Nurse's intuition - page 3

Have you ever had a premonition that a patient was going to code (and been right) without any obvious symptoms, abnormal labs, or vitals?... Read More

  1. by   Eric01
    I may be new, but I kinda had the same feeling the other day. I work as a student on an ortho floor. We sent a pt down for surgery about 0830. She came back at 1200. I did her first set of vitals, and everything was ok. Her primary RN asked me to do post op vitals q 15 min. No problem. At the same time, I was feeding one lady down the hall and doing vitals on another gent who had blood being transfused. Anyway, I was feeding this lady, but ducking out every 15 min to do both sets of vitals.
    So the second set of post op vitals were fine, too. Went to do the third. Pulse, respirations, temp, dressing were ok. Checked her BP, thought I got like 80/40. I wasn't positive, so I asked another RN covering to come check. She got something really similar. We managed to get her stabilized some before it progressed. She was still breathing when I left for the day. Later that evening, I was worried about her, so I called to check. They said that she transfered to CCU.
  2. by   Stargazer
    Eric--good job! Trust me, nothing feels crappier than ignoring that feeling, or talking yourself out of it, or letting someone ELSE talk you out of it, only to have the patient crump later. I wish I didn't speak from experience.

    Fortunately, the pt ended up okay, but I never let anyone talk me out of that feeling again.
  3. by   VAC
    Thanks to everyone who wrote. I had a feeling I wasn't alone.

    Another question, When you feel that way about a patient, have you ever let the patient or thier family know it??
  4. by   RNConnieF
    More times than I can count. What's even more frightening is that a colleague and I have both dreamed that a patient who has been unresponsive for 17 months following an aspiration incident that resulted in anoxia, code, resuscitation and so on, awoke, was fully responsive,and even conversant. We both dreamed this within a week of each other. We did not discover our similar dream until well after it occurred. Kind of scary.
  5. by   Gardengal
    More times than I can count. The really tricky part is figuring out what small sign gave me that feeling and descrbing it to the physicians. Thankfully, most of the docs we work with will pursue the nurses' feelings as well.

    Sometimes I never discover what casued that feeling, but it's rarely wrong.
  6. by   Sourdough
    I get those feelings all the time...I have even dreampt that a patient has died and who was there with them, only to find out that I had dreamt it exactly as it is very scary sometime
  7. by   Jenny P
    Originally posted by Dr. Kate
    The way I was taught nursing, there was no such thing as nurses intuition. Rather there are numerous extremely subtle variations in patient behavior, appearance, reactions, etc, that lead you to know something has changed and bears attention. I think that's why you turn into a room, just to check. Something was seen and assessed, probably unconsciously, and demanded a look.
    Too often I hear nurses denegrate the assessment part of patient care when it is the one thing that distinguishes us from other healthcare professionals. Nurses are assessing and reassessing their patients constantly. Even when you aren't thinking about it. Once you learn how to assess on the fly, you do it as automatically as you breathe, to everyone.
    How do we grow in our assessment skills? How do we "just know" when something isn't right when the vitals are all within normal limits and the pt. "looks" okay? How is it that we can predict that this pt. won't make it-- hours before he begins to look bad? Maybe it is something we unconsciously assessed Dr. Kate; but if we can't consciously put our finger on what it we sense; what should we call it? I do prefer to call it my intuition or gut feelings just because (in my experience) the docs I work with LISTEN to our gut feelings when they know us and they trust it too. My intuition tells me something is wrong long before any clinical signs or symptoms or vital signs change.

    Dr. Kate, have you ever read "From Novice to Expert: Excellence and Power in Clinical Nursing Practice" by Patricia Brenner?
    Susy, this would be a good book for you to read also for your Masters program because of the ideas it contains. I read this book about 10-15 years ago and it is very powerful in its message about excellence in nursing practice. Many of the narratives have the nurses referring to their "gut feelings" or their intuition about patients and how they were correct in their feelings about the patient going bad. I have not read the new edition; maybe the updated version has changed some of these terms; but the older version showed how often the nurse herself referred to her feelings and intuition. I will read this newer version soon; I wasn't aware that there had been a new edition published.
  8. by   deespoohbear
    One of our docs tells me that he gets the chills when one of us nurses call him and say: "This pt isn't right. not sure what the problem is, but it is not right." Most of our docs are pretty good about listening our intuition. And if a patient looks like crap, I will tell the doc that in those terms. The night nurses just hate it when I tell them "this one is going to crash" because I am usually correct. I definitely believe that nurses get a "sixth" sense, and so do mothers.
  9. by   SnowymtnRN
    DEFINITELY! Its kinda creepy...but you can't ignore it!
  10. by   bagladyrn
    Docs do not get away with brushing me off if the intuition is strong - I keep calling back until they come in just to get me off their back. One of the scariest occurrences for me was one evening when I came on shift to work the nursery, got report on all the babies out with moms. One was born about 45 min prior and was reported normal babe currently breastfeeding in birthing room. For some reason, I went directly from the report room, without stopping in the nursery, to see this baby. Mom (16 yr. old) said "He's asleep" Baby was sort of tucked under the breast - waxen, limp, no resp. hr in 40's! Yelled for help - poor room design - couldn't reach the code button above mom's bed- ended up doing a full code - baby responded and went home later that week.
  11. by   renerian
    Many times. They get "the look"

  12. by   CMERN
    Kavi... your story was just too funny....( Man convinced its his time, power goes out, lights on,harp music, ).
    dontcha just love quick witts?
  13. by   nimbex
    And the infamous ... out of nowhere... "I don't feel so good"