So I had a fellow co-worker tell me that I am no longer a rookie nurse…now usually this would be a good thing, but in actuality…this statement was not a welcome statement at all. It was a night of many firsts for me…1) first really bad patient deterioration 2) first code and the final first 3) first pt death.
The evening began like any other shift for at least 15 or 20 minutes then things begin to go wrong. The tech came running into the nurses’ station saying that one of the patients was bleeding. I go into the patient’s room and find the patient sitting up in bed holding her nose. She was gushing blood all over herself, her sheets, and everything else within her vicinity. I grab some towels and manage to get her nosebleed to stop. After getting back to the nurses’ station, I asked the day nurse inform me on this patient next so I would have an idea of what was going on. She was admitted for a GI bleed, but had been stable ever since she had been brought to the floor a couple of days earlier. The day nurse was not aware of any problems or concerns; in fact, she thought the patient was going to be discharged the next day. I paged the doctor just to give them a heads up. They said they would come assess the patient.
The doctors arrived and said that the nose bleed was most likely due to an increase in her blood pressure. They told me to go ahead and give her the scheduled blood pressure medication. I gave the medication and finished my assessment. Everything else seemed to be okay. I asked the tech to get another set of vital signs. Her blood pressure was decreasing back towards normal, but her Heart rate was a little increased. I spent the night keeping a close eye on her with nothing out of the ordinary occurring.
Morning came and it was time to draw labs. She was a nurse draw and had quite a few to draw. I went in there and she was watching tv. As I drew her blood, she was telling me about her family and how she couldn’t wait to see them all again for Thanksgiving, since her children all make the long trip home to see her. I finished getting the blood I needed, and told her I would be back in a few minutes with her medicines.
The lab results came back showing her hemoglobin was 4.2 (a decrease from 10.6 the morning before). I paged the doctor and was ordered to hang 3 units of blood stat. As I was walking into the room to check her vital signs before hanging the blood, I noticed she was lying down in the bed, and didn’t respond when the light was turned on. I quickly went to the bed and found that the patient was not breathing. I yelled for help and pulled the code light. As the tech arrived to check her vital signs for me, I was connecting the ambu bag and began ambuing her. Another tech was grabbing the code cart for me, while the other nurse was entering the room to be of assistance, and checked for a pulse. There was none!!!!. The nurse started compressions while I ambued. The tech arrived with the code cart and we got the patient hooked up to the zoll machine and continued compressions. Rapid Response and the doctors showed up and the craziness began. Amidst all the business of the code, the patient’s daughter walked into the room. (She had gone home for the night, and was just returning). One of the techs quickly grabbed the daughter and pulled her out of the room, and took her to the waiting room.
Unfortunately even with all the interventions being done, the patient was not saved. About the time, the code finished the hospital Chaplin arrived. The doctors and rapid had to take off running to another code. This left the Chaplin and I with the burden of finding the daughter. I had to tell the daughter that we had done everything we could, but we could not save her. The daughter began to cry, which made me want to break down crying with her. (I’m not going to lie, there were tears in my eyes, and it was one of the hardest things I have ever had to do). The Chaplin stayed with the daughter as I went to finish up my shift as if nothing had happened.
So depending on who you ask…I am no longer a rookie nurse because I have experienced my first patient death…I think I would much rather prefer to stay a rookie
Monday, November 21, 2011
Friday, November 18, 2011
If Only For Moments Like These
Since I have started working at UK, I have had many unique and interesting patients. However, over the past four months, I have had this patient that has managed to bring about so many feelings and emotions for me. He is definitely what would be considered a “frequent flyer” (yes those really do exist). He is also a difficult patient to care for. In fact when most nurses hear his name…they shudder and pray that they will not be the nurse to care for him. He is a difficult patient, for sure, but at the same time, I think he has become one of my favorite patients.
If this patient had a talent it would be to cause emotional rollercoasters for his nurses. One second I feel sorry for him since he is a little pathetic (and he can look at you with his puppy dog eyes and there is no telling him no) and in the next I want to drug him up because he can be the most annoying person on the planet…especially since he knows my name so all night I hear… “ALICIA…ALICIA…ALICIA…ALICIA! ALICIA!!!!!!!!!!!!!!!!!” Let me tell you…it makes for a very long night…
But I just can’t help but feel sorry for the guy…I mean he’s in the hospital in excruciating pain (or at least that’s what he wants me to believe)…with an unidentifiable stage pressure ulcer on his coccyx…so yeah he’s kind of easy to feel sorry for…
Especially when you consider that most of the other nurses do not treat him very well..They see him as more of a laughing stock and a good joke then the human being that he is. They spend their time laughing at him because his mental status is not at the same level as theirs…
Enough ranting about that…I have spent quite a bit of time with this patient in caring for him and trying to calm him down…and we become what he likes to call “buddies” and “she’s the best nurse in the world and she’s my favorite”…surprisingly when you spend time with him and talk to him while you are doing your care you find that he is such a sweet guy who is scared and lonely…
One night he was very upset and would not calm down no matter what I did…so the 45 minutes of torture for the dressing change of his multiple wounds, seemed like forever…while I was talking and distracting him from the pain, I learned that he doesn’t watch much television, but he does listen to the radio a lot and he is a huge country music fan. With this I had a thought.
The next day, I went out and got a cheap radio and took it to the hospital for him. The joy and excitement on his face was priceless. When I turned the radio on, he began to sway to the music and fell asleep (this is a miracle in itself since he almost never sleeps).
That radio became his calming method and any time the music was on, he was much calmer and less likely to call out. Every time I visited or cared for him after this…he would thank me profusely “I love my radio…you are the bestest friend ever…I love my radio I just love my radio”.
From that moment on…I remembered why I had become a nurse…believe it or not it is not for the paycheck or for the benefits or any other reason than for seeing that smile on his face and knowing that I had made a difference in even one person’s life…and that I was there and willing to help in any way possible and that meant the world to someone. Even though I have tough nights and frustrating patients…I think I have the best job in the world…if only for moments like these.
If this patient had a talent it would be to cause emotional rollercoasters for his nurses. One second I feel sorry for him since he is a little pathetic (and he can look at you with his puppy dog eyes and there is no telling him no) and in the next I want to drug him up because he can be the most annoying person on the planet…especially since he knows my name so all night I hear… “ALICIA…ALICIA…ALICIA…ALICIA! ALICIA!!!!!!!!!!!!!!!!!” Let me tell you…it makes for a very long night…
But I just can’t help but feel sorry for the guy…I mean he’s in the hospital in excruciating pain (or at least that’s what he wants me to believe)…with an unidentifiable stage pressure ulcer on his coccyx…so yeah he’s kind of easy to feel sorry for…
Especially when you consider that most of the other nurses do not treat him very well..They see him as more of a laughing stock and a good joke then the human being that he is. They spend their time laughing at him because his mental status is not at the same level as theirs…
Enough ranting about that…I have spent quite a bit of time with this patient in caring for him and trying to calm him down…and we become what he likes to call “buddies” and “she’s the best nurse in the world and she’s my favorite”…surprisingly when you spend time with him and talk to him while you are doing your care you find that he is such a sweet guy who is scared and lonely…
One night he was very upset and would not calm down no matter what I did…so the 45 minutes of torture for the dressing change of his multiple wounds, seemed like forever…while I was talking and distracting him from the pain, I learned that he doesn’t watch much television, but he does listen to the radio a lot and he is a huge country music fan. With this I had a thought.
The next day, I went out and got a cheap radio and took it to the hospital for him. The joy and excitement on his face was priceless. When I turned the radio on, he began to sway to the music and fell asleep (this is a miracle in itself since he almost never sleeps).
That radio became his calming method and any time the music was on, he was much calmer and less likely to call out. Every time I visited or cared for him after this…he would thank me profusely “I love my radio…you are the bestest friend ever…I love my radio I just love my radio”.
From that moment on…I remembered why I had become a nurse…believe it or not it is not for the paycheck or for the benefits or any other reason than for seeing that smile on his face and knowing that I had made a difference in even one person’s life…and that I was there and willing to help in any way possible and that meant the world to someone. Even though I have tough nights and frustrating patients…I think I have the best job in the world…if only for moments like these.
Thursday, November 10, 2011
Aww! So Kind and Thoughtful of You
Now most who know me…know that I hate controversy and will do everything I can to avoid it. I would much rather just do my job or go on with my own business…of course avoiding the controversy as much as I can. But we all need to vent every now and then. So here goes.
It really aggravates me when people become nurses who don’t seem to want to be nurses...you know the ones I am talking about…they sit on the computer all day, talk on the phone consistently, avoid patient rooms, or don’t adequately care for their patients. I mean really, why are you in a profession that is all about caring for people, if you would much rather avoid people and patients????
I arrived at work last night and learned that there had been a new admit about 15 minutes before I was receiving report. Now I understand that in the last 15 minutes of a shift there isn’t a lot of time to get stuff done, or you are just so busy trying to finish everything that you might forget about or not do something…believe me I’m really understanding and normally I’m fine with doing whatever wasn’t done…because I know you tried your hardest and did your best…but when I walk into the nurse’s station and I hear “There is a new patient in this room…I got report…but I don’t really know anything about them…well I do know that they are mentally retarded but that’s about it”…REALLY!!!! WTH!!!! Gee was that really your report??!!!
As I looked over the patient’s orders I noticed that the patient had STAT lab orders (for 10 vials of blood)….these orders were put in at 1830…it was not 1930 and the blood had still not been drawn…of freaking course!!!...
As I was gathering everything I would need to get the blood…the phone rang…It was radiology checking to see if the pt was ready for a CT scan… WHAT!!!!??? I explained that the patient was not, I didn’t know that there was going to be a CT scan and wasn’t even sure of why the pt was in the hospital…the radiologist seemed to know more about the pt then I did (there’s something wrong with that picture)…
I called the primary medical team…and started asking questions…the pt was here for an abscess in the face and may need surgery…the CT scan was to determine if surgery was going to be necessary…As I was just about to hang up the phone, the dr informed me that the pt was going to be sedated for the CT scan. Okay that’s fine…not really my problem…was my thinking at this time…
I returned to getting all my supplies to draw the blood. I decided that since the pt was mentally stunted, I would draw the blood from the IV (of course I would have to be careful to not blow the IV). When I entered the room, I saw two caregivers with the patient. I explained who I was and what I was going to do… “Um…there isn’t one yet.” I looked at the caregivers and explained that I would go ahead and put one in since it was needed for the CT scan…Although what I really wanted to do was scream… “Are you kidding me!!!???”.
This patient had arm flapping, which meant it was going to be almost impossible for me to start an IV in the arms…and I was a little concerned that if I could get the arms to hold still long enough to try, the pt would not help keep the arm steady and would most likely jerk away just as the needle went in which would lead to 1) a blown vessel 2) an unsuccessful IV start, and most importantly 3) another attempt at starting an IV…Now I’m what you might call a nice nurse that really doesn’t like sticking my patients more times then I need to…so I decided to start the IV in the next logical place…the foot.
Just as I was about to start the IV, my fellow nurse told me there was a dr on the phone for me. It was the radiologist asking if I was going to be coming down to recover the patient after sedation since they didn’t have any nurses that could do that…I explained that I would not be able to…but that I would call the team to see if the pt could be sent to the PACU after the CT scan…After finally getting everything figured out, I went back to the pt’s room to finish the IV.
I had never started an IV in a foot before, but “oh well, there’s a first time for everything”. I grabbed a 20 gauge IV (since it had to be a bigger IV, because of the CT contrast). Finally there was IV access…OH CRAP!!!, I forgot to get the blood for the labs!!!!” I tried to draw back blood…but alas, the IV would not draw…I was going to have to stick her again. I was able to get the blood with no problems…the pt did an amazing job…but decided that I was not the most favorite person and anytime I came near, there was an involuntary flinch for the rest of the night. :(
By the time, I got this all figured out, it was midnight and I still had not even started any of my own work, because I was too busy playing catch up from the day shift…I thought that I was going to get back on track…but not so lucky…I had to keep playing catch up until about 2 or 3. It was a very frustrating night that made me want to stack the patients the next morning and give the nurse who had handed me off her patients, really hard patients so that she would know what it was like…but once again…I’m a nice nurse and managed to get everything done so that the day nurse would only have to do her part of the patient care.
It really aggravates me when people become nurses who don’t seem to want to be nurses...you know the ones I am talking about…they sit on the computer all day, talk on the phone consistently, avoid patient rooms, or don’t adequately care for their patients. I mean really, why are you in a profession that is all about caring for people, if you would much rather avoid people and patients????
I arrived at work last night and learned that there had been a new admit about 15 minutes before I was receiving report. Now I understand that in the last 15 minutes of a shift there isn’t a lot of time to get stuff done, or you are just so busy trying to finish everything that you might forget about or not do something…believe me I’m really understanding and normally I’m fine with doing whatever wasn’t done…because I know you tried your hardest and did your best…but when I walk into the nurse’s station and I hear “There is a new patient in this room…I got report…but I don’t really know anything about them…well I do know that they are mentally retarded but that’s about it”…REALLY!!!! WTH!!!! Gee was that really your report??!!!
As I looked over the patient’s orders I noticed that the patient had STAT lab orders (for 10 vials of blood)….these orders were put in at 1830…it was not 1930 and the blood had still not been drawn…of freaking course!!!...
As I was gathering everything I would need to get the blood…the phone rang…It was radiology checking to see if the pt was ready for a CT scan… WHAT!!!!??? I explained that the patient was not, I didn’t know that there was going to be a CT scan and wasn’t even sure of why the pt was in the hospital…the radiologist seemed to know more about the pt then I did (there’s something wrong with that picture)…
I called the primary medical team…and started asking questions…the pt was here for an abscess in the face and may need surgery…the CT scan was to determine if surgery was going to be necessary…As I was just about to hang up the phone, the dr informed me that the pt was going to be sedated for the CT scan. Okay that’s fine…not really my problem…was my thinking at this time…
I returned to getting all my supplies to draw the blood. I decided that since the pt was mentally stunted, I would draw the blood from the IV (of course I would have to be careful to not blow the IV). When I entered the room, I saw two caregivers with the patient. I explained who I was and what I was going to do… “Um…there isn’t one yet.” I looked at the caregivers and explained that I would go ahead and put one in since it was needed for the CT scan…Although what I really wanted to do was scream… “Are you kidding me!!!???”.
This patient had arm flapping, which meant it was going to be almost impossible for me to start an IV in the arms…and I was a little concerned that if I could get the arms to hold still long enough to try, the pt would not help keep the arm steady and would most likely jerk away just as the needle went in which would lead to 1) a blown vessel 2) an unsuccessful IV start, and most importantly 3) another attempt at starting an IV…Now I’m what you might call a nice nurse that really doesn’t like sticking my patients more times then I need to…so I decided to start the IV in the next logical place…the foot.
Just as I was about to start the IV, my fellow nurse told me there was a dr on the phone for me. It was the radiologist asking if I was going to be coming down to recover the patient after sedation since they didn’t have any nurses that could do that…I explained that I would not be able to…but that I would call the team to see if the pt could be sent to the PACU after the CT scan…After finally getting everything figured out, I went back to the pt’s room to finish the IV.
I had never started an IV in a foot before, but “oh well, there’s a first time for everything”. I grabbed a 20 gauge IV (since it had to be a bigger IV, because of the CT contrast). Finally there was IV access…OH CRAP!!!, I forgot to get the blood for the labs!!!!” I tried to draw back blood…but alas, the IV would not draw…I was going to have to stick her again. I was able to get the blood with no problems…the pt did an amazing job…but decided that I was not the most favorite person and anytime I came near, there was an involuntary flinch for the rest of the night. :(
By the time, I got this all figured out, it was midnight and I still had not even started any of my own work, because I was too busy playing catch up from the day shift…I thought that I was going to get back on track…but not so lucky…I had to keep playing catch up until about 2 or 3. It was a very frustrating night that made me want to stack the patients the next morning and give the nurse who had handed me off her patients, really hard patients so that she would know what it was like…but once again…I’m a nice nurse and managed to get everything done so that the day nurse would only have to do her part of the patient care.
Wednesday, November 9, 2011
Umm...And Why Didn't You Tell Me That???
(sorry for the language...but the pt gets across)
I have no idea why, but for some reason, I keep getting crappy reports from nurses who hand off the patients to me…it is very frustrating and makes for a very long night of playing catch up…trying to figure out what in the world I am supposed to be doing for my patients.
On one of these great occasions…I asked the nurse before me if the patient had received the 2 units of platelets, 2 units of packed red blood cells, and the 1 unit of plasma that had been ordered at 1300. She told me yes. However, when I walked into the patient’s room, the family member looked me dead in the eye. “Are you going to hang the blood that the doctor ordered????!!!!” I stared at her and replied…”I’m pretty sure that the blood has already been hung.” Apparently I was wrong…gee what a shock…but of course it took me 5 hours to discover this and by this time…I ended up spending the majority of the remainder of the night in this pt’s room, doing blood transfusions.
On another occasion…I got report from my co-worker and went to round on my patients. Now of course the information that she forgot to tell me…was of course very important…she didn’t tell me that the patient’s family member was in the room, trying to be the doctor…and had decided to soak the patients arms in warm soapy water…Now of course normally this wouldn’t be a problem and I wouldn’t have cared…except this patient had second degree burns up the arms…and the bandages were still on the arms…so much for the use of the sterile field…and the next morning when I warned the SAME coworker who had neglected to tell me…she rolled her eyes and said “Oh yeah, she was doing that all day yesterday”!!!! REALLY!!!! Gee thanks for the heads up…
During my short time…as a nurse I have seen firsthand, and learned from many bad and difficult situations that communication is a very important thing…however it needs to be good communication…communication that actually communicates…gee what a novel idea!!! I know that you have had a long rough day but PLEASE I beg of you…take another 15 minutes and tell me about the patient!!!!!
I have no idea why, but for some reason, I keep getting crappy reports from nurses who hand off the patients to me…it is very frustrating and makes for a very long night of playing catch up…trying to figure out what in the world I am supposed to be doing for my patients.
On one of these great occasions…I asked the nurse before me if the patient had received the 2 units of platelets, 2 units of packed red blood cells, and the 1 unit of plasma that had been ordered at 1300. She told me yes. However, when I walked into the patient’s room, the family member looked me dead in the eye. “Are you going to hang the blood that the doctor ordered????!!!!” I stared at her and replied…”I’m pretty sure that the blood has already been hung.” Apparently I was wrong…gee what a shock…but of course it took me 5 hours to discover this and by this time…I ended up spending the majority of the remainder of the night in this pt’s room, doing blood transfusions.
On another occasion…I got report from my co-worker and went to round on my patients. Now of course the information that she forgot to tell me…was of course very important…she didn’t tell me that the patient’s family member was in the room, trying to be the doctor…and had decided to soak the patients arms in warm soapy water…Now of course normally this wouldn’t be a problem and I wouldn’t have cared…except this patient had second degree burns up the arms…and the bandages were still on the arms…so much for the use of the sterile field…and the next morning when I warned the SAME coworker who had neglected to tell me…she rolled her eyes and said “Oh yeah, she was doing that all day yesterday”!!!! REALLY!!!! Gee thanks for the heads up…
During my short time…as a nurse I have seen firsthand, and learned from many bad and difficult situations that communication is a very important thing…however it needs to be good communication…communication that actually communicates…gee what a novel idea!!! I know that you have had a long rough day but PLEASE I beg of you…take another 15 minutes and tell me about the patient!!!!!
Monday, November 7, 2011
GI Bleed...Ok...That's Nothing to Worry About
Last week I had to go to a patient deterioration class. In this class we discussed identifying patients who are at risk for deterioration and how to spot early signs and symptoms…now one might ask…why is it so important to recognize early signs and symptoms…well to avoid placing yourself in the middle of a Code Blue situation of course.
All during this class all I could do was think about work the night before. I had a patient who was in the hospital for a GI bleed. Now while I was getting report on this patient, a nursing care tech came in and told us that the patient was acting “funny”…the pt was sleeping and not waking up when there was someone in the room like normal. The day nurse just continued to give me report like she wasn’t concerned at all…I looked at her “um…is this normal for the patient?” “Well they never sleep so they are probably just tired”. Uh…huh…
After getting report, I decided the first thing I should do is go in and check out this patient. As I was about to enter the room, I noticed there was a dr in there with the pt…I figured the best thing would be to wait until the dr finished.
About five minutes later, the dr came into the nurses station. “Has the pt been acting like this for awhile now…is this normal…because I was here the last two nights and when I saw the patient they weren’t like this at all?” Ummm….why are you asking me when you answered your own question…is what I wanted to say. But I told her “Actually I have never had this patient before, but the tech who was here earlier said that it’s abnormal.” My fellow nurse spoke up… “I had the patient before and this is not normal…they are never like this…they usually are talking from the moment you walk in the door until you leave”. The dr looked at us and said “Well, I’m sure it’s just because they’re tired…keep monitoring, I’m sure there’s nothing to worry about”
Off on a little side note here…WTH does it mean when a dr tells you “keep monitoring the pt” What exactly does that mean!!!! What do you think I have been doing since I got here and the last 8 hours!!!???? Ok back on point.
I continued monitoring the patient…who slept for the next 6 hours but would wake up when I was in the room. Throughout the night, I kept in contact with the dr…but got the same message… “Oh it’s fine…” Well that’s what I heard until I checked the morning labs and saw the hemoglobin was 4.5 and the hematocrit was 18.3%,... which means nothing until you consider the last labs from yesterday showed a hemoglobin of 11.2 and a hematocrit of 29.2%...
Don’t you love how it was no big deal…oh yeah…except the patient was actively bleeding out!
All during this class all I could do was think about work the night before. I had a patient who was in the hospital for a GI bleed. Now while I was getting report on this patient, a nursing care tech came in and told us that the patient was acting “funny”…the pt was sleeping and not waking up when there was someone in the room like normal. The day nurse just continued to give me report like she wasn’t concerned at all…I looked at her “um…is this normal for the patient?” “Well they never sleep so they are probably just tired”. Uh…huh…
After getting report, I decided the first thing I should do is go in and check out this patient. As I was about to enter the room, I noticed there was a dr in there with the pt…I figured the best thing would be to wait until the dr finished.
About five minutes later, the dr came into the nurses station. “Has the pt been acting like this for awhile now…is this normal…because I was here the last two nights and when I saw the patient they weren’t like this at all?” Ummm….why are you asking me when you answered your own question…is what I wanted to say. But I told her “Actually I have never had this patient before, but the tech who was here earlier said that it’s abnormal.” My fellow nurse spoke up… “I had the patient before and this is not normal…they are never like this…they usually are talking from the moment you walk in the door until you leave”. The dr looked at us and said “Well, I’m sure it’s just because they’re tired…keep monitoring, I’m sure there’s nothing to worry about”
Off on a little side note here…WTH does it mean when a dr tells you “keep monitoring the pt” What exactly does that mean!!!! What do you think I have been doing since I got here and the last 8 hours!!!???? Ok back on point.
I continued monitoring the patient…who slept for the next 6 hours but would wake up when I was in the room. Throughout the night, I kept in contact with the dr…but got the same message… “Oh it’s fine…” Well that’s what I heard until I checked the morning labs and saw the hemoglobin was 4.5 and the hematocrit was 18.3%,... which means nothing until you consider the last labs from yesterday showed a hemoglobin of 11.2 and a hematocrit of 29.2%...
Don’t you love how it was no big deal…oh yeah…except the patient was actively bleeding out!
Wednesday, November 2, 2011
I Know I'm Forgetting Something...
Since I can’t stay out of trouble at work…because 1) its just way too boring if I do and 2) being a new nurse just invites trouble…Of course I have a story about my shift tonight.
One of my lovely co-workers asked me to help her hang a blood product since she had never had this experience before…
And of course thanks to one of my patients…I have quickly become a pro at hanging blood…so being my nice self…I graciously agreed to help…
The other nurse pre-medicated the pt with Benadryl and then went down to the blood bank to get the blood. The tech took the pre-blood vital signs…and we were ready to go.
We compared the information from the blood, with the blood paper. We gathered the Normal Saline and the blood tubing…(we even made sure to make sure it was legitimate blood tubing…with 2 spikers). We were on a roll.
So naturally we spiked the normal saline and flushed out the tubing. We were then ready to go to the patient’s room, and compare the arm band with the unit of blood. All this vital information matched…nothing was going to stop us now.
The nurse spiked the bag of blood and flushed the line…she then started the infusion, and wrote down the time of initiation. We then reviewed what she was going to assess for in the first 15 minutes…any signs and symptoms of a transfusion reaction (including…rash, back pain, fever, feeling of doom). I then left the patient’s room to go about the rest of my nightly duties…
Of course the story doesn’t end there…it wouldn’t be a typical “me” story if it did. Along comes the clinical nurse expert…she was checking in on us since it was the other nurse’s first time. My fellow nurse reassured the expert we were fine and we had this…then the expert asked a question… “Is there consent in the chart?” “SAY WHAT!!!???”
Probably one of the most important part of the process and both of us had totally forgotten to even think about the consent. I think at this moment…both of our hearts jumped out of our chests and we just looked at the expert in sheer panic…
She laughed at us and went on to calm us down. After looking in the chart, we felt much better, seeing as how the consent was already signed and in the chart.
“Phew…I guess I get to keep my job for a little bit longer! Thank goodness!!!”
One of my lovely co-workers asked me to help her hang a blood product since she had never had this experience before…
And of course thanks to one of my patients…I have quickly become a pro at hanging blood…so being my nice self…I graciously agreed to help…
The other nurse pre-medicated the pt with Benadryl and then went down to the blood bank to get the blood. The tech took the pre-blood vital signs…and we were ready to go.
We compared the information from the blood, with the blood paper. We gathered the Normal Saline and the blood tubing…(we even made sure to make sure it was legitimate blood tubing…with 2 spikers). We were on a roll.
So naturally we spiked the normal saline and flushed out the tubing. We were then ready to go to the patient’s room, and compare the arm band with the unit of blood. All this vital information matched…nothing was going to stop us now.
The nurse spiked the bag of blood and flushed the line…she then started the infusion, and wrote down the time of initiation. We then reviewed what she was going to assess for in the first 15 minutes…any signs and symptoms of a transfusion reaction (including…rash, back pain, fever, feeling of doom). I then left the patient’s room to go about the rest of my nightly duties…
Of course the story doesn’t end there…it wouldn’t be a typical “me” story if it did. Along comes the clinical nurse expert…she was checking in on us since it was the other nurse’s first time. My fellow nurse reassured the expert we were fine and we had this…then the expert asked a question… “Is there consent in the chart?” “SAY WHAT!!!???”
Probably one of the most important part of the process and both of us had totally forgotten to even think about the consent. I think at this moment…both of our hearts jumped out of our chests and we just looked at the expert in sheer panic…
She laughed at us and went on to calm us down. After looking in the chart, we felt much better, seeing as how the consent was already signed and in the chart.
“Phew…I guess I get to keep my job for a little bit longer! Thank goodness!!!”
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