Lost my first patient.

[nurseinmo]

I am a "new LPN" (graduated in August 04) and have worked in the same LTC/MRDD facility for the past five years. Lately due to shortage of staff issues I have been the only nurse in our building on the weekend(there is an RN in our other building across the street from us) and when this happens I still am expected to pass meds to 32 individuals who take an average of 8 meds each and still be responsable for any medical issues/emergencies that arise. I discussed with my "boss" today how uncomfortable I have become with this current situation because we have had several "minor" emergencies lately. Last night we sent an individual to the ER because she was very pale, not responding normally for her and I could not find her BP (though she was obviously breathing) Our Dr. came in and could not find one either... Anyway we sent her and they sent her BACK HOME! with a dx of bronchitis and hyponatremia. Anyway, long story short, she quit breathing at 9:25 Our facility is kind of odd the way it is set up but we have a one-number emergency line that is supposed to be used in this type of situation and all medical staff are to be paged to whatever area STAT. My pager never went off! The people who were with her found me very quickly and we handeled the situation as best we could but she passed away at the hospital at 10:02. This is the first patient I have lost so that makes it hard anyway but then all the other events surrounding it just made the whole thing that much worse. No one knew what time the ambulance was called (I called the swithchboard operator who is supposed to log every call regardless and she told me she thought it was 9:40....they left w/the pt at 9:40! It was just a very stressful evening, one I hope I don't have to relive!

[Saved_by_Grace]

I'm so sorry that you lost your patient. Things in your facility seem way too chaotic to say at the very least. I don't really have any advice as I am just a student but I can let you know that I'm sorry for the situation you're in. Hang in there.

[ClaireMacl]

I'm sorry this happened to you

When I worked on the wards, if someone looked that sick, we'd not send them to the ED, but get the on-call up. I understand things are different with you.

Your instincts were clearly right, you sent them to ED because they didn't seem right and sadly were proved right.

Just remember that you made the right judgements at the right time. Clearly the ED diagnosis was wrong, but that's another learning curve. You done everything you could.

Rest assured, I'm an RN with a few years behind me and I wouldn't do anything different.

Claire x

[RosesrReder, BSN, MSN, RN]

I am so sorry to read that this happened to you. It does seem quite chaotic and disorganized at your workplace. You did the right thing to talk to the boss, and hopefully it does you good and the situations lightens up. Needless to say, if it does not and it is too stressful for you, then look elsewhere for better working conditions. Best wishes to you. :)

[Bird2]

I am so sorry that you had a rough night. It sounds as though your nursing instinct was very right reguarding your resident. Why did the ER send her back?? Sounds as though your resident was to unstable to be sent back to the LTC. Very sad.

[mdoze911nurse]

I am sorry to hear about your experience. I hope after you sleep on it you are not so overwhelmed. LTC has got to be hard when you have so many patients and one you.

You've done the right thing by talking to your boss and you obviously had good instincts. Maybe you can use this experience to correct some of the policies in the facility. Possibly suggest a group to review the incident. I work in the ER and on the ambulance and all deaths or calls with bad (undesirable) outcomes go to review. This is not to BEAT anyone up but to see what we could do differently - if anything. We call it Q and A.

I'll be praying for you. Good, Caring nurses are needed in LTC (and everywhere). My mom was a LTC nurse and she was so very special. I wish I had some of her qualities. She is now a patient in the facility she worked in.

[nurseinmo]

Thanks to everyone for thier support. I am trying to prep. myself to go in to much the same situation tonight, though hopefully with no one this critical. I had already deceided last night though that I am going to demand (as nicely as possible) help. I just don't feel comfortable being in the same situation so quickly after this happened.

[chattypattyCRNA2B]

I'm sure losing a patient is hard enough, but under these circumstances it can be harder to accept. At least you have the comfort in knowing that you did everything you could for the patient. I hope the working conditions get better for you.