Vent thread... when to send a pt out - page 3
I've been at an LTC facility for 3 months now. One thing is clear at my facility: take caution before sending residents out to the hospital. I was always taught as far as LTC goes, especially as a... Read More
Nov 29, '12Well, since being sent to the ER is a doctor's order, I don't see how any DON could get mad at *nursing* staff for too many ER admits. All we do is provide the doctor with our assessment and he decides on the course of action. If a doctor says the pt needs to go to the ER, what right does a nurse have to question it?
With that said, I *do* think we should treat as much as we can in-house. Not because of $$$ issues (which I couldn't care less about) but because a trip to the ER is very traumatic for our elderly residents. And, I'm sorry, but hospital staff can be very rough and uncaring toward our residents. It's obvious many of them look down their nose at LTC residents.
As for the 'sepsis' thing I agree that in, in theory, we can give some IV ABX, fluids and Tylenol as good as any hospital floor. BUT asking a floor nurse who already has FORTY other residents to also be responsible for someone acutely ill is an insane burden. It's undoable.
Dec 2, '12How is that her baseline if she was admitted with urosepsis?
If a resident is stable then by all means keep them in the facility and get an order for IV abx. But your resident to me doesn't sound too stable and you did the right thing by sending her out.
Lets say you kept her and she went even further south.. people would be saying "why didn't you send her out...". You never want that to be the case so .. better safe then sorry.
Dec 3, '12Quote from pppp87Um..no. Many residents can have a UTI or bacteremia, but not urosepsis. Yikes!The evening charge called the hospital this evening and found out the pt was admitted to the ICU. My DON is still brushing it off and saying that everyone here probably has urosepsis and that's something that could be treated here... I was offered a job at a PCU in a teaching facility so hopefully I can move on and get a better nursing foundation there...
ICU....you picked up on this person right in time...good job!
Dec 5, '12When i was a new nurse working in a LTC i had a patient that was in resp distress. no matter what neb tx and o2 i adminstered he pulse ox and ease of breathing never got better. The doctor on call was very rude and ordered more neb tx. I knew something was not right. I called the family and told them that the doctor did not want to send her to the ED but i felt something was extremely wrong. I sent the lady to the ED. A few hours later the nurse from the ED called and told me that she doesnt normally call but she wanted to tell me the patient had a PE. Had i not sent her to the ED she would have died. Thank goodness i iused my assessment skills and gut instinct.