The other night I went to work (3-11) shift. I got report from dayshift nurse. I asked about a specific resident who had been on antibiotics for a UTI for a few weeks now, was told that she was OK, had pain pill earlier that morn. Just as we were finished our narc count and came out of the med room. The residents son comes up to us and tells us his mother is c/o a headache and would like something for pain. But he says he would rather she have Tyl rather than narc, because she seems to be very loopy from the narc.As he was telling me this, I thought I gave her narc pain pill the night before and she didn't act loopy, (she is normally a very alert and oriented person).
The dayshift nurse leaves, I take my little lady her tylenol. She is acting very unlike herself, very lethargic, confused and disoriented. I get vs and her bp was 90/40 HR 80 RR 30 and SPO2 86%, I start her on 02@2L/NC and call the Dr. Was not able to speak to Dr, but spoke with Dr's nurse told them what was goin on with her, nurse said he would relay the message to the doc and have him call me back, her 02 only came up to 90%. I was really uncomfortable with her condition, so I just went ahead and sent her out the hosp w/o waiting for the dr to call me back. She was admitted to ICU with hypotension and sepsis.
The admin called me later that evening and asked me what had gone on with her, and I told him, he asked" which dr. sent her out ?"I told him "I sent her out", he then said to me, "You sent her out ? So you used your nursing judgement and sent her to the hosp ??" I replied "Yes I did. I was not comfortable with her condition and felt that she needed to go to the hosp and she was admitted to ICU." And then he said I did a" good job." I felt good about sending her out b/c I knew it was what needed to be done, but I also felt bad that the dayshift nurse didn't do it earlier.
I was off the next day and when I went back to work another nurse said the dayshift nurse made a comment about the resident going to the hosp and how she must have had a change in condition rather quickly after she left. (mind you I started my shift at 3pm, I had that resident out of the facility and on her way to the hosp by 4:30). i guess she got a call from the hosp inquiring about this resident and the dayshift nurse was overheard saying "I don't know why they put her in ICU, I didn't think that would have been necissary, cause she wasn't like that one my shift." or something to that effect. Really trying to cover her ass. She never said anything to me during report about her until I asked if the hosp had called, and they said she was doing a hundred percent better. Really kinda made me feel good about my decision to send her out.
Since I am still new and inexperienced. I dont' think the vetern nurse I followed very pleased about it. I didn't get a good thing you caught that, or good job, or anything else from her. I got kudos from the RN super, another nurse (who doesn't even work LTC as she works the Rehab part) and another nurse plus the Admin. Not that I want the dayshift nurse to praise me or give me kudos, would have just been nice if she would have acknowledged me for it.
Anyway, I was pretty proud of myself. It really boosted my confidence as a nurse.
