Vent about a patient

[Ortho_RN]

Ugh... I forgot to finish filling out my 24hr assessments so I go back up to the hospital to fill it out, when the Unit Sec comes up to me and says your patient in *** just threw a PE... I was like what??? I said she was fine all night... No complaint of anything... The other nurse said as soon as she went in to see her, the lady said she was having SOB.. Said she was SOB a few times during the night but never told anyone!!! Even the doctor came in there this AM and she didnt mention it.... I feel bad, but what could I have done.. She looked fine, wasn't in any Resp. Distress.. How can I help a pt if they don't tell you whats wrong, just say I am fine, when you check on them!!! UGH!! :angryfire

[justanothernurse]

Aren't we glad that diagnosis comes from the physician? We had a patient several years ago who presented with the same s/s- SOB, chest pain, anxiety, tachypnea, etc. No one could find the physician, and the nurses who eventually coded the patient felt the patient had a PE. The doctor made fun of them later in front of the family since they didn't recognize that the patient was in pulmonary edema. I told him I didn't care if it were a PE, pulmonary edema or a chicken bone in the throat. The patient was in distress, the nurses appropriately treated the symptoms and successfully resuscitated the patient. Diagnosis and treatment is a physician responsibility. Recognition of symptoms, physician notification and treatment within our scope is our responsibility. Our physician did back down and apologize to the nurses and the family members for his thoughtless statements. Your actions were very appropriate, and I agree with everyone that documentation is always something we have to take time for.

In reference to the critical values, it is our hospital policy that only a licensed staff member may accept critical values, C&S results or orders over the phone. Unlicensed staff as a general rule do not have the education to recognize the importance of the information given, and they don't have the rest of the picture on the patient. It sounds like this person may just like to be in the spotlight. I may be wrong, but she needs to function within her scope. It will protect her, too.

Well come to find out the patient didn't have a PE... She has Pneumonia...

Also at your hospital is an unlicensed hospital allowed to take critical lab values etc... and pass it on... I don't think they are suppose to, but this same US who diagnosed PE, took a critical blood glucose lab value from the phone???