So I was taking care of a patient yesterday who had major abd surgery about a week ago. She was intubated and she was quite a complex patient. She was in restraints because she was constantly messing with her lines and ET tube. She was sedated with a fentanyl drip but she would become alert with stimulation. It was a crazy day in our ICU yesterday. We had already had a code and an emergency intubation all before 11AM. It was about 12:30 and I grabbed another nurse to help me reposition my patient before I went to lunch. The RT came in at the same time to check her vent setting ect.... So we turned and repositioned my patient, did PROM on her arms ect ect... I asked her if she was in pain and she shook her head no.... but then she started biting her ET tube. We tried to get her to stop by reassuring her and telling her not to bite down. I went and got some prn morphine to help calm her down and gave it to her..... But she continued to bite her ET tube forcefully. We tried to pry her mouth open without any luck. I don't know what her problem was but ultimately her sat dropped and she brady'd down. It was only after she went unconscious that she let go of the dang tube.
We got her back after 2 rounds of CPR and some atropine but geez woman!! Stop biting your tube!!!
The scary thing is. When she had a death bite on her tube. I said "If you want to live, stop biting your tube." She sure didn't let up......
What a nurse has available to sedate/wean with is entirely up to the physicians. Each hospital/physician has their own protocols and "comfort levels" if you will for what they do with patients needing sedation. Can a nurse ask for certain medications to assist with weaning or increased sedation? Of course! Does that mean it will just be handed to them if the physician is not accustomed to ordering those things? Consider for a moment that one might not fully understand the situation as explained and therefore doesn't have all the answers or the moral high ground.
Take the title of the thread for what (I assume) is it's intent: a little dark humor after a crappy, busy day.
We all know how ugly it can get when a patient has an undesirable outcome and lawyers get involved. No need to hash it out.
This thread is super old. I am the OP. I actually work in the NICU now. When I reread my thread I thought I sounded a little harsh.. I actually left ICU because I was burned out and felt like I had lost compassion. I remember this day very clearly. It was a BAD day...
This thread is super old. I am the OP. I actually work in the NICU now. When I reread my thread I thought I sounded a little harsh.. I actually left ICU because I was burned out and felt like I had lost compassion. I remember this day very clearly. It was a BAD day...
We currently have a patient in my ICU that keeps biting down on his tube more so than most patients. I honestly wish I would sedate him and paralyze him sometimes. Lol. All for his own good of course
Hailipaige
1 Post
Well said! I agree 100%. Inexcusable