patient choked after taking pills..

Published

Specializes in OB, Peds, Med Surg and Geriatric Nsg.

I had a patient that choked after taking her pills the other night. Happened around 2200. I was there standing in front of her while she was taking her pills. I left the room after she drank her water. A minute after that, a heard a moan in the room and went back. Saw patient holding her throat. Asked her if she was choking, she nodded yes. I did the Heimlich and she started coughing. I rejoiced after doing the Heimlich as I never had done it after I had my BLS certification. Little did I know, it is a severe case that is reportable to nurse supervisor, admin on-call, MD, and the state.

My mistake: Didn't told my nurse supervisor about it right after the incident happened. Though she overheard it when I was giving report to the incoming shift. She told me to make an IDT about it and make an IR. Admin on-call wasn't informed since nobody in my shift nor the incoming shift knew that she needs to be notified about it. Family wasn't made aware because of the time though I forgot to pass it on to the incoming shift. MD was made aware thru fax but forgot to document it on my nurse's notes.

Now, I feel like I'll be totally grilled today when I come in to work. My clinical directors would be there. And only God knows what's gonna happen. I did my very best to give care to my patients, but right now, I just don't know what to think about myself. I am new to LTC and had 6 weeks of orientation. I am on my last month of my introductory period. Should I ask them for more training? I've been having lots of mistakes in the past few days because of improper documentation, unfinished admission papers and little things. Can I get fired from being written up?

Please share me your thoughts. I'm feeling so down right now. :crying2:

Up Vote Up Vote ×
Specializes in PICU, NICU, L&D, Public Health, Hospice.

Take a deep breath...you should be okay...the patient survived and apparently suffered no complications from this incident.

We all make mistakes, especially when we are new to nursing or a particular job. This should serve as a learning opportunity for you and will improve your care delivery in the future. Hopefully your management will see this as an opportunity to mentor and nuture you into a career as a successful nurse in their facility.

Up Vote Up Vote ×

I can't see that your did any thing wrong clinically. You watched her take the pill, you left after she swallowed some water. You returned and did the Heimlich correctly. The patient is fine. It was such a brief episode I assume your thinking was she is fine now, (I assume she was talking, breathing, doing fine after your Heimlich.) I really praise your quick thinking and reaction. (I've never done the Heimlich.) Be brave with your director. Answer any questions they ask simply and honestly, don't blather on and on, just simple short answers to any questions they ask you, "yes or no." Yes you should have told your supervisor or the doctor, yes you should have documented it. But keep telling yourself "I did the right thing, the patient is fine!" If you lose your job they are losing an excellent nurse!

Up Vote Up Vote ×

I could be wrong but I believe that after you do the Heimlich maneuver on a patient, particularly a nursing home resident, the resident has to be further checked by a doctor because they are frail and it is possible to unintentionally break their ribs.

Up Vote Up Vote ×
Specializes in OB, Peds, Med Surg and Geriatric Nsg.
I could be wrong but I believe that after you do the Heimlich maneuver on a patient, particularly a nursing home resident, the resident has to be further checked by a doctor because they are frail and it is possible to unintentionally break their ribs.

I did check and asked her if she was having any pain upon inhaling or exhaling. No complaints at all. Since it was that late of night and being on a weekend, I only made the MD aware thru fax. I am just so nervous about how my day at work its gonna be like because of everything that happened over the weekend. Didn't had enough sleep last night, spent an hour crying over the mistake I've done and the outcome that may come out of it.

Up Vote Up Vote ×
Specializes in Pediatrics, Geriatrics, LTC.

By now you are probably at working and learning what to do in the future. You gave me good advice too since I am in the same new at LTC and still learning as you are. Sounds like the resident also needs a swallowing evaluation and maybe will need her pills crushed (with applesauce) in the future. Many older residents take pills this way. You also reminded me to stay nearby no matter how rushed I am! This will work out ok. You won't be fired for being written up once! You probably won't be written up. Let us know how it went and stop beating yourself up!

Up Vote Up Vote ×
Specializes in LTC.

The resident survived that is the most important. Sounds like a review of policy and procedures for all staff is in the offing for incidents like this.

Just remember to CYA. Charting will save you. With unusual incidents such as choking etc. I would call and notify the MD on call after getting vitals and doing a good respiratory and pain assessment. Usually the MD will just tell you to observe but it covers your heinie in case a problem shows later.

You did the best you could with the knowledge you had at the time. It will be ok.

Up Vote Up Vote ×
Specializes in OB, Peds, Med Surg and Geriatric Nsg.
The resident survived that is the most important. Sounds like a review of policy and procedures for all staff is in the offing for incidents like this.

Just remember to CYA. Charting will save you. With unusual incidents such as choking etc. I would call and notify the MD on call after getting vitals and doing a good respiratory and pain assessment. Usually the MD will just tell you to observe but it covers your heinie in case a problem shows later.

You did the best you could with the knowledge you had at the time. It will be ok.

Thanks for your insight, bubblymom. Really appreciate it! Sorry to bother you, but what is CYA?

Up Vote Up Vote ×
Specializes in LTC.

Cover your ass ;)

Up Vote Up Vote ×
Specializes in OB, Peds, Med Surg and Geriatric Nsg.
By now you are probably at working and learning what to do in the future. You gave me good advice too since I am in the same new at LTC and still learning as you are. Sounds like the resident also needs a swallowing evaluation and maybe will need her pills crushed (with applesauce) in the future. Many older residents take pills this way. You also reminded me to stay nearby no matter how rushed I am! This will work out ok. You won't be fired for being written up once! You probably won't be written up. Let us know how it went and stop beating yourself up!

She was actually put on mechanically soft diet a day after the incident happened. Her meds were also crushed though patient was upset about it. She even told me it was no biggie. I hope I would think the same. Swallowing eval will be done today as I wrote an IDT form about it.

Up Vote Up Vote ×
Specializes in OB, Peds, Med Surg and Geriatric Nsg.
Cover your ass ;)

LOL! I did remember someone told me that when I was just starting at my current job. I really thought old people would be smacking my ass at work. Thanks! I pray for work today would turn out fine. My weekend was a horrible nightmare.

Up Vote Up Vote ×
Specializes in Endoscopy/GI.

Hello Friend,

Sorry to hear about your weekend. I feel what you're feeling. But hey, you did the best you can and the resident is fine.

Don't be scared. When you will be facing the management, tell them the truth.

Lemme know whenever you will have your day off, I'm hear to listen and cheer you up.

Up Vote Up Vote ×
+ Join the Discussion