I'm glad I listened to my instinct.

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Specializes in Geriatric.

:)Hello everyone,

I'm posting a thread today to share a good thing I did yesterday by following my own instinct. I had a resident who is at high risk for asp.pna, everything is well the past few weeks, but the other day when I went to see him to give his regular meds, I noticed he looked a little different. His breathing was fine, his skin was warm,no cough either, all VS are good..but there is something wrong on his aura. I took my stethoscope and listened to his lungs. Crackles. Since being new, my supervisor told me not to worry since he doesn't have any fever & just order chest xray when he gets a fever. I told myself, why will I wait till he gets a fever? It's better to have him check & get a negative result than wait later. So I did not follow his instruction, I asked the MD for a chest xray and MD ordered STAT xray. He is my supervisor, he's been a nurse for quite a while, and I'm just a poor nurse for barely 3 weeks, but I am so glad that this time, I used my head really good & followed my own judgment.

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Good for you! I hope your supervisor wasn't too mad at you.

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So you left off the end. What was the outcome?

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Specializes in Hospice / Psych / RNAC.

What was the outcome. One thing I would like to teach you is that many older residents will have lung sounds without a disease process. That's why a baseline is always good to have. That's probably why your boss wasn't concerned since there were no other symptoms.

I have charted lots of "adventitious" lung sounds which means you hear something but you can't discern what it is, it's those extra noises. So in many charts where I have worked you will read that some of my patients have adventitious lung sounds.

I only tell you this for educational purposes and not to take away from anything you did; not all older residents have adventitious lung sounds. I rely on my 6th sense always. I do hope the person is OK and good for you for following your 6th sense.

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Specializes in Geriatric.
So you left off the end. What was the outcome?

+, abt started.

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Specializes in Geriatric.
Good for you! I hope your supervisor wasn't too mad at you.

I hope not too...

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Good for you. Not too long ago I had a pt arrive from OR onto the floor who just didn't seem "right". V/S upon arrival were WNL, so I just kept an extra close eye on her. Kept her door open next to the nurses station and paused every time I walked by to peep in.

Within an hour I noticed her breathing was more shallow. Went into the room to assess pt further starting with respirations...9/min. Took pulse ox... 55%. Called respiratory stat, got on the phone with the MD, and got that pt transferred to ICU real quick. She ended up being re-intubated, recovered, and came back to our floor (primarily ortho) within a couple of days.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

If he is a good supervisor he will applaud your good sense and perserverance and rejoice in yoiur accomplishments. I've told you...you ask the right questions and have a good gut....Well done.....

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Specializes in Geriatric.
If he is a good supervisor he will applaud your good sense and perserverance and rejoice in yoiur accomplishments. I've told you...you ask the right questions and have a good gut....Well done.....

Thank you...I am so glad to find a network like this, with wonderful nurses, because in my family I'm the only one who went to Health-related field...Everybody else went to Engineering or Accounting...Thanks again everyone!

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Specializes in Geriatric.
Thank you...I am so glad to find a network like this, with wonderful nurses, because in my family I'm the only one who went to Health-related field...Everybody else went to Engineering or Accounting...Thanks again everyone!

...and when I get home, they won't understand what I'm talking about.

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And it's stories like this that make me feel all warm and fuzzy.

I always get scared when another nurse tells me "I don't ever follow my gut instinct. You can't always trust it and you need to use reason only when dealing with patients."

Give me a "gut feeling" over "reason" anyday!

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Specializes in Med/Surg.

Agreed. i will always follow my gut instincts. that being said I have learned that when I do not believe my supervisor will support me. I do then inform them of the situation and course of action I am taking, i have been right often enough and they know I have the clinical knowledge so that this is not an issue.

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