My little 84 yo father went to our ED the other day with a near syncopal epsiode with a pulse of 32 at home, getting up to the 40s in the ED. He sat there for 6 hours, in that time got a saline lock placed, labs drawn, and EKG and a chest XR. No fluids po or IV were given, his pulse remained in the 40s and SBP in the 110's. He got to my unit at 2330 cold, hungry, and weak. I asked his nurse(one of my co-workers) about what the plan was--who was admitting, diagnosis, food or fluids. He had limited transition orders including clear liquids til 1 am then NPO, routine vs, cardiac enzymes q6h x3. I pointed out that he had not voided in at least 7 hours, and hadn't eaten in 12. She called the on-call doc who relented to let dad have food until 1 am, then NPO and some gentle IV hydration. He still did not void for another 5 hours.
Is this normal to restrict fluids on an elderly person who becomes syncopal on a hot day? He was told he was going to be admitted after 2 hours in ED,but didn't leave for another 4 hours(at shift change).:banghead:I was with him for this last 4 hours--a nurse came by twice. He was left on a stretcher with the rails up, no call light in reach and was never offered the use of a toilet. :madface:If I treated a floor patient like that I would be severely reprimanded. I never spoke with the ED doc--he apparently spoke to Dad after I left ED to meet him at his inpt room. Normally I see pt's come to the the floor accompanied by family but the transporter made a point of telling me to go on ahead. Hmmm, was the doc avoiding me?
PS Dad's doing much better, getting a pacmaker tomorrow.:)
awsmom8--I am very sorry for your ordeal and loss. Thank you for sharing your story.
Dad got a pacer today and is feeling 100% better. His creatinine is down from 1.6 in the ED to 0.9. :yelclap:
I did approach the ED staff several times, but they said that he might need further tests, but they had no order for admission yet. I know for a fact that there were rooms available because I had just come from my unit and the charge nurse was saving him a bed. And the ED didn't seem particularly busy as there was much socializing taking place at the desk. I spoke to the nursing supervisor after Dad was in his room. She rolled her eyes:icon_roll and told me that a six hour wait was short. I asked here if she thought I should write a letter of complaint. She says the ED gets tons already but nothing ever changes.
Are ED docs trained do only do dispos at the end of the shift? Our unit often staffs up because we are told there are patients waiting downstairs, but they don't come until right at shift change, then we are dinged for being over budget.
He was told he was going to be admitted after 2 hours in ED,but didn't leave for another 4 hours(at shift change).:banghead:I was with him for this last 4 hours--a nurse came by twice. He was left on a stretcher with the rails up, no call light in reach and was never offered the use of a toilet. :madface:If I treated a floor patient like that I would be severely reprimanded. I never spoke with the ED doc--he apparently spoke to Dad after I left ED to meet him at his inpt room. Normally I see pt's come to the the floor accompanied by family but the transporter made a point of telling me to go on ahead. Hmmm, was the doc avoiding me?
nursej22, MSN, RN
4,877 Posts
awsmom8--I am very sorry for your ordeal and loss. Thank you for sharing your story.
Dad got a pacer today and is feeling 100% better. His creatinine is down from 1.6 in the ED to 0.9. :yelclap:
I did approach the ED staff several times, but they said that he might need further tests, but they had no order for admission yet. I know for a fact that there were rooms available because I had just come from my unit and the charge nurse was saving him a bed. And the ED didn't seem particularly busy as there was much socializing taking place at the desk. I spoke to the nursing supervisor after Dad was in his room. She rolled her eyes:icon_roll and told me that a six hour wait was short. I asked here if she thought I should write a letter of complaint. She says the ED gets tons already but nothing ever changes.
Are ED docs trained do only do dispos at the end of the shift? Our unit often staffs up because we are told there are patients waiting downstairs, but they don't come until right at shift change, then we are dinged for being over budget.