Readmitted shortly after discharge (long)

[tamz04]

There are so many threads I dont know if I put this in the right place.

I am freaking out. I have been an RN for 6 months. This morning my manager called to ask me about a patient I cared for which was transferred to a nursing home and readmitted to telemetry two hours after discharge with an MI.

Her concerns: did I see any changes in his condition since the doctor saw him (No there were no changes) and did I document everything (well ***** I hope so). This patient is in his 90s came in with change in mental status after a stroke, is aphasic. Runs tachy with very low blood pressure. I checked with my charge nurse before discharge to confirm he was okay to go because of his blood pressure. The paramedics said "he does not look good" when they transferred him and I told them that this is how he looks.

When I cared for him three days before there was a period where he was diaphoretic and respirations were 34, he was on aspiration precautions, lungs were clear and I called the charge nurse to come and see him. She was not concerned and this passed relatively quickly. Should I call the manager and tell her about this?

I feel terrible for this man. I am also worried because his son told me how upset he was with the nursing home and how he is going to take the matter further about his dentures being coated in rotten food when he removed them for the hospital.

And my God I am new so I am just freaking out.

[Virgo_RN, BSN, RN]

Can't give any legal advice or anything like that, but by "tachy", can you give me a heart rate? And what is a very low BP exactly? Were his heart sounds irregular?

[leslie :-D]

my goodness, this man is in his 90's and recently had a stroke.

your notes were fine, and the md discharged him.

don't start second guessing your actions.

it sounds like he's circling the drain and his time has come.

hoping someone has some common sense and keeps him comfortable.

leslie

[tamz04]

I suppose tachy is a bit harsh but he runs high in the high 90s occ low 100s. At 4pm his bp was 73/39 he usually runs about 65/45 but when i took it when he was transferred to the stretcher to go it was like 90/70 so I assumed it was positional.

I keep running the day through my head to make sure I dotted all my i's and crossed all my t's. bloody scarey