A Flutter with RVR


  • Specializes in Long Term Facilitly. Has 6 years experience.

Had an elderly pt with A flutter with RVR. History of two MI's, one a year ago or so. PT respiratory rate like that of cheyne stoking and rapid response called on him several times without change in condition. Blood pressure bottoming out, desating, pt anxious trying to get out of bed so he could breath. We wanted pt to be transferred to ICU but it never happened. Pt is a full code and the pit in my stomach was terrible. I was having chest pain from worrying myself to death and from running myself ragid. I had seven pts all primary care. When I asked if he could be transferred to ICU the supervisor stated he was not a candidate, even though that is where he was transfered from. I felt so useless.


1,170 Posts

So sorry you didn't get the support you needed from the supervisor. He was hemodynamically unstable and he wasn't improving with what you were doing on your unit. I agree he should have been in ICU. He would have at my hospital. Have your spoke to your manager about this? Did you file an occurrence report?

What was the patient outcome? Did his doctor or cardiologist want him transferred to a higher level of care? If the doctor wants it, it will happen. Our biggest problem is sometimes getting the doctors to agree. If it is for change in patient condition then they have to come in and see the patient. If it is for hours of nursing care they don't. There is no way you could have managed the other patients in your assignment with that going on. Very scary.


101 Posts

Specializes in Long Term Facilitly. Has 6 years experience.

No sure what the final outcome of the patient. The rapid response doctor did not write an order to send him to ICU, why I am really not sure. This was the second rapid response that was called on him within 12 hours so one would of thought the plan would of been ICU. I asked the supervisor what the plan was, and she said she just did not know. I have only been in the hospital setting for a short period of time so all this was very new to me.

Tait, MSN, RN

6 Articles; 2,140 Posts

Specializes in Acute Care Cardiac, Education, Prof Practice. Has 16 years experience.

What kind of meds were being pushed on him?

Sounds like my night with adenosine last night, but she went to the ICU, hell or high water be damned.



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