You Know the patient is going bad when...

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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 NICU.

When the cath lab team brought the patient back to the unit everyone standing at the room could tell he was dead the moment they got off the elevator. "The monitor leads must have come off during transport, but he had a rhythm."

We got the leads back on him and he was asystolic.

No one dies in the cath lab.

How very short-sighted of whoever was bringing that patient back. From a medico-legal perspective, one could argue that if the pt really did have a rhythm when he left the cath lab, then the leads coming off mid-transport led to a failure to diagnose a possibly salvageable situation.

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Specializes in neuro, ICU/CCU, tropical medicine.
When the patient has a coccyx decub the size of a football and your cleaning the site while the cna is holding pt over, the cna says he just turned white as a sheet, then you hear it his last gurgled breath.

When I was a CNA I got a post-cholecystectomy patient up to walk. I got her out into the hall with her family encouraging her, "Come on mom, you're doing great!"

I got her back in her room, sat her on the bed, then bent down to take her slippers off. The patient's daughter-in-law said, "Why is she breathing like that?" She was agonal (of course, I had never seen agonal respiration before, so I didn't know what I was seeing).

I grabbed the nurse who walked in the room and told everyone that she was dead (DNR).

I was the kiss of death after that - everytime there was a PITA patient on the unit someone would say, "Why don't you go down there and walk that guy?"

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Specializes in neuro, ICU/CCU, tropical medicine.
How very short-sighted of whoever was bringing that patient back. From a medico-legal perspective, one could argue that if the pt really did have a rhythm when he left the cath lab, then the leads coming off mid-transport led to a failure to diagnose a possibly salvageable situation.

Hey, V-fib is a rhythm!

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Specializes in neuro, ICU/CCU, tropical medicine.
When the agency nurse in ICU says to you "my head injured patients blood pressure a little high, and he's got a bit of a brady now. But at least he has stopped trying to pull his lines out, I think I'll just let him sleep it off "

Classic!

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Specializes in med-surg, psych, ER, school nurse-CRNP.

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.

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Specializes in FNP, Peds, Epilepsy, Mgt., Occ. Ed.
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.

Whew. I'd much rather have the patient who hears the angels singing, thank you very much!!!!:uhoh3:

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Specializes in neuro, ICU/CCU, tropical medicine.

I remember one patient who was alert, oriented, appropriate - and kept begging me to take her outside so she could smoke. I finally made time to take her out for a cigarette, and she refused.

I should have known something was wrong!

A few minutes later she was in full-blown steroid psychosis. She pulled her IV apart and was bleeding on her room mate - a young woman who was terrified to be in the hospital. She bought restraints for that, then for the next several hours screamed my name at the top of her lungs, "Why are you doing this to me?!!!"

I saw her some time later, and she apparently had no recollection of the event, but over ten years later, I can still hear her screaming my name!

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Specializes in Med/surg, pediatrics, gi, gu,stepdown un.

They tell you " I don't feel good"

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Specializes in everything.

I detect a certain smell a couple of days before...it happens everytime,

after all these years now I call the doc and have him order bld work.:nurse:

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Specializes in Home Care, Hospice, OB.

...a patient who has been semi-comatose and unresponsive sits up in bed and has a lucid "good-bye" chat with the family at the bedside.

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...a patient who has been semi-comatose and unresponsive sits up in bed and has a lucid "good-bye" chat with the family at the bedside.

ahhh.........

that happens a lot.

not only saying their goodbyes, but enjoying a meal after being unable to for wks;

wounds suddenly healing within hrs;

vss, good color, eyes bright, fever gone.

i mean, these folks look and act fabulous.

then they're gone.

this still blows me away.

leslie

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Specializes in neuro, ICU/CCU, tropical medicine.
I detect a certain smell a couple of days before...it happens everytime.

Did you see the new item about the cat that lives in a nursing home and would sit with patients before they died? There was an article about it in the New England Journal of Medicine.

http://content.nejm.org/cgi/content/full/357/4/328

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