What did I do wrong here?

CritterLover, BSN, RN · Feb 1, 2005

well, what did you want? :)

from what you have said, it sounds as though you wanted to be "checked out" due to a seizure and an apenic spell. neither of which should be taken lightly.

while it wasn't unreasonable for the nure to ask you that, her wording leaves something to be desired. when i am in triage, i usually say something along the lines of "so what brought you to the hospital tonight?" this frequently elicits a long, involved story. to which i tend to reply, "what was it that happened tonight that made you decide to come to the er?" pretty much what she asked you, but maybe a bit more professional.

it sounds like you feel that you wern't taken seriously, and that you feel like they treated you as possibly drug-seeking (asking you if you were there for sleeping pills). so my question would be, what sort of tests did they run? was this a first-time seizure, or have you had them before? do you take any anti-seizure meds? had you run out? from what you have stated, it sounds as though you have never had a seizure before, and you suspect it was due to the apnea spell.

you said that once you were admitted, it was found that your o2 sat was in the 80's. was this around the clock or just when you were sleeping? did they check an o2 sat on you while you were in the er? if so, was it normal?

where i work, we check an o2 sat on everyone in triage, as part of vs. in general, anyone who has had a seizure gets a head ct, unless they are one of our ffs who are known to be non-compliant with their dilantin, etc. they also get a cmp and a cbc, and the appropriate drug level if indicated (phenobarb, dilantin, valproic acid, etc). new onset of seizures are generally admitted for a work-up/neuro consult to determine the cause.

when you left, were they finnished with their work-up, or were there still tests to run? were they planning on admitting you? did you have any idea what the plan was? waiting in the er can be very frustrating, and some doctors, residents especially, are not very good at letting you know what the plan is. it is possible that even if they hadn't gotten around to the above-mentioned tests, they were planning on it. (maybe when the resident said he had no idea what to do with you, he was going to talk with his attending to figure it out?) sometimes things move sooo sloooowly in teaching hospitals, becuase the least senior resident is often the one who goes in to make the first assessment. the he conferrs with his more senior residnent, who then conferrs with his more senior resident.......all while you wait and wonder "what is wrong with me?"

so in answer to your question (or sort of answer your question) as to what you did wrong, it is hard to say since i wasn't there. you definatly did the right thing by going to the er after having a seizure. no question about that. maybe you didn't articulate the problem very well to the triage nurse. (i don't know; but really, in my hospital system, anyone who comes in with a seizure complaint is brought back pretty quickly, even if we have to put them in the hall. can't have someone seize in the wr, right?) you might have had a little too high of an expectation to think that the er doctor would figure out why you had the seizure. while they are specialists in emergency medicine, they are not specialits in neurology or pulmonology. sometimes they just have to admit and let the other specialists figure it out. its possible that you didn't give them enough time to figure out what tests to run (and by that i don't mean the time you were waiting, which i'm sure was quite a while; i'm talking about giving the resident a chance to talk with his attending and get back to you once he figured out that he, well, couldn't figure it out).

if they didn't run any tests, and wern't planning on it (o2 sat and a chemistry pannel at least), then i would say they were out of line.

in the future, please remember that if a resident isn't getting where you think he/she needs to go, it is your right to ask to speak with his/her supervisor.

i hope this helps, and i'm so glad someone figured out what the problem was.

rjflyn, ASN, RN · Feb 1, 2005

No you should have not been treated the way you describe. Unfortunatly you cant teach tack and caring to everyone. I hope you are doing better and getting the much needed health care it sounds like you need.

As far as why the seizure its is pretty obvious in your post why. 2 mins of not breathing is significant and most likely the cause of you seizures.

One suggestion if it has not already been done, you need to be seeing a specialist in sleep apnea. The will do sleep studies and recommend further treatment- possibly beyond a CPAP machine.

rj

medsurgnurse, RN · Feb 2, 2005

Recently I went to the ER due to having a severe sleep apnea episode (2 min not breathing and a seizure) and ended up walking out. Im wondering if I could have done anything different to have been treated better or was it just my luck.
During triage after explaining my situation the nurse asked me if I was there for sleeping pills. Ummmm no....that probably wouldnt be the best idea considering my situation. Then she asked "what do you want us to do?" I looked at my Mom who was with me and looked back at her and said...you all are the specialists!
Then when the nurse was getting me settled in....she was asking questions and I was giving her examples of how bad my memory has been lately. I told her that every time I walk into a room...i forget why I went in. She proceeded to laugh and say that happens to her all the time. Ok but 8-10 times a day? made me feel as if my symptoms werent very important.
Then the resident comes in...asks me all the same questions...then gets pulled away to a trauma. Hey i understand that. So I sat...and sat....he comes back an hour later and says he has no idea when he will be back to me.
That did me in...i just had to get out of there.
This is the same hospital i worked in for years and yet i keep trying to give their ED a chance but it never works out!
Could I have done something different here?? or was it just my crappy luck.
Oh and i was hospitalized after my doc found out about my seizure. O2 stats were in low 80's. Been having severe daytime fatigue and delousional episodes for 6 months. Finally on a CPAP machine :)
PS my nurses in the hospital were just great! really made me feel at home...

Are you a nurse? This board is for nurses to discuss issues, not for the public to ask medical questions. If you are a nurse member, my apologies.

MLL · Feb 7, 2005

Are you a nurse? This board is for nurses to discuss issues, not for the public to ask medical questions. If you are a nurse member, my apologies.

I was wondering the same thing!

needsmore$ · Feb 7, 2005

According to the profile and the posts they have answered- the OP is not a nurse. We must be careful as we wouldn't want our information to be misused by others. We are not giving out advice as medical experts---and I wouldn't want any of my posts to be used by another --

ex- "This nurse on this website said this ED should have done this and this and this...."

I am not saying that the OP would do this--but remember this is a public forum and our comments are available for any and all to read. If we post as professionals-please make sure you are posting accurate info and using good legal judgement in advice given

JMO

Anne

RN Rotten Nurse · Feb 7, 2005

Wether or not sunnykc is a nurse does not matter. A question was asked and we should be kind enough to answer. To answer your question, you did NOTHING wrong. Walking into a busy ED sometimes feels like walking into what health care might be like in a third world country!

needsmore$ · Feb 7, 2005

RN is right- ED nurses who are obtaining histories of the presenting chief complaints sometimes do have to ask specifically what the emergency is--some people utilize the ED for problems that will not be solved in the ED ( ex- abd pain x 6 months-have had CT scans, GI consults but want to know "what the cause is today". When asked more in depth the emergency is that the pain has reoccurred or now there's a fever- or maybe they are just tired of having the problem) Sometimes this questioning has to be done with tact and by an experienced triage ED nurse. This is why triage requires a lot of experience as well as knowledge of policies/procedures/standards of practice/ EMTALA regs and good ol people skills. As the OP found out, triage is often the first impression that is made on the public by the ED staff. Maybe the ED nurse was unsure of what the emergency was? All in all- obviously not a good experience for you- maybe you could review this with the ED clinical manager of that facility- Clinical managers want to know what their patients are experiencing so they can help educate the staff and provide better services.

Good luck

Anne

teeituptom, BSN, RN · Feb 9, 2005

Well what is the ER going to do with sleep apnea anyway

Go see a specialist, there is nothing an ER can do for you

MishlB · Feb 9, 2005

How do you know you were apneic for 2 minutes??

z's playa · Feb 9, 2005

How do you know you were apneic for 2 minutes??

I was wondering that same thing. Unless there was someone standing over the person,watching them not breathing...... how do you know?