I hope the title gives enough info to peak the curiosity enough for responses.
This past weekend, I was at work. Neutropenic patient with dx of sepsis. Saturday was day 3 of admission. Patient on 2 iv abx, but still spiked temp of 101.2F on my shift. I was concerned. I didn't know what to do, so I requested the ID MD phone number to place the call. wbc 0.2 anc 0.
the attending was adamant that i shouldn't be soo concerned. the patient didn't look septic and was not symptomatic for being septic. This is true, however, we are not the usual unit for onc patients and to me it is reasonable to question whether we are headed the right direction with the abx currently being used. is this incorrect thinking on my part? should i have just read the progress notes and stated patient so and so has an elevated temp but other vs are stable. all the while thinking, pt not on ivf to assist compensation for potential septic shock.? hope that makes sense.
anyway, i was later encouraged that i should have read the progress notes to see that patient was actually improving, which is true, i admit. i'll be chalking this one up to remember to read the progress notes. or at least try to read the notes and ask for interpretation when needed.
on the other hand, i don't think we have many policies for onc patients and i also think i did the best that i could under the circumstances. at any rate, the patient is safe and secure on my watch.