I am a nurse extern at a medium size regional medical center just a few miles from my house. My home unit is the ICU, and I love it. The hospital is only 3 years old so everything is new, and it is in fact a beautiful building--gourmet chef to boot. The ICU is only 16 beds, but we do get our fair share of cool stuff. There are several heart surgeons who do surgeries, and our cath lab is super busy. About the only thing we don't see is major traumas--which in all reality is just fine by me.
One Saturday we got notified by the house supervisor we'd be getting a transfer from the floor. The patient was hypotensive (70s/30s), bradycardiac (low 40s), and her last blood sugar had been 28. My preceptor was the nurse open for the next admission, so the patient would be ours. I began setting up the room for an incoming patient and my preceptor did a quick look-in on our other patient while waiting for the floor nurse to call report.
No sooner had we turned our backs, then guess who came rolling through the door--without calling report. The floor nurse was in a dead panic, you could see the shell shock in the glazed look in her eyes. Even the transporter was sweating.
And the patient?
Well this sweet woman in her 80s smiled sweetly back at me from her comfortable hospital bed, and gave me a little half wave.
"Uh...how are you m'am?" I ask, more than a little incredulously, turning to look at the floor nurse.
"Fine!" is the response I got.
Now, I'm just a nurse extern, but super critically hypotensive, hypoglycemic, bradycardic 80-something-year-olds don't grin and say "Fine!"
We got her into the room, got a set of vitals and a blood sugar. Her pressure was 100s/60s, her HR was low 50s, and her sugar was 88. As I'm entering them into the computer I notice that these values are pretty much consistent with where she'd been running since she'd been admitted a few days ago. I also noticed that if the scary findings had been retested to verify, they certainly hadn't been put into the computer. Even more importantly, nothing had been done! No volume, no atropine, no D-50. Nothing.
Not sure why the floor nurse panicked quite so badly, but needless to say she was more than a little sheepish as she was finally giving report to my preceptor, and then quite defensive once she realized how silly she looked.
Meanwhile, the patient was prattling on about her 3 kids and 246 grandchildren, happy as a lark.
She got transferred back upstairs by the end of the shift.
lol.
ReplyDeleteThanks for saying hello.
I am sure being in OK, it was even more difficult.
I am adding you to my nurse/SN sidebar :)
Yeah, I'm surprised they didn't just give D50 and call it a day. Although don't laugh too much, once we nearly coded a woman in the ICU until somebody thought to check a sugar. A little D50 perked her right back up to full consciousness. Oops?
ReplyDeleteI just learned that they trained med/surg nurses at our hospital to use the AED feature on the defibrillators, but the nurses decided they didn't feel comfortable using them and would rather wait for MDs to show up. I mean, AEDs! The average layperson should be able to use them. I think they need to be a little more aggressive with the average nurse's emergency training.
Thanks W.M.N., I've added you as well. :)
ReplyDeleteChris--the defibrillator we trained with in our sim lab has the pads and can function as an AED. Some of my classmates lost major points for using it during our simulated code.