What's your best catch?

[beekee]

I was reading another post called what was your worst mistake? I find reading about mistakes very informative and educational, but we never get kudos for all the good stuff we do. We just get lambasted (sometimes by others, often by ourselves). So, I want hear about your best "I rock" stories!

I don't have any great stories, but I'll share one recent encounter. I had a CHF patient who became fluid overloaded and went into respiratory distress. Doctor ordered P.O. lasix instead of IV. I took the time to double check that the doctor had indeed wanted PO (he didn't). I was a little hesitant to bother the doctor again, but he had a reputation of belittling staff. But, I did it anyway and he thanked me for calling (and changed the order).

[KelRN215, BSN, RN]

Either the time that I discovered my school aged r/o seizure patient wasn't having seizures at all but a dystonic reaction to Mom's compazine, which she had found/taken on her own to treat a stomachache or the diluted bottle of valium that I found in my patient's home (patient who there were many concerns about and an open case with CPS) which led to the state taking custody of her and, eventually, placing her with an appropriate caregiver.

[waterdrifter]

I'm a nursing student who is graduating in June. My best catch during clinicals was for a patient who had new orders for medications to be crushed. When I was reviewing medications in the MAR prior to pulling them out of the Pyxis, I noticed that he had metoprolol succinate ordered. In class the last week, we were just learning about why you shouldn't crush an ER tab. I informed the pharmacy and the pharmacist changed the order.

I know it's not as exciting as some of your stories, but for me as a student, I kinda felt on top of the world.

[beckysue920]

GOOD CATCH, waterdrifter.

[beekee]

I always double check before I crush. You'd be amazed at how often people suddenly lose the ability to swallow pills when I come on (in other words, pills were crushed before me, but shouldn't have been...so....).

[Been there,done that, ASN, RN]

Been a few. Think the best one was .. I was working midnight shift. I started my assessments with the new admit ( forgot the DX). She was a-okay! Went across the hall to settle in the next patient for the night.. that took ten minutes. I made it a habit to glance into any room I passed.

Lo and behold .. new patient was gray... that also was my LAST code.

P.S.. she made it!

[Nurseways]

I was working on a high-risk antepartum unit. The attending physician and the perinatologist agreed to discharge a patient when they made the morning rounds. This lady was there for "abdominal pain" at 36 weeks gestation and had been a patient for about a week. She had practically every test available, but they could not find a definitive source of her pain. The attending felt that she was a drug-seeker, and made arrangements for her to be seen at a pain-management physician once discharged.

The patient and her mother were very concerned about the discharge. The patient was crying, "I don't understand why they are sending me home."

Her mother said, "I know her, she is not a complainer, if she says she's hurting something must be going on!"

On the physician orders, she was to get a Biophysical Profile every other day. Normally, unless the physician requested it, we did not do them on the day of discharge. But the order was still available.

She got the Biophysical Profile, and she had no amniotic fluid present in her uterus. I left a message with the attending's office nurse (he was in surgery) then called the perinatologist and told him the results. He ordered to prep her for a Cearean, and said that he would notify the attending.

When the perinatologist came down to discuss the plan of care, he stopped at the desk and said,"What the f*** did you do to her?", but he was smiling. He told me that if the patient would have been discharged there was a high probability that the baby would not have survived due to sepsis.