Diagnosing before procedure in the Cath Lab

  1. I am a traveler in the Cath Lab.

    I open up the Ambulatory at the end of my shift, which is pretty much the Admission part before they go for their procedure. I was told when I came in the next evening that I didn't read the EKG before the procedure, and the patient was sent for a Cardioversion with a NSR, and they had to be sent home. OK...

    Anyhow during my 10 minute orientation lol, I was told the NP, PA, or DR reads the all the information before sending them to the procedure (yea I know you can't rely on what anyone says as a Traveler), but apparently the NP (or anyone else for that matter ) did not read the EKG, because the patient was sent to the procedure room. I am sure I was already home by the time the NP started the consent with the patient. They are also suppose to go over information as well. But, alas all the blame fell on me. :uhoh21:

    The nurse said I was reported to the Manager. Of course no one called me before my shift to explain how to fix it or if I did anything wrong. So I was demoralized by the nurse when I came in, which is just part of their daily routine at this hospital. Personalities. I of course emailed the Managers myself who said they would discuss it with me this week. So is this a normal occurrence where you work in your Cath Lab? Do nurse's make the decision if a patient had a procedure done or not?

    This has never been the case for me anywhere. I have read EKGs sure and will be glad to for them if they need that extra minute, but have never sent a patient home based on my decision. This is suppose to be one of the top hospitals of the country, so this kind of scares me. lol! Then again many of the nurses there have been there longer than I have been alive so maybe they are so good, they just know! Who knows... Goodness grief.
    Last edit by dance4life on Jun 25, '12
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    About dance4life

    Joined: May '10; Posts: 311; Likes: 146
    RN; from US
    Specialty: They know this too!


  3. by   Esme12
    I have worked in the cath lab and I was a "Cardiac Anesthesia Nurse" which meant I was the "wet nurse" for the cardiac fellows so they didn't hurt anyone or kill them in transport, and I greeted/prepared the patients of the day; room, IV's, art line, labs meds, so anesthesia could have another cup of coffee.

    In both areas, reviewing that all was on the record as per policy was the norm; like labs,H&P, EKG's, we looked at the coags, ECGs are were responsible for reporting any abnormalities to the physician. Now all these patients are supposed to be seen by the NP,PA,MD prior to the procedure but I was still responsible for looking that extra time. If I had a patient scheduled for a cardioversion and I saw the EKG was not only present....but a NSR....I would get another 12 lead to confirm the rhythm and page the MD toilet them decide the patients fate.

    That being said......being a traveler if someone males a mistake, of course you are the one they will blame. Their feeling is that they pay you good money" to be perfect. "Personalities" is probably the reason that this place uses travelers for their lab.

    I don't think they were expecting you to make the decision to send the patient home...if they are, call your agency to as to leave this unsafe assignment. I think they are saying the patient was unnecessarily sen/prepped/medicated for a procedure that would not occur. I can hear to now. Cardiologist...What the heck is this patient here they're in sinus. NP/PA.... I told them to double check. Nurse....Oh, that traveler. I so sorry but this is the unfortunate truth.

    I think they are saying you failed to notify. They should not have shared it with the staff (I hate that behavior). You probably should have checked the result of the EKG and not that it was just present...and called the MD.

    I'm sorry that you are going through this....I wish you the best.
  4. by   dance4life
    Thank you so much for letting me know this!

    I wish they would of me from the beginning of the mistake, instead of playing this cat and mouse chase when I came in that night. It is really simple. Anyway,

    Things can be so much worse. But, now I do understand.