"Good Catch!" ---Tell us about yours

allele, LPN · Jan 9, 2006

This happened only a couple of months after I became a nurse, but I'm still proud of it since just because the doctor told me it was a good catch and something he hadn't thought of!! A few years back I worked in acute rehab and we had a 'frequent flyer' of a patient. A wonderful man with bad luck. Anyway, he had a shunt in his head that had somehow occluded. His family found him in his apartment unresponsive. He went to the hospital and then to our rehab, but in bad shape. Still confused, slurred speech, etc. Anyway, DPOAH was activated and the family made this 42 year old man a DNR (which made sense at that time). Well one day our neurologist "played" with the shunt...lo and behold a day later this man was literally back to his old self!! A little weak, but MUCH better. Well, I saw the doctor and asked that since this man was back to his 'ol self, he was competent and shouldn't we revisit the DNR issue since it wasn't him that decided on it? The doctor immediately took off his coat (he had been on his way home) and spoke with the patient, who did NOT want to be a DNR anymore!! This was years ago, but I considered it a good catch and I'm still proud of it! :nurse:

Angels' · Jan 10, 2006

Thank you for the "Positives" of Nursing :) :)

A returning student,

Angels’:)

"Footsteps In The Sand"

lsyorke, RN · Jan 10, 2006

Years ago as a new nurse I get a ER admit with "gallstones". She was medicated in the ER and a surgical consult was called. I go in to do the admission and low and behold as the pain med wears off the pain is RLQ not RUQ. I called the surgeon and told him that looks like an AP to me. Long story short, surgeon comes in.. off to the or. Ruptured AP. The surgeon came back out to tell me I should work in the ER!! LOL

CardioTrans, BSN, RN · Jan 10, 2006

I dont know if this falls into this category, but here it goes.

Had a patient in home care that had knee surgery from being thrown off a horse. Over a period of 6 months, she went from ACL repair, MCL repair to total fixation of her knee. She was on a continuous infusion of IV Nafcillin. Also on Coumadin, since she was post surg and over 40. The first time I drew her PT/INR, her INR came back at like 0.5. Inc her coumadin...... this goes on for a few wks and everytime her INR comes back extremely low even though she was up to 15mg of coumadin each day. It was like she wasnt even taking it, even though I saw her take it. So I do some researching of all the meds she is on to see if they decrease the effects of Coumadin.

So 5 weeks and 30mg a day later, I find that Nafcillin decreases the effects of Coumadin. Call the infusion company and specifically ask them about the 2 meds together. I was told "monitor INR closely". I brought it to the attention of the MD that was following her INR. He also finds this to be true.......... He continues to adjust it.......... She winds up taking almost 50mg of Coumadin a day while she is on the IV med.

Needless to say, I told her DO NOT shave your legs, brush your teeth hard or bump into anything. The MD wound up writing a letter to my supervisor about how I had potentially saved her from a thrombus and he was proud I was taking care of his patients. I didnt do it for him, I did it for the patient.

hipab4hands · Jan 10, 2006

Had a patient who kept complaining of "heartburn". After talking with him a few minutes, I found that the "heartburn" only occurred during excerize.

I consulted with our On Call dr, to get authorization for a same day cardiac eval.

I found out later that the patient was admitted for an MI. I was called later by the on call dr, who told me "Good Catch".

TazziRN, RN · Jan 10, 2006

I work ER. Recently the ambulance brought me (code 2) a young woman who was pregnant, had miscarried last year, and now had abd pain. VS stable, no bleeding, abd benign per medic. Field impression was another miscarriage. We were busy when she got in and the house supe was there helping out. I directed the medics to the OB room and the supe went in to get the initial assess done. She came out and told me, "Jo, this girl just doesn't look right." I went in, asked the girl how she was feeling, she said "Bloated." I turned around, got on the phone to the doc (ours do 24 hour shifts and he was in his sleep room) and told him I thought I had a ruptured ectopic. We had her diagnosed and in the OR within an hour, pretty darned good for a rural hospital. The doc and my nurse manager were at a meeting with the CEO the following week, and he told the CEO that I had saved the hospital from a possible malpractice suit because I had caught what the medics missed. (When I came running out of the room the medic asked what was up, and when I told her she said "I didn't even think of that.")

MMARN, BSN, RN · Jan 10, 2006

Keep these coming. They're awesome!!!!

Cute_CNA, CNA · Jan 10, 2006

This is a great thread! Keep 'em coming. Nurses make a lot of difference!

mhull · Jan 10, 2006

I work ER and went to the lobby to call a patient to the examining room. Well when i turned the corner, I seen a little old man sitting in a wheelchair. He had the "gray look" and was diaphoretic. I laid my original chart down and went over to the man. His son had brought him in and went to park the car. No one has put his sheet in the pile so we didn't know he was there. He was complaining of upper back pain radiating into his left shoulder, OK, her we go. I take him to a cardiac bed and hook him up. EKG showed inferior MI. Call MD stat to bedside, gave TNKase along with NTG gtt, etc. The gentleman actually ended up coding, but we resuscitated and sent him by the bird to a level 1 center.

The doctor I was working with actually used the words "great catch" in the letter he wrote to my manager, CEO of hospital, and others in the chain.

I love times when it is appropriate to brag like these. Keep em coming.

Michelle