Ever walk into a room and think, "Something isn't quite right?" I'm sure you have, and I personally hate that feeling. I want to know WHY I feel that way, and sometimes, I don't! There isn't enough there to call a rapid response, and I often wish there was something--anything--to justify that nagging feeling...
A patient I had today gave me that awful feeling. I eventually acted upon it, and an ICU eval was in progress as I clocked out.
Ever just go, "Oh, I'm just gonna make the call and see what comes of it"? I hemmed and hawed on this guy until I made the call. I figured, "My job is to monitor and know when something isn't right; it's the docs' job to figure out what it is."
Give an example of when something "just wasn't right," and tell me how it turned out.
We got a burn in. 40%ish. He is a little drunk but many of our patients are. Denied a drinking or DT history. But I can spot a fellow drunk from a mile away. We admit as ICU and I am telling everyone that will listen that we need an aggressive AWAS order set because he is going to DT really hard. No one listens. He started seizing about 36 hours in.
It really is that nurse's sixth sense. I have had many moments where I just had a "bad feeling" about a patient. I had a patient not too long ago, had gotten a stellar report from the off going nurse.... he had been improving, I was told, and possibly would be discharged in the next few days.
The moment I walked into that room I just had that feeling. But like other posters - vital signs were fine, everything looked good.
I work in LTC and had a resident that everyone kept saying "just had a cold." She was usually very feisty but was quiet all shift. I am an lpn and reported to the rn her change of behavior. I told the supervisor that I felt the resident was going to die and her family only thought she had a cold. The supervisor basically told me I was overreacting and that I could waste the family's time if I wanted. I ended up calling them and they came out to see her that evening. The resident died the next day!
I've also had that intuition the times I have made errors as well! There is always something in the back of my head telling me to rethink what I'm about to do but I have shrugged it off when I shouldn't have!
........I've also had that intuition the times I have made errors as well! There is always something in the back of my head telling me to rethink what I'm about to do but I have shrugged it off when I shouldn't have!
Sometimes that same little voice will tell me that something I'm about to do isn't right. I just have to find out what is the problem.
My first job as an RN on 11-7, I had to medicate the early pre-ops and then send them off to OR. One morning I drew up the Demerol and atropine, but I stood there with the syringe just looking at it. Couldn't give it - something was wrong. I held up that OR, big time! They called me twice and even sent an OR tech. Still I couldn't give that injection.
Then I did that old TV trick of 'recreating the crime scene'. Retraced all my steps and looked at my syringe's meds and the empty vials as compared to the order checkoff. DANG! I drew up dem & atropine when it should have been Demerol and Phenergan. If I had let the error go thru, I don't know if it would have made very much of a difference. But that rattled me. I quickly drew up the right meds, gave it and sent the pt off.
I believe 'when in doubt, err on the safe side'. I knew something wasn't right and I had to fix it.
I remember getting that nagging feeling when I worked in acute care. I hated it. For the most part the assessment and labs were normal but there was something that just wasn't right. I worked in a teaching hospital so we always had an intern available to evaluate the patient...I learned to trust that feeling. Most of the time there was a very valid reason for it.
Specializes in Psych, Corrections, Med-Surg, Ambulatory.
When I was working acute psych we had a patient with an IV and foley (both rare on psych). He also didn't speak English. Late one evening, I went into his dark room to change his IV bag by the bit of light coming through the doorway. I thought he was asleep. I didn't see anything amiss, but something raised my hackles and I flipped on the light. The first thing I saw was the tip of his foley, with a partly-deflated balloon, lying on top of his bed linens. I whipped back the covers and saw more blood than I had ever seen in one place. He had self-d/c'd his foley, without benefit of a syringe.
I still don't know what gave me the urge to flip on the light. I must have smelled all that blood without immediately realizing it. I also learned my first Spanish words that night: "Mucho dolor."
I believe it's a mix of instinct, experience and subtle/intangible signs. It has never steered me wrong.
I always say, "As nurses, we have spidey senses." It's a gut feeling that we all gain with that mix of instinct, experience and intangible signs as you've described.
I'm "only" a student, and I work as an aide too. I had a pt two work shifts in a row; the second day I walked in and instantly something about the pt alarmed me. No objective changes like vitals, just something "off" that I couldn't put my finger on, so I grabbed the RN. Pt coded very soon after. I'll never forget that alarming feeling, it's eerie.
I've only been a nurse for a year. Many many times I have had "feelings" that something wasn't right, but each time I seemed to be wrong. I'm still trying to hone my nursing sense, but my anxiety keeps getting in the way!
Med Surg. Mid 2000s. young female patient who didn't feel well. Next thing crashing from Toxic Shock Syndrome. Stuff got real..REAL quick. My hands were shaking when she was finally stable. Was ok in the end. I still have nightmares about that. Anyone going into nursing who thinks it is just a paycheck has no idea what they are getting into.
Many times! I worked pediatrics and saved 3 kids because of it (I hate saying that too b/c I don't want the credit for it b/c it was my job). I use to be a clinical instructor and remember telling my students to listen to that gut feeling. It's always better to be wrong than to have been right and never act on it. I really wish I knew what it was b/c each time I never had any objective info and never even knew the pts when I had that feeling.
dirtyhippiegirl, BSN, RN
1,571 Posts
We got a burn in. 40%ish. He is a little drunk but many of our patients are. Denied a drinking or DT history. But I can spot a fellow drunk from a mile away. We admit as ICU and I am telling everyone that will listen that we need an aggressive AWAS order set because he is going to DT really hard. No one listens. He started seizing about 36 hours in.