ok, so this is going to sound totallllllly stupid!
But, yeah, I totally saved my patient last night….hahah not.
Anyway, she had major abdominal surgery; was completely necrosed inside/ major sepsis from a perforated bowel from extreme IBS and narcotic use for the pain. So, yesterday she had some serious blood pressure issues. They couldn’t keep her MAP about 65, etc. and received like four 250ml bolus’. When I came on, she was holding steady, but then at like 1 in the morning, her pressure started to drop. 99/50 to 88 to 78.. I’m like…c’mon dude! So I bolus her once. I know it sounds insignificant and I will laugh about this later in life, but I felt proud that I just went ahead and did something rather than ask someone; mostly because this was only my second night off orientation and usually I have someone looking over my shoulder and when something goes wrong, they know about it, ask me what I would do, or tell me what to do.
Also, I am still getting used to the extreme autonomy I have as a nurse in the unit. I would never be able to just give someone fluids without talking to the MD first on the floor. Granted, we have standing orders/early goal direct therapy, but still…
So the point…I’m bolusing her, blablabla, still not coming up. And then I woke her up while fiddling with her lines (effing DUH) and her pressure went right back to 120-140!!!
I’m like…ok, note to self: whenever someone starts dropping their pressure, freakin’ wake them up. Nursing 101 people, i have mastered it. For the rest of the night, whenever she started to look like she might drop her pressure, I just went in there and like slammed something or called her name and her pressure would shoot right back up, ahhahaha. I crack myself up.
I guess I didn’t think to wake her up because she was in such intense pain and everytime she was awake she would moan out. I figured, sleeping and not moaning=no pain=happy patient and happy nurse.
I’m a total hero and genius, I know…hold your applause!
