I think that nursing today is often forgetting the basics. I had a patient this weekend who I transfered from a stepdown bed to med/surg. I followed the patient and floated to Med/Surg. By the end of the shift I became aware that the patient really needed a BM, and in report I suggested that the patient needs some MOM, ect.
This didn't get addressed and the patient went into A-fib with RVR in the night and ended up an ICU patient on a cardiziem drip. I took care of him the next day, he was distended and no appetite, and was more SOB (his underlying dx was pneumonia)
I told the hospitalist I was going to get his bowels moving when I reported some things to him in the AM, which I did with MOM and a suppository, much to the patient's relief. He had been having runs of wide-complex beats, most likely V-tach, and once he got into bed after his BM (med, hard) he settled down, his nausea went away (doctor had started troponin protocol based on nausea sx), and his heart gradually slowed down, allowing me to wean him off the drip. He converted to NSR at around 1500. The hospitalist put the patient on metamucil, and suggested that cardiziem (patient was on PO cardiziem at home) is a poor choice for a patient with tendency to be constipated.
My point in telling this story is that, I notice patients are being allowed to go too long without BMs. It seems that the basics of nursing care are being lost in a sea of regulatory overdrive demands and high tech wizardry.
