I had a pt that I can't stop thinking about. 50 year old female. The diagnosis from the doc wasn't infection related, but they were not very communicative or active -stuporous is probably accurate. They were brought in with altered mental status which turned out to my be more psychiatric in nature. regardless...
lungs were clear, otherwise stable vital signs...etc...no wounds.
Periodically their temperature would go up to 100.1 or 99. I think if I remember it MAY have gotten as high as 100.6.
Anyway, on my first assessment it was 100.1 or 100.6, and then i rechecked it an hour later and it was 99. On my next assessment it was 100.1. NOW this patient had a heating pad (the kind with the water circulating, like a blanketrol) on their upper arm per physician order d/t a DVT. and the temperature in the room was elevated because for whatever reason, people love to crank up the heat in the patient's rooms at night. (I work 3rd shift).
I had a suspicion that the temperature was probably related to the room, especially because where I work we generally don't call unless it's over 101, and the physicians usually appreciate it if we stick to that train of thought, unless the pt is otherwise symptomatic with infectious like symptoms.
So I lowered the room temperature, and got a fan for the pt to help fan off some of the surrounding heat coming from the heating pad -which was toasty! Obviously it didn't burn them, but it was rather warm.
I rechecked their temperature later and it was normal.
I made a note (we use EPIC) and documented that I was going to reassess their temperature and the steps I took and noted I would notify the physician if the temperature remained elevated. (I'm big on documentation, I've seen too many incidences where too little was documented and actions were explainable later).
Keep in mind I work on an advanced care floor.
Was this outside of my scope? I've only been on my own as a nurse for about a year and a half. I put a lot of thought into what I do..but I think I am starting to depress myself my second guessing everything and worrying about losing my license or getting sued. I see the world as out to destroy me/my choices; or at least not there to help.