Ummm, I think the patient looks bad....

[SweetLemon]

So last night I had a patient who is normally very bright, pleasant and talkative get up in the middle of the night practically unable to walk. She was very lethargic with slurred speech and a dramatic overall general weakness. While sitting in a chair she slouched over and while she was oriented x 3 still appeared to be very generally confused. While her BP & Pulse were both a little low from here norm neither of which were alarming. Blood sugar was good temp normal, but she continued to complain about an intense headache and generalized body pain. So my dilemma, I had another nurse as well as my supervisor come down and take a look at the patient and we all three were in agreement that she probably was going to need some additional care, So I get on the phone with the doctor (who was incredibly gracious, especially for it being 3am and attempt to explain my pt). First of all I have to admit I was a little nervous I dont mind interacting with the doctors and find the majority of the staff come across to be very decent but I hate calling them in the middle of the night. With the vitals and the blood sugars being as they were I just felt as though it was impossible for me to convey the actual status of my patient. Coupled with my neves I found myself repeating the phrease, "ummm, well she just looks really bad". How do you convey that a patient looks bad without having things like vitals to back you up???

[GeauxNursing]

so what happened??

[SweetLemon]

I was unsure at the time but had a feeling that the patient was either A: way over sedated from new scheduled meds she began taking or B: possibly having a stroke. With her current medication and status A was most likely but I did not want to rule out B simply because it was 3am and I did not want to bother the doc. After waking the patient up a little more with constant 1:1 monitoring and vitals/neuro checks she became a little less lethargic. I also gave her snack, even though BS was fine just to see if it would not help wake her up a bit. within an hour she looked much better and by then end of the following day she was back to her old self. A feel a bit embarrassed that I made everyone jump through all those hoops and it ended up (appearing) to resolve itself but on the other hand at the moment I really was uncomfortable about the patient, I had 2 much more senior nurses look at her and they agreed the doc should be called, and a learned a lot from the experience. If I could do it all over again I think I would probably still call the doc, maybe not suggest that the patient needed to be sent out quite so quickly though. Thanks for all the support and tips! :[anb]: