I think my resident may have been having an MI

[Spritenurse1210, BSN, RN]

Resident a presented in the bed moaning "owie, owie, owie" clutching her chest, grunting, and writhing in the bed. T 100 P 112 R 26 BP 171/102 which had elevated 10 minutes after I took it manually (first reading was 172/98). She had a history of CVA, and HTN left sided weakness. She had Dementia and wasn't able to give me a pain rating or tell me what kind of pain she was having (her baseline is the mindset of a 6 or 7 year old) . I asked her if it felt like someone was standing on her chest, she said yes. I handed her Teddy ( she has an attachment to a black teddy bear) told her to squeeze her every time it hurt, called 911 and she was sent to the hospital 10-15 minutes later once EMS showed up. My question: Was she having an MI? Her doctor is nearly impossible to get in touch with (he didn't return calls after a month of myself, 7-3, 3-11, DON or ADON trying to contact as well as numerous faxes) So i just sent her to the ER without a doctor's order. I charted everything I did for her, will I get into trouble for sending her to the ER without a doctor's order? I didn't even bother trying to contact her doctor, just got her to the ER asap. I did the right thing, right?

[Virgo_RN, BSN, RN]

Could be an MI, or a PE, or a dissecting aortic aneurism, or a lot of things. But yes, you did the right thing. Hopefully she will recover from whatever it was.

[kittykatty]

You did the right thing but next time just put in a call to the Doc even if you know he won't return it--just to cover yourself.

[Orca, ADN, ASN, RN]

You had no choice but to call EMS. If you called the doctor, make sure to chart the date and time and that there was no response.

[scootertrash nurse]

you did the correct thing!!! but your DON and Administer HAS to talk with with the doctor!!!! residents are people too. patient advocate and safety is your first job. Now unless the patient had something on there chart like DNR but still should of had the Dr return you call and some pain meds and basic lab, and or xrays (Have the family yell at the Dr also)

[rn-jane]

You did do the right thing, but always call the doctor. Even if it is just the doctors office, service to cover your behind. If you can't get in touch with the doctor relay it to the supervisor, don and call the er and notify the er md that you attempted to get in touch with the md. Always cover your behind! Then CHART, CHART AND CHART!

[txspadequeenRN, BSN, RN]

dnr or not if there is someone in a nursing facility that has chest pain they go out to the er.. to the op...you can send someone out by nursing judgment...you could have been waiting all week for a doc to return your call and the patient could have died ...leaving you in big trouble..

you did the correct thing!!! but your don and administer has to talk with with the doctor!!!! residents are people too. patient advocate and safety is your first job. now unless the patient had something on there chart like dnr but still should of had the dr return you call and some pain meds and basic lab, and or xrays (have the family yell at the dr also)

[Spritenurse1210, BSN, RN]

I sent the doctor a fax before I left for the morning, forgot to add that to my OP

[NurseKatie08, MSN]

You absolutely did the right thing---as others have said just chart what you did to cover yourself...I have sent out patients (sub-acute rehab) via 911 before I could get a hold of the doctor as well--its nursing judgement.

[OrthoRN09]

you did the correct thing!!! but your DON and Administer HAS to talk with with the doctor!!!! residents are people too. patient advocate and safety is your first job. Now unless the patient had something on there chart like DNR but still should of had the Dr return you call and some pain meds and basic lab, and or xrays (Have the family yell at the Dr also)

DNR does not mean do not treat.

And to the OP, yes you absolutely did the right thing!! Your patient/resident was lucky to have you.

[morte, LPN, LVN]

i'd say the OP is a new nurse with his/her critical thinking skills intact.....

[mustlovepoodles, RN]

You absolutely handled that correctly. You had a patient with cognative impairment unable to articulate who was giving you a clear signal of distress. You *have* to respond quickly in that situation. I don't think anyone at your facility should be upset. If anything, they should give you a pat on the back and a free meal for catching it early!