Why Nurses Go Crazy

[zenman]

At 0445 one of my patient's BP dropped out to the 70s and he was ashen and diaphoretic. He had finished dialysis at midnight. He was a full code in spite of ESRD, CABG (twice), Bilateral Carotid endartectomies, AAA, etc, etc.. I dropped 250 ml of fluid in him and put him in reverse trendelenburg. Finally got the doc who was covering for the attending. Called him back twice and he advised me to call the renal guy. He also advises more fluid. We still can't keep the guys BP over 80 when we level out the bed. I page the renal guy who is covering for the renal doc who normally sees the patient multiple times and he never calls back. Charge nurse and respiratory therapist are helping me with the patient while I do all the calling. I call the doc covering the attending to see if he wants to do anything else. I told him I'm calling the Hospitalist and he agrees. They come up, check out the patient and think that he will be allright where he is. BP is still labile. The crisis nurse has a Dopamine drip ready to hang and every one is ready to transport to MICU. I can't do a 1:1 cause I have other patients. At 0600 the regular renal guy resumes call and I get him. He wants SPA hung. Now we're getting somewhere. BP still does not respond. We call the intensivist and he sees the patient, orders 100 ml of 25% Albumin and slaps the patient immediately in MICU. 3.5 hours to finally get a patient where we wanted! Thanks to the other nurses who picked up my patients.

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[fab4fan]

Sounds typical, unfortunately. Congrats for staying sane!

 

[Katee80]

Good for you zenman! You lived to tell the tale.

Katee

 

[NPs Save Lives]

At 0445 one of my patient's BP dropped out to the 70s and he was ashen and diaphoretic. He had finished dialysis at midnight. He was a full code in spite of ESRD, CABG (twice), Bilateral Carotid endartectomies, AAA, etc, etc.. I dropped 250 ml of fluid in him and put him in reverse trendelenburg. Finally got the doc who was covering for the attending. Called him back twice and he advised me to call the renal guy. He also advises more fluid. We still can't keep the guys BP over 80 when we level out the bed. I page the renal guy who is covering for the renal doc who normally sees the patient multiple times and he never calls back. Charge nurse and respiratory therapist are helping me with the patient while I do all the calling. I call the doc covering the attending to see if he wants to do anything else. I told him I'm calling the Hospitalist and he agrees. They come up, check out the patient and think that he will be allright where he is. BP is still labile. The crisis nurse has a Dopamine drip ready to hang and every one is ready to transport to MICU. I can't do a 1:1 cause I have other patients. At 0600 the regular renal guy resumes call and I get him. He wants SPA hung. Now we're getting somewhere. BP still does not respond. We call the intensivist and he sees the patient, orders 100 ml of 25% Albumin and slaps the patient immediately in MICU. 3.5 hours to finally get a patient where we wanted! Thanks to the other nurses who picked up my patients.

Unfortunately, this is turning into status quo out here at the hospitals. I can't count how many times nursing has saved doctors asses by being persistant and watching the time tick away waiting for orders while patients are CTD... I have had doctors yell about not telling them how to practice medicine and then come in and write the same damn orders I asked for!!! That's why I am pursuing the NP track in adult health so my hands aren't tied as much.. I understand that some medical professionals don't know what's important to call about but when we do, it's frustrating as hell to be ignored and have to deal with the family at the bedside who's practically screaming "why isn't something being done??" Great work saving that patient through perserverance!!!

 

[ISU_Steve]

Doctors save patients; RN's save doctors

Oh and RT saves nurses *runs and hides*

 

[zenman]

Doctors save patients; RN's save doctors

Oh and RT saves nurses *runs and hides*

I appreciate RTs. Anyone who can suck snot for longer than one year has something!!

 

[ISU_Steve]

Other than a $19 an hour paycheck and a strong desire to get into a professional school.....what are you talking about?