what would you have done?

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This situation just kind of sits in my caw. I floated to a same day surgery orthopedic unit. My patient a 30ish year old otherwise healthy man, came out with ACL repair. He had had a femoral block but soon upon arrival was complaining of a lot of pain, but he was acting weird, saying he needed to straighten his leg, he needed to stand up, even kind of trying to get out of bed, then saying he has claustrophobia, that he gets panic attacks when he flies. I asked if he had seen a doctor for his panic attacks, he said no, I asked what he did when he got panic attacks, he said he drank (I'm pretty sure he was referring to when he flew??? I don't think? he was an alcoholic?) I was giving the IV pain meds as ordered but was thinking this guy could use some versed?

I mention to the charge nurse his weird behavior, that I had maxed out his pain meds (not a whole lot had been ordered) and that I thought he needed versed (I would have called anesthesia for an order). She said NO if he got versed he would be here too long. I gave more IV pain meds, (he never got a LOT, I have given more than he got to different patients)

I was trying to push his PO intake so he could get PO pain meds, I had alreayd given him IV Zofran, and as I was getting the PO pain meds he threw up!!!! By then it was my turn for lunch, he was passed onto another nurse and it was mentioned to me "she will get him out of here!" He was gone when I got back but still I feel annoyed. How did the charge nurse get the idea some versed would lengthen his stay???? I have no idea if it would have helped, or made any difference, but to say, no then he will be here longer seems crazy?

Sounds to me like the guy had a reaction to the versed. I had the exact same thing happen to me when I had toe surgery. I felt like I couldn't stay still and constantly needed to move. He probably would have been fine with some benadryl, but the last thing he needed was more versed.

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
Maybe the pt was a bit hypoxic? needed some O2?

I would have called anesthesia......maybe the block didn't take or placed wrong......and shame on the nurse who just wanted to get the patient out of there....poor nursing

Schoochy, yes, you seem to "listen" i.e., get the point. I could, should, have gotten anesthesia involved.

On my own unit I would have. Since I ran it by the charge nurse first and was told it was not a good idea, I didn't push it!!!!

I think versed is fine post op. Sometimes the anesthesiologists routinely order is prn post op if they knew the patient was very anxious pre op.

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
Schoochy, yes, you seem to "listen" i.e., get the point. I could, should, have gotten anesthesia involved.

On my own unit I would have. Since I ran it by the charge nurse first and was told it was not a good idea, I didn't push it!!!!

I think versed is fine post op. Sometimes the anesthesiologists routinely order is prn post op if they knew the patient was very anxious pre op.

Don't beat yourself up......................follow your gut........besides I hate floating!.......

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