Momma1RN, MSN, RN, APRN 219 Posts Has 9 years experience. Nov 21, 2014 This. When in doubt go up the chain. It's your license- not the charge nurses, not the docs, YOURS.
VANurse2010 1,526 Posts Has 6 years experience. Nov 21, 2014 The patient does not have to be unstable to warrant a write up. A change in LOC is a significant finding. Can't just assume" A little bit of overnarcing".Your overnarced patients are on a vent, big difference.Whatever, they had the opportunity to make this a teachable moment, or a punitive. Choices, choices.
psu_213, BSN, RN 3,878 Posts Specializes in Emergency, Telemetry, Transplant. Has 14 years experience. Nov 21, 2014 but I didn't read anything here that indicated true instability.I have to disagree on this point. Of course I wasn't there to actually assess the pt, however decreased LOC--only moaning--presents a awful lot like head bleed I took care of recently. More than likely, the pt was snowed, but there are definitely more sinister causes for her ALOC.Anyway, with a RR, the primary should be notified…if the note gets lost of otherwise not read by the primary, there is a chance that the narc/Benadryl order may not be adjusted.Did it warrant a 'write up'? Well, that term mean different things everywhere I have worked…but, I would say probably not. A teaching moment existed, and a write up makes it punitive, not teaching.
APRN., DNP, RN, APRN, NP 995 Posts Specializes in Family Practice, Mental Health. Has 32 years experience. Nov 21, 2014 I am an RRT RN as well as an RRT Rounder. If a nurse feels uncomfortable about what is going on with a patient, an RRT Rounder can come take a look at the patient to support both the nurse and the patient. If the situation warrants the physician to be called, I'll help the nurse with that thought process and give him or her guidance. If a patient is altered and that is not their baseline, the Dr should be notified. The Dr will probably want to adjust the orders and evaluate the patient.
tyvin, BSN, RN 1,620 Posts Specializes in Hospice / Psych / RNAC. Nov 21, 2014 I haven't read any of the other posts but that's a huge no no! If rapid response was called, whether they did anything or not, the doc should have most definitely been called right after you called rapid response. Think about it, if you were the doc, would you want to know?
Emergent, RN 2 Articles; 4,109 Posts Specializes in ER. Has 30 years experience. Nov 21, 2014 It's been three days since this thread was started. I hope all is well with OP.
VANurse2010 1,526 Posts Has 6 years experience. Nov 21, 2014 I have to disagree on this point. Of course I wasn't there to actually assess the pt, however decreased LOC--only moaning--presents a awful lot like head bleed I took care of recently. More than likely, the pt was snowed, but there are definitely more sinister causes for her ALOC.Anyway, with a RR, the primary should be notified…if the note gets lost of otherwise not read by the primary, there is a chance that the narc/Benadryl order may not be adjusted.Did it warrant a 'write up'? Well, that term mean different things everywhere I have worked…but, I would say probably not. A teaching moment existed, and a write up makes it punitive, not teaching.I wasn't here to assess the patient either, obviously, but I doubt very seriously this was some random head bleed given the information presented.
psu_213, BSN, RN 3,878 Posts Specializes in Emergency, Telemetry, Transplant. Has 14 years experience. Nov 22, 2014 I wasn't here to assess the patient either, obviously, but I doubt very seriously this was some random head bleed given the information presented.I doubt it also, but it certainly has to be a consideration given the ALOC. Also, we don't know anything (hx, VS, etc) about the patient. Just saying that it could have been a serious situation.
