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You Know the patient is going bad when...

Nurses   (35,595 Views | 161 Replies)

Nurseboy1 has 12 years experience and specializes in MICU, SICU, CICU.

7,954 Profile Views; 294 Posts

You are reading page 10 of You Know the patient is going bad when.... If you want to start from the beginning Go to First Page.

Antikigirl has 13 years experience as a ASN, RN and specializes in Education, Acute, Med/Surg, Tele, etc.

2,595 Posts; 13,461 Profile Views

One of my favorites was in RN school. I was going to witness a cardioversion done by this very top notch doc. Okay I was told as nauseum that I was to remain perfectly silent, blend into the walls, and do not move, breathe or anything. I understood!

So all is set, the patient is given valium...probes are set, pads on, RT standing by...and there I was...silent and pushing into the wall as if to blend in physically...LOL!

So the RN and MD and PT are talking and looking at the machine. They didn't realize like I did that all the sudden the patient was NOT breathing anymore! I waited looking in total astonishement...nope, not breathing! But I am to remain silent right? LOL! I happened to be against the wall with a bag valve mask just above my left shoulder. I took it down and said "RT"..and tossed it to him. Okay that got their attention towards their non-breathing patient. Seems they pushed some meds to fast or something...but needless to say they got him breathing again without difficulty and were able to do the cardioversion in a few moments and it was sucessful!

I remained silent and part of the wall the whole rest of the time.

As I walked out after it was done, I was near the RN desk..and that MD..who is not known for thank you's or any sort of kindess towards patients or staff alike...patted me on the back and said "when you are done with RN school, call me, I have a spot for you on my team!".

The nursing desk attendants were all gaped mouthed! LOL!!!!!!! I just smiled and went onto finding my RN to see what was next! (full knowing it was better to act as this was typical than jump up and down with excitement like I wanted too...LOL!!!).

But yeah...not breathing patient is a bad thing!

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aeauooo has 18 years experience and specializes in neuro, ICU/CCU, tropical medicine.

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I called the doctor who declined to order an H&H. After talking with the house supervisor and informing her of the patient's retro bleed and my decision, I got an H&H. Sure enough he needed 2 untis of blood. I called the doc back with the results and got he order for blood. He gave it along with the fact that he was going to write me up. Go ahead doc, at least my patient will get what he needs.

The next morning they ordered a STAT ct on him and he had a huge retro bleed (DUH). My nurse manager took the write up and attached a note congratulating me on a great save.

Good job!

I recall a similar incident - a nurse that didn't believe me when I told her her patient was bleeding out. It didn't end well.

I can't talk about it - 'nuf said?

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mamason has 5 years experience and specializes in cardiac.

555 Posts; 6,709 Profile Views

Good job!

I recall a similar incident - a nurse that didn't believe me when I told her her patient was bleeding out. It didn't end well.

I can't talk about it - 'nuf said?

THANK YOU!!!!!! I hate it when you try to tell someone something and their ego is way to big to listen. Very frustrating.:hdvwl:

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554 Posts; 8,593 Profile Views

When they are s/p cardiac cath, off bedrest. Ambulating fine, then say "I don't feel good". Turn pale, sweaty, fall backwards and lose bowel control. HR 20's...give me an amp of Atropine STAT!!!

When you go to assess a s/p stent to R fem artery that you just took over from another nurse, pull back the sheet and go "oh.....dear...." the pt was a bloody mess, and she was c/o excruciating L leg pain. She lost pulses in the L leg. And she had a hematoma (grapefruit sized) in the R groin that I had to push out before it affected the circulation to the R leg, and you really couldn't give much pain meds because the BP iwas 70/40...we ended up giving 2 liters IVF, hespan, and she went for a fempop bypass to save her L leg. R leg was ok after hematoma resolved. The nurse I took her over from isn't allowed to take cath pt's anymore. The worst part was having to have her lay in those blood soaked sheets for so long, because every time we moved her, the L groin would bleed, or the R groin hematoma would come back. She recieved blood in the OR, and more blood the next day.

When you are sent to charge nurse on a floor that isn't yours, 7 minutes into your shift and you hear the rapid team paged to your floor, but no one told you they needed help. You walk in to find Respiratory bagging a trach pt with spO2 at 50% whose not on continous monitoring but was supposed to be, and suddenly everyone wants to know 1. whose his nurse. 2. who is the charge nurse. 3. why has this man been neglected. The pt went to back to the ICU. I filled out an adverse event form and sent it to my nurse manager.

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gentlegiver is a ASN, LPN, RN and specializes in Geriatrics.

848 Posts; 8,767 Profile Views

I love it when I take report, and walk into a room and get that cold -fuzzy feeling that this Pt is "on her way to that happy place". Never knew what to call it. Guess that's what you all call intuition.

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Nurse Lulu specializes in critical care.

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a) when you can do blood gasses and the patient doesn't so much as flinch (or a central line for that matter)

b) when you walk in the pt room, and something is off- everyone thinks you are paranoid, but there is something nagging you.....

c) when your pt who drinks "only" three beers a day (hmmmm) starts getting fidgety.......

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anurseuk has 6 years experience and specializes in Paediatric Cardic critical care.

140 Posts; 3,613 Profile Views

When you come on shift and the defib is next to the patients bed

When doing your initial post op head to toe the patient has hands free defib pads in situ

When the inotrope concentration in the syringe needs to be doubled and then doubled again

when they come out of surgery and the dr says, "their (patients) heart is ******!"

pt feels 'impending doom!'

when the pt thinks it would be a good idea to be reintubated (between gasps)

................fun!

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anurseuk has 6 years experience and specializes in Paediatric Cardic critical care.

140 Posts; 3,613 Profile Views

one more...

when the pts pco2 is equal or higher than their po2...whoops!

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daverika has 35 years experience and specializes in Critical Care.

57 Posts; 3,008 Profile Views

you come back from lunch and the see the code cart disappearing into your (previously stable) patient's room...

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186 Posts; 3,463 Profile Views

When you're getting an admit from the ER and the house supervisor calls to let you know that the pt coded in the ER, then the family decided to make him a no code due to his terminal state, so they're sending him to our floor so his death won't be in the ER's death statistics. Myoglobin of 1000 and trop of 0.6, BP in 60's (not to mention his LFT's and renal labs). Thank you, ER. Pt died an hour after the ER rushed him to the floor, and I'd never seen them rush a pt to the floor so fast before. Hadn't even finished to admission paperwork before we had to begin the expiration paperwork.

I had that happen on my floor once. I was told we have extra staff tonight you will be ok. The family member was trying to recruit me to another local hospital while here mil is dying. I couldn't make this up!

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17 Posts; 1,438 Profile Views

When you have one who is known to be mean as a snake, not doing well, and all of a sudden he starts clawing and kicking, "Get it away from me!!!", all the while never taking his eyes off the corner of the room.

He died about an hour later.

You can NOT convince me that he was not seeing a demon (Or the big man himself) come to escort him downstairs.

I think that would freak me out for awhile!:chair:

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