I am an LPN that works for a HH agency owned by our local hospital. We have probably 60 nurses and only 5 of us are LPNs. We are used for re-visits only since we can't do admits and discharges. I saw a post open heart patient the other day, had a CABG X 4. She was extremely SOB and could not even hold a conversation with me, was coughing after about every other word. Respers were 28, recounted again to make sure and got 30, very shallow and rapid. Her lungs were clear but slightly diminished throughout. She has a history of lung disease so i did take that into account. I quickly reviewed the notes of the RNs that saw her previously and both had noted the same s/s as i did but had not contacted the Dr. I totally did not feel comfortable leaving this patient. I made the decision to call the Dr and they wanted her to come in for a CXR and then see the Dr. The patient was very grateful and thanked me repeatedly for calling the Dr, I just worry sometimes that the case managers will get upset...as if i'm "stepping on thier toes", so to speak. I mean the other nurses didn't think it was necessary to call the Dr so did they know something i didn't???? I just keep telling myself that i couldn't leave the pt seeing her in such distress, i would never forgive myself if somethig was wrong and i didn't do anything. Better to be safe than sorry, right????
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