You Know the patient is going bad when...

[Nurseboy1]

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

Feel free to add and keep the list going!

[canoehead, BSN, RN]

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.

I hope someone got kicked in the butt for that one.

[nrsang97, BSN, RN]

I hope someone got kicked in the butt for that one.

Wow did I ever reem out the ER doc, (One of the head guys to boot), He thought she was a DNR and just sent her to a medical floor. The DNR paperwork from the nursing home was clear as mud. I tried to talk with the nurse who gave me report but she went home already, I tried the charge nurse who refused to talk to me and demanded someone and ended up with the doc. He got a nice piece of my mind. I incident reported this.

[mama_d, BSN, RN]

How about when the inexperienced EMT who is transporting your patient from the ED tells you "the monitor started malfunctioning in the hallway" as the patient is turning a nice shade of cadet blue...

When the family changes the code status every hour and the nurse keeps the entire floor up to date on it..."It's an even hour, she's a full code...fifteen more minutes till they change their mind again...I've got the cart ready just in case..."

When you come it at shift change and the previous nurse is doing the "they didn't code on my shift" dance...

[Susan9608]

How about assessing equal and reactive pupils at 0730, but at 0800 finding pupils that are unequal and unresponsive? (child later declared brain dead that day and organs donated.)

MD calling for your baby's head to be packed in ice to preserve blood flow to the brain.

Receiving report from transport that pt. is a "little hypotensive" and finding them airlifted to you on dopamine, dobutamine, epi, norepi, and vasopressin. (Pt. later placed on ECMO at bedside, too unstable to even transport out of picu to or - died 2 days later.)

[Spritenurse1210, BSN, RN]

When your insulin dependant diabetic starts gasping and thier breath gives off a fruity odor

[CseMgr1, ASN, RN]

Multifocal PVC's in the ER on a 70-y/o female with end-stage cardiomyopathy.....

A nurse rushes into the Treatment Room and asks: "Does she have a DNR?"

"Yes".

The patient looks at me, her eyes wide with fright and her face the color of a dirty pillowcase and gasps: "I'm dying....."

"I know".

************************************************

I am at her bedside five days later in ICU, watching the monitor. She is bradying down. A euphoric smile crosses her face as she slips away peacefully.

That patient was my Mother. She died ten years ago.