Yesterday when I got to work and received my assignment, I noted that I had a patient that was admitted to the hosp with back pain. This patient came in through the ER and as part of her workup, they did a pregnancy test. The test came back positive with a quantitative number of 67,000. The patient did not know that she was pregnant because she had been on depo shots. Anyway, she was admitted to our floor and arrived to the floor at about 0200. The ER did not do a pelvic ultrasound and apparently did not assess the pregnancy in any way. When I came in, my CNA told me that the young lady was in tears and in "A Lot of pain". I went down to the room to assess her and take the only pain med that was prescribed (tylenol). When I got there she told me that her pain was increasing and coming in waves across her back. I settled her in bed and went to notify the md of her status. After being given an order to get an OB on consult and then talking to the OB and getting her orders, I was entering the orders in the chart. At this time the CNA came back and said, "you need to come now, something is wrong". I went back to the room after tapping a doctor on the shoulder and saying to please come. When I got there I did a non-invasive lady partsl assessment and lo and behold there was the head of a baby in my view. I called immediately for an ob nurse and got the md to move faster. We transferred the patient to the ob floor and the baby was born less than six minutes later, very premature. She was intubated shortly after birth. I felt very fortunate that I was able to get this patient to the right location in time, but felt that had she been properly assessed in the ER, she would not have been placed on our floor. Does anyone else have any comments on this? Anything I could have or should have done differently? Any comments or suggestions will be welcome. Thanks in advance. :stone
