was i wrong?

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Hi, i am a fairly new nurse. ive been working on a rehab floor in a ltc facility. yesterday, while i was passing meds, the aide called me to check on a resident because he was not responding. I went inside the resident's room, called him by his name several times but didnt respond at all, his eyes were just open, he was breathing, he was perspiring and he was a little cold when i touched him. Cant obtain BP. Oxygen sat was at 87%. I put him on oxygen. Called my supervisor for help. I asked her right away if i should call 911 since this might be going on for more than 5 minutes and she said yes. So i called 911. Went back to pt room and tried to get his BP and it was 80/60. When EMT arrived, after 2 mins, the resident started to talk. Eventhough he started responding, we still sent him to er for evaluation.

now, the unit manager and the other staff nurses are questioning me why i sent the man out. I told them the whole story but they keep on talking behind my back and saying that i was wrong. btw, the resident was admitted to the hospital.

Yes, exactly. My current facility isn't always thrilled to have the census go down but the DON trusts our judgment and understands that pt safety is more important than money. She doesn't require us to call her before sending anyone out.

At a previous facility the DON wanted to personally give her okay before anyone got sent out. She hated seeing the census go down and wanted us to keep patients in the facility whenever possible. She would even ride the doctors about it, telling them not to order people sent out so often. I think it's crazy to have a pt. with a possible MI/stroke/etc. and waste time calling the DON at home.

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Pinkpig, could they have been trying to mentor you as opposed to 'belittleing'?

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The only thing that I may have done differently is to check his blood sugar, then would have still called 911. Trust your instincts and your knowledge.

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Specializes in LTC, Hospice, Case Management.
Unless the resident was DNR, hospice, or palliative care what the heck else are you supposed to do, wait and see if he dies?

I always remind people that DNR does NOT mean do not treat.. it means do not resuscitate! Therefore in this patients case he still should have been sent to the ER for eval regardless of his code status. (No disrespect intended towards this poster - this is just one of my pet peeves and even Doctors need reminded of this from time to time).

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Things like that make me worry about becoming a nurse. Years ago, a local man was burned badly in an oil pit fire. He was taken to our local hospital but they were NOT even CLOSE to being equipped to care for him but no one seemed interested in doing anything about that. One nurse arranged for him to be transported to a metro area hospital that WAS equipped to care for him. She was fired immediately. Of course, she moved on to bigger and better things but I have always been baffled about that situation, all these years later. BTW, the man did end up dying but still, I guess she felt like she had to try...

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Specializes in M/S, MICU, CVICU, SICU, ER, Trauma, NICU.
thanks I'll try to remember that the next time.... I'm in the south... so be patient with me.

Not a problem :D

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"its so hard being new at work coz it seems that they dont trust you with your judgement that much. "

ur so right. I remember my first code, and the comments I got from Sr. nurses saying everything they would have done different. Something I hate about nursing is the culture of belittling amonst nurses. Well you know what it's something that you learn from, and in your specifc case I think you did everything you could. I'm sorry you have to go through that but it only makes you stronger and more confident in your nursing practice! :nurse:

I hope it makes her stronger and more confident. Sometimes, being gossiped about and critized and questioned and misunderstood makes a person sad and lonely and nervous and unsure of himself. And the more that happens, the worse it can get, to the point that a person just quits. :mad::crying2::confused::eek:

OP, I think you did right and your coworkers should just read your charting and talk to the supervisor who told you to call 911 if they have a problem.:yeah:

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Specializes in LTC.

I might've gotten a BG, too, but with what you posted, I would've sent him out, too. Good job.

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Specializes in Rehab and skilled nursing.

hey everyone! been so busy at work. Thanks for all your responses. Btw, I just got a second job at another LTC. Then I have one hospital interview coming up. :) we'll see how everything goes. Hope all is well with yall!

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Things like that make me worry about becoming a nurse. Years ago, a local man was burned badly in an oil pit fire. He was taken to our local hospital but they were NOT even CLOSE to being equipped to care for him but no one seemed interested in doing anything about that. One nurse arranged for him to be transported to a metro area hospital that WAS equipped to care for him. She was fired immediately. Of course, she moved on to bigger and better things but I have always been baffled about that situation, all these years later. BTW, the man did end up dying but still, I guess she felt like she had to try...

How could a nurse transfer him without the doctor's agreement and order to do so?

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How could a nurse transfer him without the doctor's agreement and order to do so?

if you encountered a pt that was obviously in need of emergent med'l care, would you really waste precious time by awaiting a dr's order?

even if an order is needed, i can promise you, they would eat you up and spit you out, if/when it went to court.

a "prudent" nurse would recognize and act upon a pt in emergent, medical need.

i can't even imagine a nurse answering question, "why wasn't pt sent out?".

nurse: "because dr said no."

seriously, we truly need to think of consequences to our passive/non-existent actions.

leslie

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No, I absolutely would have done the same thing!!

I work LTC and we've had a bad last 2 weeks.... feels like I send somebody out every day!! But they always stay out and are admitted.... so I know that I am doing the right thing.

I would much rather send someone to the ER for evaluation, then have them code and have to explain that I thought they were 'faking' or 'exaggerating' and 'just needed attention'

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