Did I do the right thing?

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I work in an ALF and today one of my residents called me complaining of chest pain radiating down her left arm and SOB. When I checked her vitals, BP was normal but pulse was 122. This has happened with this particular resident before and it turned out to be nothing but anxiety. I gave her nitrostrat, little to no effect on her chest pain. Her pulse worried me so I called the on-call physician who ordered her to go to the ER. When I told my supervisor, she sort of rolled her eyes and said something along the lines of this has happened many times before with her and it's always nothing. About 2 hours later, the hospital discharged her and also treated me the same way.. like I had wasted their time. My issue is.. if I would've blown it off as her anxiety again, then what if it had been an actual emergency and then I'd be in trouble for not sending her out? What would you have done?

Specializes in Medical Oncology, ER.

you did the ABSOLUTE right thing, and don't let how they treated you make you fearful of responding the same way again. I recently had a similar episode with a pt, called rapid response, didn't need to transfer her to higher level of care, but still. better to call for help and not need it vs need it and not call for help.

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I called rapid response team on pt. Change in LOC....well, daughter didn't think momma has diabetes because she only takes pills. We had been given NO home med list & pharmacy clised, PCP out of country. Her sugar was 13. We got her stabilized. Her sugars had been normal in ER, so we didn't have any orders for checks. After that, checking sugar was on my list whenever the pt goes "weird" & I'm about to call for more help. I don't care WHAT I was told from H&P or family report.

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Specializes in Hospice.
I like to live by the question, "what would a prudent nurse do?". I have had situations where family got mad at me after the pt was sent to ED for "nothing" and pts that reluctantly go and then die in the hospital. While I don't care to get reamed out by families, I would rather work to protect my patient (and myself) and be wrong, than do nothing and be right.

Edit:

Even the time with the CHFer w/ the massive generalized edema, struggling to breath with 02 sat in the low 80s, and blue oral mucosa. Neither pt nor wife knew if he was hospice (I had a inkling he was), but couldn't find any hospice docs or reach other family. Called 911, sent to hospital. Next day Hospice and family were annoyed at me, too bad!! I worked with the info I had and stand by my call.

Don't get me wrong, I agree with the prudent nurse thing. However, one thing bothers me.

Being admitted to Hospice is a process. People aren't just "put on Hospice" without either the family, patient or both knowing. Facility staff is aware of status, as well.

Was this a process breakdown, that no one at the facility knew? Was it a day where there was no (or very little) regular staff there to say "Yes, he's Hospice"? At the very least, we scan our signed paper consents and IPOC into the facility computer system and they can be found as attachments.

This is one reason I miss hard copy charts. We used to slap a big "This is a Hospice patient" sticker on the front. Everyone knew.

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Specializes in kids.
It's not about all the times it turns out to be nothing, it's about that one time it is something.

THIS!!

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Specializes in Med-Surg, OB, ICU, Public Health Nursing.

Even hypochondriacs get sick. Yes, you did the right thing.

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Specializes in Home Care Mgmt, Med-Surg.
Don't get me wrong, I agree with the prudent nurse thing. However, one thing bothers me.

Being admitted to Hospice is a process. People aren't just "put on Hospice" without either the family, patient or both knowing. Facility staff is aware of status, as well.

Was this a process breakdown, that no one at the facility knew? Was it a day where there was no (or very little) regular staff there to say "Yes, he's Hospice"? At the very least, we scan our signed paper consents and IPOC into the facility computer system and they can be found as attachments.

This is one reason I miss hard copy charts. We used to slap a big "This is a Hospice patient" sticker on the front. Everyone knew.

This was in a private home, admitting visit, so no resources unfortunately like that! But otherwise, I would agree, that would be a big lapse in communication at some point.

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