experienced nurse question

[mugwump]

I am trying to get examples for a paper I am doing on how experienced nurses demonstrate exquisit foresight in anticipating problems and intervenes before exlpicit diagnostics signs are evident.

Also how does a nurse conduct and dissemonate research findings related to needs/trends of moral/ethical/legal aspect of patient family outcomes

any examples of this would be appreciated.

[htrn]

Could you be a little more specific about what you are looking for? There are many times when something just doesn't 'feel' right or 'look' right in which me and my coworkers will put things in motion that end up saving the day - and the baby.

Can think of one in which an elderly primip that the OB decided to have the ped there - just because. This mom had no risk factors except that. The anesthesiologist had wandered up to the floor to check on the epidural and the RT was up on the floor for his nightly "let's solve the problems of the world" conversation. Wee hours of the morning, small hospital in which we only keep the ER doc in house 24/7 in addition to minimal nursing staff, one RT and one lab tech.

Anyway, tight nuchal cord, cut on the perineum. Nasty shoulder distocia and apgars of 0/0. He's about 3 now, doing great with a little sister (born by elective PCS) and only has Erbs Palsey. If all of those people hadn't been on the floor at the time, he very easily could have died.

Have a few other stories similar to this, but this is truely the most dramatic. Good luck with your research.

[augigi, CNS]

A million times in CTICU where you would notice a cluster of things which are "off", and intervene appropriately if you feel the patient is heading downwards, before anything overt happens. This is based on clinical signs, but also on just knowing your patient - none of us are psychic, but close surveillance and high degree of suspicion when things change is essential.

[Jolie, BSN]

The other posters are right that you will develop a "sense" of when things are headed the wrong direction, often well before any overt signs or symptoms are present. You will learn to trust your "gut" and advocate for your patient by asking the physician to come in and check the patient, consider ordering labs or other studies, putting ancillary staff on notice that trouble may be brewing, etc. Wise, experienced physicians trust and respond to this.

Another source of such "gut feellings" is parents. When a mom or dad tells you that they think something is not quite right with their child, believe them and respond!