I feel really awful

Nurses General Nursing

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Last evening I was taking care of a lady with an extensive past medical history. For most of the evening she was complaining of feeling weak, since she is older and just had surgery I figured it had taken a toll on her. The whole shift her oxygen level was low so I got an order to put a mask and the level incresed. She had one episode of acting very strange. The other nurse and I decided to do an ECG then we called the doctor. They didn't seem very concerned and had the medical student examine the patient. He didn't think anything was wrong, he consulted with the resident and they told me just to monitor the oxygen level overnight. The other nurse and I found this strange but the patient was feeling much better and the oxygen level had gone up so I didn't persist that something more be done. Well today I found out that the patient coded during the night and is now on the cardiac unit. I feel really awful, that I should have been more persistant. I had a gut feeling but for some reason I ignored it. Unfortunately my gut feeling was pretty much on target. This is the last time I take a gut feeling for granted.

Last evening I was taking care of a lady with an extensive past medical history. For most of the evening she was complaining of feeling weak, since she is older and just had surgery I figured it had taken a toll on her. The whole shift her oxygen level was low so I got an order to put a mask and the level incresed. She had one episode of acting very strange. The other nurse and I decided to do an ECG then we called the doctor. They didn't seem very concerned and had the medical student examine the patient. He didn't think anything was wrong, he consulted with the resident and they told me just to monitor the oxygen level overnight. The other nurse and I found this strange but the patient was feeling much better and the oxygen level had gone up so I didn't persist that something more be done. Well today I found out that the patient coded during the night and is now on the cardiac unit. I feel really awful, that I should have been more persistant. I had a gut feeling but for some reason I ignored it. Unfortunately my gut feeling was pretty much on target. This is the last time I take a gut feeling for granted.

you did your part increasing o2 and doing an EKG, this is a lesson for the physicians here. IT's easy to beat yourself up after the fact but I think you did recognize a problem which is why you did your interventions and notified the physician.

Instead of beating yourself up you should be proud that you are developing good nursing instinct and follow through. Sounds like you did everything right. We cannot stop the inevitable. :yelclap:

Specializes in Telemetry, ICU, Resource Pool, Dialysis.

You have NO reason to feel bad. Sometimes people feel very strange hours before an event like that. Many times there is NO concrete evidence of something wrong - like lab values, ekgs, etc until it actually happens. If there is no evidence, there's nothing to treat.Your instincts are right on!! Sometimes all we can do is closely monitor those patients who arouse our "something's not right" instinct. Then we're that much closer when something does happen.

You did everything right, you are not a psychic.

Specializes in Education, FP, LNC, Forensics, ED, OB.
Last evening I was taking care of a lady with an extensive past medical history. For most of the evening she was complaining of feeling weak, since she is older and just had surgery I figured it had taken a toll on her. The whole shift her oxygen level was low so I got an order to put a mask and the level incresed. She had one episode of acting very strange. The other nurse and I decided to do an ECG then we called the doctor. They didn't seem very concerned and had the medical student examine the patient. He didn't think anything was wrong, he consulted with the resident and they told me just to monitor the oxygen level overnight. The other nurse and I found this strange but the patient was feeling much better and the oxygen level had gone up so I didn't persist that something more be done. Well today I found out that the patient coded during the night and is now on the cardiac unit. I feel really awful, that I should have been more persistant. I had a gut feeling but for some reason I ignored it. Unfortunately my gut feeling was pretty much on target. This is the last time I take a gut feeling for granted.

You should be proud of yourself for being the patient advocate. You did not ignore signs and symptoms. You treated appropriately and notified the physician in a timely fashion.

Please know that you are a good nurse and always go with your gut instinct as you did in this instance.

My hat is off to you.

Specializes in Med/Surg, LTC.

Like all the other posts here, I'm not sure what else you could have done?? It seems you did everything to do and you put the ball in the right place - with the physicians. Hope you went home and had a good soaking bath with lots of bubbles!

Specializes in Med/Surge, Psych, LTC, Home Health.

I agree, what else could you have really done? You totally put the ball in the MD's court. You did a good job.

I have also had patients code the shift or two after mine, and it makes me feel bad too, like there's something more I could have done that I didn't do. Majority of the time though, it's nothing I could have predicted.

Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac.

Don't ever take the gut feeling for granted.

I agree with the others, you did a great job. We always look back in hindsight, which is a good learning experience, but sometimes it doesn't matter what you do, we're going to loose patients and patients are going to code.

Show me a nurse who does not wonder if more could be done and I will show you a nurse I don't want to take care of me.

Specializes in Hemodialysis, Home Health.
Show me a nurse who does not wonder if more could be done and I will show you a nurse I don't want to take care of me.

I like that ! Well said !!! :balloons:

And I certainly agree.

You did all you could... you left off where your responsibilty ended, and the docs' began.

Carry on. (((HUGS)))

Specializes in med/surg, telemetry, IV therapy, mgmt.

From the way you describe this incident I think you took the appropriate actions. The medical student consulted the resident after seeing the patient. The only other thing I can think of that you might have done was to, perhaps, call the resident back and be a little more assertive and tell him that you want him to come up and evaluate this patient because something just is not right about her. You didn't mention it, but what part did the nursing supervisor play in all this? If it's any consolation to you, this medical student and resident will have some explaining to do to their clinical supervisor and the rest of the residents and students on their clinical team with regard to the care of this patient.

There are times when even the doctors are doing all that they can based on signs and symptoms they see. The patient still codes. This may be one of those times. I sure would like to know what the medical student told the resident when he called him.

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