Can't believe this (VENT)

[Marie_LPN, RN, LPN, RN]

Had a pt. at work last night that had been admitted from the ER around 7 pm with pneumonia. This pt. was disoriented, very confused, came ffrom a nursing home, and any family hadn't showed up by 7:30 this morning, so we (me and the LPN) had her 12 hours at least.

Problem was she screamed bloody murder all night when her sedative wore off (sedative because she kept trying to climb over bed rails and couldn't walk at all). Me and the nurse took turns sitting with her when she was awake, and one hand on her arm calmed her down like you couldn't believe. Just a light handrest on her arm and saying "we're here with you" and reminding here of where she is and who we are.

The nurse finally got ahold of family, who informed us that this pt. is completely BLIND. I mean we figured she couldn't see well (80 years old), but we didn't think she was blind because when you talked to her she looked right into your eyes.

Why did we not know she's blind? When she was asked in the ER if she could "see OK" she said "yes". No one at the nursing home found anywhere in her chart info saying she's blind. No one in the ER told us she's blind. NO WHERE on ANYTHING did it say she is blind, actually on either (nursing home, ER, or hospital) chart there is NOTHING about her eyesight at ALL. NO ONE even mentioned from the nursing home to the EMT's that she can't see. No one knew this poor woman couldn't see.

No wonder she was the way she was. She's in an unfamiliar area, with unfamiliar sounds, and feels hands holding an arm down to get blood out of her arm.

This just TICKS me off, this is info that is needed, and not that i'm looking for someone to blame, but you almost have to, to figure out where this lack of information started

Called up there today to ask about her, luckily she's not panicking as bad, but she's also on Ativan. The nurse put her in a gerichair (correct SP?) and had her sitting beside her asking about her children, husband, anything about her life. This woman answered the questions and then explained to the nurse that years ago a cleaner had splashed in her eyes causing her blindness. She'd come to our hospital for treatment. We have records dating back to 1948 on this lady, and no where was their anything about any treatment for eyes of any sort

[caffine addict]

Wow, what an ordeal. We have had simular situ. in LTC when family isn't around during the admission assessment period. It's too bad thet the nursing home didn't feel that the information wasn't important enough to share. I hope my nurses aren't forgetting this type of info on transfer sheets. I will be reminding them at the next staff meeting.

Kudos to your caring team to take turns sitting with this traumatized patient.

[Marie_LPN, RN, LPN, RN]

Well the reason why we had the time to take turns was that we had a pt load of 24 and everyone slept. That was a rare thing lol.

But since the nurses can't sit in there the whole time, what they did was brought her out in the chair in the hall to sit next to them while they chart and answer lights. This way everyone could watch her. But as long as people say who they are, their job title, and "i'm right here with you", she's napped on and off.

[caffine addict]

Thats what we do in LTC to watch all of our fallers. But it's really hard to get anything else done.

It's your compassion that makes you a great nurse. How many people would have researched her problem.

[Marie_LPN, RN, LPN, RN]

Actually nurse aide.

The LPN i worked with that night called the family. But i learned to find out how well their sight is for sure!

[caffine addict]

Sorry, Nurse Aide!

Thats where I started. And I cared for my patients just as you do. Have you thought of becomming a nurse? If not, and you have decided to be a career CNA, we need more like you!

[Marie_LPN, RN, LPN, RN]

I'm in my second year of LPN school, graduate in June, then i'll continue to college.

[Tweety, BSN, RN]

It's amazing the things one discovers about a patient after they are admitted. Little details left out like "where did this PEG tube come from and why is it in this patient's belly?".

I got an alert and oriented patient admitted to a room, took her to the bathroom she shares with her roommate after which she said, "I'll be glad when I get over this c. diff. diarrhea".

I could go on and on.

[caffine addict]

3rd Shift Guy

I needed a good laugh today after the weekend on call I just went through. Thats the stuff that makes me keep going back.

I makes me crazy, but if you don't laugh about it you'll pull your hair out.

Oh Im still trying to find out who put those J tubes and such into all our residents. You have to know who put them in or you can't get them replaced.

[CoffeeRTC, BSN, RN]

Those little details are often missed when we ge pts admitted to our LTC facility. I cant tell you how many pts we get from the hosp, home or other LTC with just a sheet of paper with their name on it and the clothes on their back. Then when you try to call the d/cing facility they try to cite HIPAA! Hello people I need more than a name.. Oh and of course its a saturday or sunday admit and the famiy is no where to be found........

[redshiloh]

Hate to ask...but how bad could her pneumonia have been if she was screaming all night. Sounds like her lungs were fine!

[Marie_LPN, RN, LPN, RN]

Very garbled.