My night shift ended with a pt who had abdominal pain 10/10. Given dilaudid 6mg po fell alseep and woke at 0600 again with pain. No distention with bowel sounds rule out constipation. Has renal failure and liver transplant. Kept wanting to send out to er but pt was stable its a skilled facility we can keep pt stable.
Anyway another pt began to desaturate with 102 temp. Started fluids with 100% o2 and tylenol. Both pt was stable except for pt c/o abdominal pain.
Bickering know it all nurse comes in and begins to accuse me of nonesense and went to both pts and wanted to bag the desating pt. For some reason my rn supervisor switched his nonrebreather mask back to his venturi mask which he shouldnt since he was not doing well on it anyway. So nurse goes wack i put him back on the nonrebreather mask and goes back to 98.
Next, pt with abdominal pain starts to cry. Ive literally tried what i could.Tums massage dilaudid and just wants to go to the er. Vital signs stable but for some reason bickering nurse starts to yell his bp is high! Student nurse checked it...i checked 150/68....i just said look ive charted we called the doctor got new orders waiting for doc of pt with abdominal pain to call back. I said im sick i need to go home it passed my shift bye. Was there seriously something wrong in my part? By the way im an lvn whos rn supervisor takes off at night and falls asleep somewhere where no one can find him!! All the time! So sometimes im stuck! Trying to keep pts stable!!
Jan 23, '13
Also i know its a pts right to go to the er when says so but why didnt my supervisor say ok lets send the pt. He just kept nodding and saying oh ok oh ok....
Jan 23, '13
How was his bowel sounds? Did he had any diarrhea or constipation before hand? Is the blood pressure normal for him? Did you call the doctor to inform him about his situation? If so, what did he say?
I do get where you are coming from. I was once told by a physician to send the patient to the ER once he hits a certain temperature, while my supervisor doesn't want me to send the patient out. I am bound to the specific orders of the physician, and I do agree with the decision, so I sent the patient out regardless of what my supervisor thinks and said afterwards. All I told her is that I am following the doctors orders and the instructions are clear, I will not jeopardize my patient's safety and my license.
You should also document those in your notes. If anything happens, it'll be your savior.