You Know the patient is going bad when...

Nurses General Nursing

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You know the patient is going bad when their PA pressure is higher than their blood pressure (Pt quickly coded and died)

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Specializes in aged, palliative care, cardiac, agency,.

How about when a student nurse (read = inexperienced nurse) comes to the nurses station and says "The lady in bed xx didnt want her breakfast. She's fast asleep." especially when you know this patient is always wide awake early looking for food. Sometimes complicated by the fact that the student nurse may say "l had a lovely chat with her although she didnt say much."

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Specializes in aged, palliative care, cardiac, agency,.
They tell you " I don't feel good"

or the family says "is this normal?"

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YOU KNOW THE PATIENT IS DOING BAD WHEN WHEN VITALS SIGNS DECREASE OR INCREASE RAPIDLY .

WHEN SKIN COLOR CHANGE FROM NORMAL TO CYANOSIS .

WHEN PATIENT IS NOT RESPONDING TO VERBAL OR PAINFUL STIMULI .:redbeathe

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Specializes in Cardiac.
Wow.. What do you say when a pt tells you that?

btw..i'm a student

I told him that he was doing fine and had recovered well from surgery, and that I hoped that he would still be here tomorrow but if it was his time to go then I'd understand.

One thing I've learned- if it's their time, then it's their time.

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Specializes in Utilization Management.

One thing I've learned- if it's their time, then it's their time.

Yup. :saint:

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This is what exactly happened to my grandmother, i didn't know what to think and I just finish the lpn program waiting to take state boards........ I thought she was getting better.

Yep EXACTLY!!! It's when the patient looks to be improving after declining for days that you KNOW he/she is near the end.:crying2:
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The pt arrives by ambulance "post resuscitation" his pupils are blown and his eyes are wide open and you hear, he has a rhythm but I can't feel a pulse. NOT GOOD

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

similar incident: when you come back from lunch (break room does not have a speaker for the pa) and the rest of the er staff is coming out of your previously stable pt's room asking, "where were you??"

from a pt's point of view: you think you might be sicker than you were told when you hear harp music. this really happened to my dad: he was admitted for a mild gi bleed to a tele unit, all the rooms are private. he heard harp music and just about freaked out, until a staff member came in and told him a harpist was in the hallway volunteering his time!

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You know the patient is going bad when there's more blood in your shoes than in the patient...

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Specializes in Neuro ICU and Med Surg.

When no one can identify the pt heart rhythm. Pt pulse was 160. I had this happen. Pt K+ was 1.8 and I was replacing it when it was being drawn. Also the 12 lead EKG machine we have printed out with unidentified rhythm.

Amazingly this man lived. He just wouldn't die no matter what happened to him. Amazing. He was eventually discharged with his wife. He went from GCS of 14, to GCS of 3, back to GCS of 14.

Another one is when the pt is medivaced from a close hospital to you. You go down to the ER to assist with EVD placement and CSF is squirting out. Fixed and dilated pupils. This pt died, but family donated her organs.

I recieved a pt from the ER dead. I took a look at her and something wasn't right. I touched her and she was ice cold. Brought her back brain dead. Family requested that we let her go. We extubated her and let her go.

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Specializes in MICU, SICU, CICU.

Had another one the other night:

When the bladder pressure is 71 and the HR is 50 and falling......

Quickly led to code and bedside ex-lap ......very poor outcome

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Specializes in Oncology.

Their temp drops from 104 to 91 in 4 hrs.

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