I posted this in the Renal Nursing Section, but think I should have maybe put it here since more people will see it. I really need some help thinking all this through.
I have a little situation that happened yesterday and with me being a newbie I am not sure if I handled it right or not.
As a GVN who has not taken her boards yet, I cover for PCT's while they are at lunch, have patients that are assigned to me and am also being trained with the caths (take off is very easy as far as cath care by the way, but put on I am still nervous about) anyhow. Here is the scenario:
Lunch time coverage is taking place. I have 6 additional patients to cover plus the 2 that currently I am caring for. 7 of them were doing fine, no problems to mention, one I noticed he was sweating and started yawning, so I do a BP on him, (when he arrived it was 140/86) this was almost 2 hours into his Dialysis, his BP started dropping and was at 88/64, I asked him how he felt he said he felt fine, but new it was dropping, I laid him back and gave him a damp cloth, 5 minutes later it had dropped to 76/56, so I gave him 200cc's NS, the patients eyes started watering, but he really was not complaining, I wasn't for sure if he was being tough or felt like doo doo and couldn't muster up the energy to talk. Amongst all these 5 minute BP's, I am adjusting the cuff and making for sure I am getting a right reading. 5 more minutes later it had dropped to 66/44. I requested a Hypertonic from the Med Nurse, who was on the floor, his response was "he is not my patient, I have another hypertonic to give, plus Immodium to one patient and another Med to give to another patient." I am thinking OK, maybe he will give the Hypertonic and be over here after that. 10 Minutes later the pt's BP was down to 55/35, Charge Nurse was gone to lunch and Med Nurse still had not come over there. The whole time I am documenting my 5 and 10, minute BP's, pt's symptoms, request for Hypertonic yada yada. This is where hell breaks loose, Correct me if I was wrong. I documented with the 55/35 "Hypertonic was pending Med Nurse Arrival".
I never left the pt's side, I stayed with him and finally a tech came by and I asked her to get either the charge or the Med Nurse now, she got the Med Nurse and he walked up with a pissed off look on his face and I showed him my VS on the Screen, informed him once again of everything I did. I told him, I needed to go and check on my 7 other pt's and I would return. Done, I thought, oh heck no, I got jumped by the PCT who was/is my preceptor (mind you these both are of an International origin and they do stick together, they also speak in their language on the floor while caring for patients who do not speak their language) anyhoo. She told me that I was documenting wrong BP's and why would I Take BP's every minute and document I was taking them every 5 mintues, she felt like I was trying to get the nurse in trouble and we don't document like this, we cover for our Nurses. I told her that as a GVN, I have a legal obligation to document what I do and the time that I do it, she told me know I don't. She told me that I should never, ever of wrote that and that I was wrong for doing it, I then got the rath from the Med Nurse, stating that if I had looked at his previous BP's I would have noticed that he came in with a low BP. He told me that the PCT who was taking care of this patient falsified BP's on Paper but if I had looked at the machine, I would have realized that. NOT because what he was looking at was the BP's that the Monitor was showing, he didn't scroll up and so I told him that if he would scroll up on the screen he would see that the patients original BP was what the PCT had documented. He told me I was trying to make him look like a bad nurse and I promptly replied, "you know what, I am not here for your license, I am here for mine and for these patients and if you don't like that, you know where you can put it."
So now that I have had time to breath and reflect, did I do something wrong here, should I not have documented what I did?
Before I give you my Charges response to all of this, I want to here what everyone has to say. I don't want to sway anyone. I want a God's honest truth.
