When a patient states "something isnt right..."

  1. 2
    And try just cannot put their finger on it, what do you do? I have encountered patients like this and was told to never ignore it, because usually when patients think they are going to die, they do. Thankfully nothing has happened with these encounters. I try to get an idea of "what is wrong" but the patient doesn't know. Usually VS are WNL, might be a little tachy from anxiety or something. Upon assessment, everything just seems benign.

    So what do you do?
    asjsmall and Joe V like this.

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  2. 37 Comments...

  3. 7
    I think all you really can do is assess the patient, let them know that you're taking their concern seriously, and stay calm. I think it's worth noting if someone tells you this, but if your assessment does not reveal anything not WNL, then all you can do is continue to monitor. If the patient has known anxiety and has a PRN ordered, I might offer that. Otherwise, I might try distracting them with conversation, or find something on the TV they want to watch, or offer to find them a newspaper to read or a cup of herbal tea. Sometimes anxiety is indicative of something physically wrong, and sometimes people just feel anxious outside of their normal environment, and that anxiety can manifest as a feeling of "something not being quite right". The only thing you can do is assess and intervene based upon your assessment. Follow the nursing process.
    leslie :-D, joanna73, kattycakes, and 4 others like this.
  4. 14
    Listen to them and watch them like a hawk! And if they tell you 'now it's time to call son in Boston', RUN, do not walk to make the call to Boston.
  5. 10
    This happens a lot in peds where the parents say something isn't right with the child but can't quite put a finger on it. LISTEN TO THEM! Watch them, notify the doc, in peds we heavily rely on the parents when they say something isn't right. It might be just as simple as them not being interested in a favorite TV show, not wanting to eat, breathing slightly faster (but still WNL), etc. Last time I had a parent who told me kiddo didnt look right the kiddo arrested 30 minutes later. And he spent most of the morning sitting up in bed, watching Mickey and telling me about him. I personally thought it looked a little tired, like any child would be in the intensive care unit days after a major surgery, and his parents couldn't quite point out what was wrong except that something was wrong (it was his heart failing, by the way). Even if it's something that seems silly it doesn't hurt to listen to them and pay them a little more attenction
  6. 6
    I honestly thought that this "feeling" was basically bull, despite hearing stories about it. Then I had a moment where I just didn't feel right and couldn't describe what was wrong. 5 minutes later I was fully into my first anaphylactic reaction.
    leslie :-D, CountyRat, merlee, and 3 others like this.
  7. 5
    I have seen many patients describe "impending doom".
    It surely is a reason to take note and re -assess their condition. That's all we can do.
    Nine times out of ten... the grim reaper showed up... and my reassessment meant squat.
    CountyRat, Dixielee, GrnTea, and 2 others like this.
  8. 3
    Get vitals, focused assessment and head to toe. Look at labs. Maybe alert doctor. Is this a change from his/her personality? CT /xray everything? Draw random labs?
  9. 7
    Check everything you possibly can, head to toe assessment (at least neuro and heart/lungs) and MONITOR! You know that "sense of impending doom" they tell us about in nursing school? Yeah, that's real.
    joanna73, sherdk, CountyRat, and 4 others like this.
  10. 4
    Anytime you hear anyone in a clinical setting say, "Something just isn't right.....", take it very seriously. I have seen patients crash and some die not long after someone uttered that phrase. It can come from a nurse, an aide, a doctor a family member or the patient themselves. As noted by PP, very, very often stated by parents. I worked with several doctors over the years who told me, when a nurse called them and said something just isn't right with a patient, if they knew the nurse, they would immediately take that very seriously and move into action. I have stood there and watched patients crash and die, who were not expected to die that day, after yelling out repeatedly that they were dying. (note: the whole time I wasn't just standing there.)

    Of course not all people yell out, "I'm dying", right before they die. Not common at all. And anxiety and panic attacks can cause the same "feeling" in a person, although it's usually always the patient themselves who think something is not right when it comes to anxiety. Others around them don't usually have "the feeling".

    So, the moral is, watch closely anytime you hear those words. Assess and monitor and rule everything out.

    If you are a nurse in a hospital or LTC long enough, you will witness this rare phenomenon at some point.
    Nurse MikeyBear, joanna73, CountyRat, and 1 other like this.
  11. 4
    I had a patient the other night that, upon looking at him, I knew something wasn't right. My charge and house supervisor agreed. I kept a pretty close eye on him all night, needed to call for orders, and told the doc of my ominous feeling. I went to hang some fluids on him at about 0430, he was talking and then told me he was scared. Sure enough, we coded him at about 0500 that morning.

    I totally trust MY gut and when the patient can tell you that something's off.....listen.
    Nurse MikeyBear, joanna73, GrnTea, and 1 other like this.

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