I was working on a med-surg floor the other night and one of my pts was an 85yo male with PNA who had been there for a few days, can't remember if he had abx during his course of tx but I believe he did.
Anyway, my shift started at 2300, listened to report (we use voice recorded report system), where I heard he had a fever (102.0) during day shift but was expected to D/C the next day. I took his temp at beginning of my shift, it was 100.0. He slept for most of my shift, and things got busy so I didn't get to his 0400 vitals...when I recorded report for day shift, I mentioned he had a fever during day shift and that for me, his temp was 100.0 but that I had heard he might be going home, etc.
When I go to give the day shift nurse updates, she says "So you think they're going to send him home with a fever?" I told her that while it was elevated, his temp was more borderline fever (orders are to give Tyl for temp >101) and that...well...I don't know, that's just what I heard from day shift and MD progress notes. She insisted that we wouldn't send people home with a fever.
I was just passing along what I heard, but also giving my objective description of his temp. I suppose any anticipation for D/C would change if his AM temp was back to 102, or other vitals were a bit off. I guess I was looking at it like this - he's 85, he had PNA, his temp is going down...his PNA wasn't totally resolved in that he still had a wet cough (though not very productive). But why wouldn't we D/C him to recover at home if his vitals are stable and any abx are finished?
I'm a new nurse (less than 1 yr) and I'm already self-conscious about my nursing judgment (and I know giving orders to D/C are out of my scope of practice ) but...am I wrong to think this guy should stay longer because his temp was 100? Am I being lazy and dangerous here??
) but...am I wrong to think this guy should stay longer because his temp was 100? Am I being lazy and dangerous here??