Do you ever just have a hunch?

Congratulations! Seems to me that you have entered the hall of fame. You stayed focus and brushed the doc to the curb. I do hope you charted all those requests/interventions along with NO ORDERS received. If that chart ever gets audited, the auditors will clearly see that you were the HERO here and NOT the numb doc.

In my ICU, since I am military, I would have just ordered the xrays and lab work up. But since you are in a civilian environment, money/insurance prevails on what you can and can't do.

I do hope you gave that doc a stern look right into his/her eyes. Perhaps next time, he would listen to you more attentively.

As for being scared, it is normal and you were aware of what you were feeling. I still get the pucker factor every now and then. It keeps you on your toes. The day you are not longer scared in the ICU, is time to do something else.

Congrats.

I found out this morning that the patient died during the night. Really sucks. I hate to see people do poorly after routine procedures. Reminds you that everything has risks and you don't need to downgrade the risks of routine procedures just because you rarely see anything bad happen!!

I've worked mostly nights so far in my time in ICU, and it amazes me how many patients of mine pass away the shif tafter I leave them. I usually have that feling and try to get things done, but our on-call docs don't oftern work with us very well. Its sad to sit and think that it could have been prevented, but that's the nature of our jobs...

I've had it happen x2 with pulmonary edema. Watched it come on all night in both patients and spent a lot of time calling docs. One with a Swann Gans and one without. The one without died that night after going into PEA and being coded for over an hour. You better believe all the calls to the docs were documented very well and as they happened. I had the crash cart outside the door within an hour of my arrival on shift. I knew it was going to go down hill all night.