Afraid patient incident will go to court

[Rncaligirl88]

Hello Everyone,

I have been a nurse on a med-Surg floor for two years and had several critical patients whose conditions were critical but always had an expected outcome. Last week I had a patient go septic on me. He had multiple other chronic and severe comorbidities and is vent dependent but came in with abdominal pain the night before and then was diagnosed with cecal vulvulus. I put an NG tube down him and got him fluids, they did another exam that was inconclusive because of positioning, etc. Anyway I had notified the physician when his heart rate got into the 130s and he ordered a fluid bolus and antibiotics and to call the surgeon if HR did not improve. Then his heart rate went up, and up, and up. It got to 160. I had the doc in there two more times but there were no further orders and the surgeon didn't order anything new except for monitoring overnight. In the midst of all my phone calls and rechecking him I did not alert my charge nurse except to tell her when we placed him on telemetry at which point she also did nothing. I know in retrospect I should've called a rapid response the moment his heart rate went above 130, but I didn't. He went to surgery and looked great the next day in ICU but now he is in renal failure because of the severe sepsis. My nurse manager knows about the situation and reassures me that he would've gone bad on anyone, but I can't help fearing more dire consequences such as a lawsuit. The patients family and I had a great relationship and knew I was in contact with the doc many times. But I still feel like I failed the patient. I'm so scared I can't sleep. Even if it doesn't go to court, if he doesn't pull through I can't help wondering if he would've been ok had we gotten him to surgery sooner and I feel like it's all my fault. Should I get out of nursing and start looking for a new job?

[psychgeribuff]

It sounds to me like you did everything you could. You contacted two different physicians several times and they made the final decision for this patient. The renal failure is not a result of anything you did wrong but a result of his illness. It sounds to me like you are a very attentive nurse and keep up the good work.