I think I messed up and hurt a pt... sort of

[NurseNature]

I just don't know. I had a pt for three shifts in a row and on the third night he had a pretty significant change in LOC. The pt's son was at the bedside and thought his father had a small seizure just prior to the change, as he had seen this before because his dad had a seizure disorder. I really felt something was wrong. It's the first time I have really had the gut feeling everyone talks about getting as a nurse. I got my preceptor immediately and she told me he was fine and that it was just age and medication related. I still felt uneasy so I called an ICU nurse to come up and take a look. She agreed that it was simply age and medication related. I just saw the pt's son in the hallway and it seems his father has been in ICU ever since that night, which was one full week ago. Darn it anyway... why didn't I advocate better for him??? The doc on call was a first year resident and I felt the ICU nurse was a far better resource, but now I am so mad at myself for not doing more or for not calling another doc. Would it have mattered? I don't know the details of what happened after my shift and only found out he was in ICU b/c I saw the son in the hallway and he spoke to me. I cannot stop thinking about it.

[NotReady4PrimeTime, RN]

Don't beat yourself up. You sought the opinions of three other people with more experience than yourself and they all agreed it was likely not serious. You did what was expected of you. Honestly, I might have told you the same thing; transferring a patient with a known seizure disorder to the ICU because he had a seizure isn't usually the first thing we'd do, unless there were new issues. People who have had a seizure will have altered LOC for some time afterward, it's called the post-ictal state. With the information you have there is no way to know that what happened on your shift precipitated his transfer, and even if it did, you did what was expected of you. You feel bad about it but it wasn't your fault.

[AirforceRN, RN]

Do you have xray vision? How about CT scan vision? No? Well, then its not your fault. Moreover...who can say with certainty that the pts transfer or decline was at all related to a possible seizure? Don't beat yourself up. From the sounds of it no one could have asked for more patient advocacy here.