I'm a new nurse in LTC and I would like some clarification from experienced nurses.
My question is at what point would you make a call to send a LTC patient to the hospital?
I'm asking this question because recently a patient who is normally independent started to present S&S of a stroke- favouring one side, drooping extremities and facial expressions to the left. Febrile at 38.9 (sorry I'm in Canada I think that equates to 102), BP 205/109. Patient's baseline BP normally ranges from 90/50-100/60. They went from being able to speak coherently to basically babbling on about nothing.
I notified the charge nurse who basically shrugged their shoulders and told me to get the personal support workers to put them to bed. The patient is a DNR with measures to send to hospital. This infuriated me as the change in health status was so severe. I could be over reacting as this nurse has more experience and has dealt with this before, but I just felt this patient should have been sent to the hospital.
In the past few days the patient went from walking to a complete hoyer lift and unable to do much of anything and to my knowledge the doctor hasn't been notified of the change in health status.
I know in LTC this is a slippery slope but I was just surprised and I am very new and inexperienced at what point you make the call to send a LTC patient tot he hospital?
I know each situation is very different and it depends on their DNR status, etc. Just looking for a bit of advice!
Thank-you in advance
Jul 29, '13
Some institutions have policys that can cause you to lose your license. I know. I have ran into them even in California. And I have also chose to ignore company policy when it is going to put my license in jeapory and faced having to explain myself before. But since I always advocate for my pt even when its against the grain, the law is on my side, and the board of registered nursing would be on my side as well if it ever came down to it. Law and company policy are occasionally at odds as well, and I choose to follow the law.
Last edit by DedHedRN on Jul 29, '13