Quote from Daytonite
I hope the patient is OK and suffered no ill effects from his seizure. I know I won't be popular and well-liked for saying this, but being ashamed hardly cuts it here. The bigger question is do you know what you should have done? Someone in alcohol withdrawal who has a seizure may not be receiving enough medication to prevent this from happening. The man was in the facility in the first place to be safe from the effects of DTs. What would it have taken to go get another nurse to ask for an opinion as to what was going on with that patient?
I suggest that you read up on alcohol detox and become a walking encyclopedia on it and what to do about seizures, how they are treated, what the seizures mean and why you want to prevent a seizure, in anybody. You need to review what to do when someone has a seizure and what to assess them for. You note the time, the length of time the seizure lasts, the activity that took place during the seizure and you attend that patient to make sure they don't injure themself during the seizure activity. They are also sometimes incontinent during or just after the seizure and sometimes they stop breathing and require supplemental oxygen.
Whether or not you decide to report this incident to your manager is your concern. I would start disciplinary action on someone upon hearing of this situation as I feel this is a serious failure of duty and an incredibly bad judgment call. I can understand fear that new grads have about reporting errors that they make, especially a big one like this, but I strongly suggest you hit your nursing textbooks and find out exactly what you should have done in this situation and vow to never let this happen again. Blaming this on the hours of the day a person works is a bogus excuse and does not demonstrate taking responsiblity for failure. In your entire post you mention no concern for how the patient subsequently fared; only concern for yourself. Very, very poor judgment was exercised here. I wouldn't trust you either. If you confess to this, your manager may not trust you anymore. There is a very heavy, very deserved weight on your shoulders right now. You dug your own hole. I hope you have learned a very hard lesson from this.
She's beating herself up and then you come in and finish the job?
I've seen worse errors by new grads, students, and even seasoned nurses. Heck, I've seen docs make way worse mistakes and they're still in practice!
Her entire post reeks of guilt and shame.
The mistake that seems so obvious to us could've been made for a multitude of reasons--not excuses--not the least of which is exhaustion caused by understaffing, poor orientation, lack of preceptorship, inappropriate placement of patients, no standing ETOH protocol or orders... all potentially deadly when combined with her inexperience.
But we know all about those systems problems, don't we, since we discuss them every single day on this board. We've had entire threads on medical errors, errors that docs, nurses and patients make that can cost their lives.
I'm surprised, Daytonite, that you didn't read between the lines on this one. Did you notice that she said she graduated a scant four months before this? That she's fairly new to the board? That instead of being uncaring about the patient, she's possibly afraid of giving details? Did anyone who's answered notice the time and date of the post--way too late to call and try to correct the error, but not too late to fix what went wrong on her end?
You give some great advice--it is very important too, but toward the end of the post especially, you become very harsh with her. You're assuming that she needs to be reminded of the seriousness of the error, and you're assuming that she has not already talked to her manager or preceptor.
I choose to assume that the next seizure was witnessed also and that the patient was ultimately successfully treated
- because this nurse is a new grad,
- because this event happened at the end of the night shift
- because the day shift nurses are usually scrambling to see patients to get their meds out,
- because I've never heard of an ETOHer dying from his first seizure
- because ETOHers never have just one seizure.