I must vent...

[Lola7211]

I need to vent...I have been thinking about this for days.

Telemetry nurse of a little over a year here. Had one pt starting Tikosyn. Spent all night worrying about his ever changing rhythms. Did a total of 8 EKG's - spent all night on the phone with the hospitalist. Ran all over the hospital to show them the EKG's - only got an order to keep atropine at bedside. Just happened to have a cardiologist there for an emergency - chased him down. He basically told me just to keep the crash cart at bedside and he stuck around to see how it went. Well sure enough - 5 minutes later - torsades. Called the code and long story short - pacemaker in place and saved - thankfully.

After coming out from the pacemaker placement I over heard him thanking the ICU nurse (who I graduated with) for coming because me and the other girl I was working with didn't know what to do. Not in a nasty way, in a "I am sure they tried their best" and laughed type of way. Then they both saw me standing there and changed the subject. All the ICU nurse did was push mag because the cardiologist said so. I could have done that.

I am not expecting a medal or anything. But that comment sure did feel horrible.

[Meriwhen, ASN, BSN, MSN, RN]

Keep in mind that the ICU nurse might have gotten the patient's accolades because she was the first one the patient encountered when the patient was no longer in danger.

That doesn't mean the remark doesn't suck any less or that you were really thought incompetent in any way.

Sorry this happened to you.

[icuRNmaggie, BSN, RN]

You need to approach this cardiologist and say something like " I do not appreciate the comment you made about my team. In the future, please know that we are all ACLS certified and quite capable of giving mag for torsades. "

He was deflecting blame for poor medical management on you and your coworkers. He did it to save face for what sounds like a real cluster. Would he ever openly make a disparing comment about his colleagues who were supposed to be managing the patient? I think not.

If your department does not routinely assist with transvenous pacemaker insertion, maybe that is what he was alluding to, and if so it was still a very unkind and unnecessary comment. I think you need to let your manager know about this whole event so that she can teach him some manners.

Ask her if the whole incident should be documented in an adverse drug reaction report.

[kakamegamama]

Aw, I'm sorry....been there, had that happen to me. I remember a pediatrician who cared for patients in our nursery. He had one specific nurse he always wanted around for procedures because he didn't think the rest of us knew what we were doing and was quite vocal about it. I finally decided I was not responsible for anyone but me when it came to skills, and if he wanted her rather than anyone else, more power to him. But, I think it could help you if you spoke to him.....make you feel better, at least?

[Farawyn]

I'm sorry, Lola.

[dudette10, MSN, RN]

It was the cardio who said it, no? That reeeeeaaaalllllly sucks for him to say that.

Once you calm down (aren't wanting to rip his head off), consider speaking with him about it. Some stuff you might want to cover: teamwork, learning opportunities, refraining from denigrating other members of the team. Be calm, cool, collected, but make it clear that you found his remark to another member of the team distasteful.

But, then again, I *always* go to the person who ticked me off first, no matter who it is. (There's a cardio attending and a couple of residents at work who will attest to that. )

ETA: By the way, giving/monitoring Tikosyn always makes me twitchy.

[Lola7211]

Sorry, it was the patient who said this. The cardiologist was great.

[dudette10, MSN, RN]

Then, I have to second Meriwhen's comment about the patient being out of the woods.

It sucks to hear that, after you've worked so hard for a patient. Maybe this gives you a chance to reflect on your demeanor in an emergent situation. Don't let it break you (you said you've been thinking about it a couple of days); let it make you even better!

[sugarmagnolia3]

I'm so sorry, that's so crappy. Instead of confronting the cards, perhaps next time you see him, you could discuss that night with him? Let him know about your interactions with the hospitalist. Seems to me the pt should have been upgraded to ICU after the 1st or 2nd aberrant rhythm. That's a huge concern. Then perhaps you could mention the comment, and let him know his assessment of the situation was inaccurate and unfair. I would also consider speaking with the ICU nurse, especially if you know her. When I used to go to rapids and codes, I never took credit- it's a team effort. Good morale among teams is how you run a good code.

[icuRNmaggie, BSN, RN]

Someone once said if you are waiting to hear thank you in this business, you might be waiting for a very long time. Who cares what he says? People are goofy.

He is alive because of your efforts and a team effort. The ICU nurse was probably almost as uncomfortable with the whole conversation as you were.

Be proud of yourself for being a strong advocate for this man who will never know how instrumental you were in keeping him safe and stable.

[ThePrincessBride, MSN, RN, NP]

If nothing else, it makes the ICU nurse look especially crappy for not bothering to correct the patient.

You handled the situation well and saved the patient's life. The patient was clueless.

[thenightnurse456]

The comments from the doc frustrate me. I'm an ICU nurse who used to work the floor and really despise when individuals put ICU nurses in this elite prodigy category of nurses.

I work hard as an ICU nurse, and I worked just as hard as a floor nurse!

I agree with other posters, I think he was covering tracks of his poor medical management of the situation. Any time a doc tells a floor nurse "just keep the crash cart at the bedside" is a red flag to me that the patient should be in a CCU or ICU environment.