How to Be the Good Patient and When to Seek Medical Attention

dwoolard

The flu epidemic has been causing overcrowding all over across the United States. In northern California the outbreak is no stranger and flu season is only half way done. Like every hospital we test for the flu and are required to ask every admitted patient if they want the flu shot to decrease transmission. It seems as though, every patient being admitted is wearing a mask and being ruled out for the flu. I received my flu shot this season but was I bound to catch the flu from the start because of my increased exposure?

Sure enough, I caught the flu this winter season. I experienced the fever, the chills, and the night sweats that are all common symptoms. I would have been more surprised if I did not catch the flu this season with all the sick calls from my fellow nurses. I only had to call into work for one day based on my three day schedule when I started getting sick. I believe the flu only lasted a couple of days because I received the flu shot and I was taking my immune boosters. I returned to work later in the week with no further signs or symptoms.

However, a few days later I started getting this chest pain feeling that I believed was heartburn. It was at the center of my chest, a burning sensation, and I had that acid reflux feeling in my throat. This was a rare occasion for me to experience heartburn but I keep tums in my household for guest. After a couple tums the pain still took an hour to be resolved and I could resume my daily activities. Later on, I had another episode of heartburn that was not correlated with my meal times that day. I started to think to myself "am I starting to get older?" I purchased some Pepcid and took some at the start of the day to help prevent heartburn symptoms but again another case of heartburn presented itself. On day three, I decided to head into the Emergency room to try a GI cocktail to knock this heartburn out.

I informed the ER clerk that I was experiencing chest pain that I originally attributed to heartburn but not was unsure. Unfortunately, all that was heard in the admission process was "heartburn" and I was told to wait. Two and half hours later I was finally triaged and seen by the MD to help resolve my heartburn. The MD told me the plan which I agreed with: Chest x-ray, EKG, Labs, and a GI cocktail for the pain.

The MD did not have a good poker face when the EKG was handed to him by the nursing assistant. I asked to see the EKG because my background is in cardiology nursing. I presented with ST elevation is majority of my leads, which caused me some alarm. The ER MD told me he was going to consult cardiology while wait for my test results and have my chest x-ray. The x-ray results normal which was a good sign.

The ER MD came to my bedside and informed me that I have Pericarditis. It finally all came together when I heard Pericarditis from my PCCN training. I had a viral infection first, then had chest pain that was affected by position, and can show ST elevation in an EKG. I was told I could be discharged from the ER and need to take Motrin 600mg every 8 hours for the inflammation.

The last thing I needed before discharge was the results from my lab test. Everything looked normal besides a slight elevation in my WBC, which caused no concern because I was recovering from the flu. Then my cardiac enzymes test results were run and I had a troponin of 11.0. No longer was I able to be discharged from the ER, I was being admitted for observation and a bedside ECHO. In our line of work people are told worse news every day. However, I am told I need to be admitted for observation and I was actually scared. I started thinking of all the worse possible scenarios that could happen i.e. heart transplant from cardiomyopathy.

I tried to be a good patient by putting on the grip socks and wearing the continuous pulse oximetry. I did refuse the SCD and tried my best not to silence my alarm monitor. I failed in the latter attempt and found myself silencing my bedside alarm because it was disturbing my sleep. I didn't want the nurses to experience alarm fatigue which is a new focus for Joint Commission.

Finally, morning arrived and I was seen by cardiology. My troponin peaked at 12.6, but finally down trended to 7.6 later on. My ECHO results were normal, and I was diagnosed with Myo/Pericarditis. The medication regime stayed the same with Motrin 600mg every eight hours.

This experience was an eye opener to see things from the patient's perspective and how disruptive those alarm monitors can be. I am happy to report everything is back to normal and I am able to resume normal activity.

Thanks again for reading.

To read more about alarm fatigue and participate in an academic research survey which I am doing for a MHA degree, please go to Alarm Fatigue Survey here on allnurses.

How to Be the Good Patient and When to Seek Medical Attention

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