Published Apr 10, 2012
MJB2010
1,025 Posts
I am new to neuro, so would appreciate some advice. Last night I had a patient wth a closed head injury from an mva. Had been in icu for over a week and unresponsive . When he started to wake up he was confused, garbled speech, but was able to be transferred to the floor same afternoon. He was finally showing improvement and knew his name etc. Alert, but disoriented to time, place, or why he was there. Kept asking questions "where am I, what happened?" seemed to be doing better.
Patient was restless and his mom asked for a sleeping pill for him. Patients mom is an RN, works as a school nurse.
My concerns
1. That the first day he seemed alert he was immediately xfered to floor. I was surprised they didn't at least wait a day to see how he progessed. Is this normal? Am I overly nervous?
2. I did not feel comfortable giving a sleeping pill to someone with his neuro status. I did not want him to get more confused or see any chanes in loc.
I checked with the charge nurse who said it was ok to call MD. MD was an on call, but knew patient and had seen while in hospital. Doctor ok'd restoril for patient. So I gave it, even though I felt very uneasy about it. Patient slept well all night. I monitored vitals all night, patient woke up a few times to use restroom. Patient was extremely confused this am, but charge nurse said it was because it was only 6am and that he would be better later on.
I couldn't help but be worried about this all day. You know that feelingin your stomach where you feel you shouldn't do something? That is how I felt about this sleeping pill. But the charge nurse ok'd it and so did the doctor and the patients mom is anb RN. Why am I so disturbed by it?