Horrible day

[zacarias]

Hey all :stone

Last noc was a nightmare. I can't go into it but basically my patient desatted and had a high heartrate and I feel I did everything OK and my charge feels I was unsafe in my care.

I've never felt so violated and hurt by what someone could say. I felt I did my best, I called docs, I told charge what was up but it seems I didn't "handle" it exactly right. I'm OK with constructive critism but blatantly telling how bad I was without any constructive criticism is painful. I don't believe I acted unsafe but that I did the best I could.

Oh well, I have to go try to get some sleep for tonights shift but I'm so disheartened.

[MelissaRN]

The exact same thing happened to me a couple weeks ago. I came in at 7:00 pm and was told that this patient was awaiting palliative care consult (cancer with mets) and that she gets SOB and aggitated and then the aggitation makes her SOB worse. I guess this had been going on for days.

Well when I went in to assess her she was sleeping soundly. I went in to give her IV push meds as scheduled and she didn't wake up. Her O2 sats were in the high 90's on 6 L oxyen. At midnight her BP was normal, pulse normal and sats again in high 90's on O2.

At 1:00 am I went in to giver her IV prednisone and the tech and I repositioned her as she was waking up more and moving around. Her sats were still good and she wasn't overly aggitated.

About 4:00 am the tech reported that she was aggitated and respirations in the 30's. I got an O2 sat that was still 93%. I had an order for IV Haldol which I gave and the was going to wait to see if it was effective.

In the meantime my charge nurse wanted report, while giving report dept. head walks by pt's room and notices she's in further distress and got angry with me because she thought that I wasn't doing anything about it. She acted as if this patient was like this my whole shift and basically said that I needed to go to an inservice with palliative care nurses because real life isn't like learning things in school. :imbar

She took over while I called the doctor to get higher doses of morphine for the SOB. I was giving her that and IV Ativan. She was still like that by morning but had settled down somewhat. Day nurses were like, oh she's been like that for days, she's really suffering! So basically I got bashed by dept. head for something that the doctors should have been doing something about days ago. The patient ended up dying two days later.

[MelissaRN]

The exact same thing happened to me a couple weeks ago. I came in at 7:00 pm and was told that this patient was awaiting palliative care consult (cancer with mets) and that she gets SOB and aggitated and then the aggitation makes her SOB worse. I guess this had been going on for days.

Well when I went in to assess her she was sleeping soundly. I went in to give her IV push meds as scheduled and she didn't wake up. Her O2 sats were in the high 90's on 6 L oxyen. At midnight her BP was normal, pulse normal and sats again in high 90's on O2.

At 1:00 am I went in to giver her IV prednisone and the tech and I repositioned her as she was waking up more and moving around. Her sats were still good and she wasn't overly aggitated.

About 4:00 am the tech reported that she was aggitated and respirations in the 30's. I got an O2 sat that was still 93%. I had an order for IV Haldol which I gave and the was going to wait to see if it was effective.

In the meantime my charge nurse wanted report, while giving report dept. head walks by pt's room and notices she's in further distress and got angry with me because she thought that I wasn't doing anything about it. She acted as if this patient was like this my whole shift and basically said that I needed to go to an inservice with palliative care nurses because real life isn't like learning things in school. :imbar

She took over while I called the doctor to get higher doses of morphine for the SOB. I was giving her that and IV Ativan. She was still like that by morning but had settled down somewhat. Day nurses were like, oh she's been like that for days, she's really suffering! So basically I got bashed by dept. head for something that the doctors should have been doing something about days ago. The patient ended up dying two days later.