathing, giving an antipyretic such as tylenol and checking the temperature every 30 minutes to see if the fever is coming down. this is what you should have told your wife to do until you were able to get home. then, you should have waited until the supervisor gave you permission to leave. you got emotional and dramatic instead of being rational. that was a mistake. you weren't acting like a prudent nurse at all.

    i worked on an online nursing advice service for a major medical insurance company and we got calls for this kind of situation all the time. we constantly told, and gave those same specific instructions to people all the time. we also instructed them to go to an urgent care facility or their doctor's office. a fever of 104 is not a 911 or er emergency. fyi. . .many insurance companies won't cover an er claim for a fever of 104 unless the patient is admitted as an inpatient.

    were you reported to the state board? i'd be more worried about losing your license over this.

    by the way, how did this all turn out for your daughter. is she ok now? what was the reason for her fever? did they ever find out? as you look back on this, would you have done the same thing?
  7. by   CyndieRN2007
    Quote from daytonite
    no, i wouldn't have done the same thing you did. i think you overreacted. nursing treatment of a fever is taught in fundamentals of nursing. it is only an emergency if the person is having difficulty breathing, swallowing, has a stiff neck, severe headache, is confused, drowsy or has gone on to have seizures. the home treatment is lukewarm bathing, giving an antipyretic such as tylenol and checking the temperature every 30 minutes to see if the fever is coming down. this is what you should have told your wife to do until you were able to get home. then, you should have waited until the supervisor gave you permission to leave. you got emotional and dramatic instead of being rational. that was a mistake. you weren't acting like a prudent nurse at all.

    i worked on an online nursing advice service for a major medical insurance company and we got calls for this kind of situation all the time. we constantly told, and gave those same specific instructions to people all the time. we also instructed them to go to an urgent care facility or their doctor's office. a fever of 104 is not a 911 or er emergency. fyi. . .many insurance companies won't cover an er claim for a fever of 104 unless the patient is admitted as an inpatient.

    were you reported to the state board? i'd be more worried about losing your license over this.

    by the way, how did this all turn out for your daughter. is she ok now? what was the reason for her fever? did they ever find out? as you look back on this, would you have done the same thing?
    sometimes, people act emotional and dramatic when it comes to the safety and health of their children. as a mother, i can absolutely relate.

    one question, do lvn's in icu take their own patients?

    how is your daughter doing?
  8. by   patwil73
    Quote from daytonite
    no, i wouldn't have done the same thing you did. i think you overreacted. nursing treatment of a fever is taught in fundamentals of nursing. it is only an emergency if the person is having difficulty breathing, swallowing, has a stiff neck, severe headache, is confused, drowsy or has gone on to have seizures. the home treatment is lukewarm bathing, giving an antipyretic such as tylenol and checking the temperature every 30 minutes to see if the fever is coming down. this is what you should have told your wife to do until you were able to get home. then, you should have waited until the supervisor gave you permission to leave. you got emotional and dramatic instead of being rational. that was a mistake. you weren't acting like a prudent nurse at all.
    Quote from vnsam
    my wife on the other hand (also working that night) called me on my cellphone at 0400, telling me that our son called her and telling her that his sister has a temperature of 104.2f orally with severe headache and with occational nausea and vomitting.
    i keep seeing posts that say you shouldn't be too worried about a high fever that appear to be ignoring the other symptoms - namely severe headache. the child was worried enough to call the parents at work in the middle of the night so he (the child) felt like he couldn't handle the problem. the other child was either 15 or 14 years old so i don't think asking for a rectal temperature from a brother to a sister is appropriate. no adult is available at home (not uncommon with teenagers in working households).

    we of course don't know any history with the child or the original poster's working relationship (other than he says he hasn't been in trouble), but the symptoms are troubling. we don't know if they tried tylenol prior to calling their parents, or if they did anything else.

    imagine you had a patient that suddenly (in the middle of the night) presented with a temp of 104.2 orally, severe headache, and nausea and vomiting. would you call the doctor? would you be concerned and upset if the doctor ignored you and gave you no orders?

    as the supervisor at my hospital one of the things i get to do is lead our medical response team that responds to concerns from the staff regarding patients. after each incident i review the chart and try and meet with the rn to go over what i discovered. often times there are warning symptoms that have made them uneasy, but they didn't call until too late. i am constantly reinforcing "if you are concerned, please call". i would rather be called a few times for nothing, than always be called when i have no choice but to code or transfer to icu (i'm not saying this rises to that level - but the poster was concerned, and should act on that).

    hope this helps,

    pat
  9. by   CHATSDALE
    can a minor present in er with a minor sibling without adult??
    a fever of 104+ that continues several hours with n/v and extreme headache can be the s/s of a very serious condition[s]

    you should have been notified by your supervisor when your wife tried to get in touch with you, the fact that you were not was because they didn't want you to leave early..they had the option to call someone to come in early or the 'staffing' problem could have been postponed and she could have pitched in - if you had caught op on your work there would probably be less to do at that time

    if this comes up before the board as abandonment stand up and fight it
    1] you were kept uninformed of a situation that could have been very dangerous to your family
    2] you gave report to your immediate superior and notified themthat you were leaving, you didn't just walk out
    3] your children were following proper instructions in looking out for each other while you were at work, they were old to be left alone but they are still too young to take complete charge in an emergency

    my best wishes for how this turns out
  10. by   CyndieRN2007
    Quote from patwil73
    I keep seeing posts that say you shouldn't be too worried about a high fever that appear to be ignoring the other symptoms - namely severe headache. The child was worried enough to call the parents at work in the middle of the night so he (the child) felt like he couldn't handle the problem. The other child was either 15 or 14 years old so I don't think asking for a rectal temperature from a brother to a sister is appropriate. No adult is available at home (not uncommon with teenagers in working households).

    We of course don't know any history with the child or the original poster's working relationship (other than he says he hasn't been in trouble), but the symptoms are troubling. We don't know if they tried tylenol prior to calling their parents, or if they did anything else.

    Imagine you had a patient that suddenly (in the middle of the night) presented with a temp of 104.2 orally, severe headache, and nausea and vomiting. Would you call the doctor? Would you be concerned and upset if the doctor ignored you and gave you no orders?

    As the supervisor at my hospital one of the things I get to do is lead our Medical Response Team that responds to concerns from the staff regarding patients. After each incident I review the chart and try and meet with the RN to go over what I discovered. Often times there are warning symptoms that have made them uneasy, but they didn't call until too late. I am constantly reinforcing "If you are concerned, please call". I would rather be called a few times for nothing, than always be called when i have no choice but to code or transfer to ICU (I'm not saying this rises to that level - but the poster was concerned, and should act on that).

    Hope this helps,

    Pat
    Quote from CHATSDALE
    can a minor present in er with a minor sibling without adult??
    a fever of 104+ that continues several hours with n/v and extreme headache can be the s/s of a very serious condition[s]

    you should have been notified by your supervisor when your wife tried to get in touch with you, the fact that you were not was because they didn't want you to leave early..they had the option to call someone to come in early or the 'staffing' problem could have been postponed and she could have pitched in - if you had caught op on your work there would probably be less to do at that time

    if this comes up before the board as abandonment stand up and fight it
    1] you were kept uninformed of a situation that could have been very dangerous to your family
    2] you gave report to your immediate superior and notified themthat you were leaving, you didn't just walk out
    3] your children were following proper instructions in looking out for each other while you were at work, they were old to be left alone but they are still too young to take complete charge in an emergency

    my best wishes for how this turns out
    Great posts, I could have never said it better myself.
  11. by   smk1
    Quote from ERRNTraveler
    Tazzi, I think you & I are the only ones who feel this way. *sigh*
    So educate us then. (not being disingenous, I reallywant to know!). A teenager with a severe headache and a fever of 104.2 and nausea/vomiting with what sounds like a sudden onset (it was around 3 am) seems like a decent call. Nursing texts say this, online medical websites say this and I can remember my physician saying this at one time or another. So why do you think this isn't a reason to show up in the ER?
  12. by   ERRNTraveler
    Quote from SMK1
    So educate us then. (not being disingenous, I reallywant to know!). A teenager with a severe headache and a fever of 104.2 and nausea/vomiting with what sounds like a sudden onset (it was around 3 am) seems like a decent call. Nursing texts say this, online medical websites say this and I can remember my physician saying this at one time or another. So why do you think this isn't a reason to show up in the ER?
    These symptoms warrant a dose of Tylenol or Motrin, and a trip to the Pediatrician's office when they open. Things that are LIFE OR LIMB THREATENING warrant an ambulance call (chest pain, difficulty breathing, severe bleeding, trauma, stroke symptoms, etc...). Sure, if you call your pediatrician in the middle of the night, 99% of the time, they will tell you to go to the ER. Why? LIABILITY! They are covering their a**.

    Now, this is just a wild guess, since I haven't seen this child, but, I'm guessing..... sinus infection?
  13. by   vnsam
    Quote from fultzymom
    I agree with the others that it would be considered abandonment. But as a mother, if my child had a fever that high, I would be on the way out the door to, with or without their approval. Sometimes you have to make judgement calls about what is the most important and it will cost you something else. I think you made the right decision. Sorry that it cost you your job. Good luck with whatever you do next.

    OH! I almost forgot: How is your daughter doing?


    Leslie
    She was diagnosed with dehydration, stomach flu and with fatigue eyes (needing to wear her eye glasses which we thought she is using when reading).

    She was given iv for dehydration and few other instructions before sending home...She missed 2 days off school but she is fine now..

    thanks

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