Published Jan 21, 2020
astormofswords
20 Posts
Today one of my patients suddenly had a seizure whilst eating lunch and began choking -resulting in him being transported to ED and I cannot stop analysing the situation and blaming myself. This patient is a mental health patient in a psychiatric facility with no Hx of epilepsy. This is the first time I've had a patient have a medical emergency/deteriorate suddenly whilst specifically under my care and I think its shaken me up a bit. How do you deal with over-analysing and anxiety after this kind of experience? I can't help but feel shame and that I am to blame even though I was thorough and careful during my shift and can think of nothing I did that could have directly caused the seizure.
I was on an agency shift - so did not historically know/have cared for the patient before. The patient was being treated for a mental health diagnosis. The only medical implications they had were them being underweight/malnourished upon admission - with them being on a malnourished pathway and food intake chart (they have been an inpatient for almost 2 weeks).
Pt had complaints of "light-headedness" the previous day during the afternoon, however, handover stated this was resolved with rest and fluid intake. I also asked the patient multiple times during the morning how they were feeling, whereby they denied any symptoms/concerns + all vitals were also in range (Luckily I had documented all of this prior to the code being called).
The patient having a seizure when they showed no symptoms of being medically compromised and no previous history of epilepsy has made me feel like I have missed something and/or failed in my care of the patient as it occurring is completely puzzling to myself and the response team. I can't even follow up and see if he is ok as I'm an agency nurse and do not work there regularly. Has anyone else ever experienced a patient/case like this in the past? What was the outcome?
Thanks for any advice/info!
"nursy", RN
289 Posts
Anybody who has a seizure history, started out with a FIRST one somewhere along the line. The things that can precipitate new onset seizures include trauma, brain tumors, drug withdrawl, toxins, fever, infection, etc. Even if your patient had a hx of seizures, what could you have done to prevent it? Absolutely nothing! Even if they were on meds, they could still have a seizure. I know it's tough when a patient decompensates, but it sounds like you did everything right.
ruby_jane, BSN, RN
3,142 Posts
Maya Angelou said do the bet you can until you know better, and when you know better, do better (I'm paraphrasing). Assess, take note of improvements that can be made, and move forward!
Been there,done that, ASN, RN
7,241 Posts
" I cannot stop analysing the situation and blaming myself. " You will have many patients die , from many problems.
Patients present with many issues. Could have been a seizure, could have been aspiration that looked like a seizure.
You need to realize , you did the best that you could.
Subee2, BSN, MSN, CRNA
308 Posts
I remember my first code well and the following days were a little sad for me. This is the only way we can grow...to have some pain from our jobs. The pain comes with the territory. Now turn this thread off and go take a walk:)