14My fingers gently lift my patient’s swollen eyelids to lookinto his eyes as he is recovering from coronary artery bypass surgery.I move the small light to assess pupil reaction. As I explain the reasons for my neurological assessment to my nonresponding patient,I’m asking myself, “Why is he not waking up? Surgery was two daysago!”I smile at his wife who anxiously watches me as I confirm his stable cardiac rhythm, monitor his blood pressure, and ensure the vasoactive medications that are dripping into his central line catheterhave not leaked into the skin.It’s the moment for me to question everything: Have we preventedair embolism, deep vein thrombosis, arterial occlusion? Have ce rebral perfusion pressures been adequate? Is cardiac output consistently stable? Is he oxygenating well? Consider lab results. Considermedication effect. I want to collaborate with the cardiothoracic surgeon to brainstorm etiology of comatose state post surgery and intervene to improve patient status.The cardiologist is standing at the chart now and with a quick lookinto the room casually comments, “Still hasn’t woken up yet? Let’sgive him more time.”As he walks away, I say, “I am curious about his thiocyanate levelsince he is on nitroprusside to control his hypertension. Or can weget a CT scan to rule out stroke?”The physician does not turn around and says, “We don’t need to getunnecessary tests! His renal function is fine.” I could have said “okay”and carried on with my other work, but my education and experience led me to challenge the physician’s view. It was my responsibilityto ensure a better patient outcome, decrease length of stay and cost,alleviate the patient’s suffering and the emotional turmoil of the patient’s wife.No Patience for PoisonBrenda CarleWhen Chicken Soup isn’t Enough : Stories of Nurses Standing Up for Themselves, Their Patients, and Their Profession,edited by Suzanne Gordon, Cornell University Press, 2010. ProQuest Ebook Central, http://ebookcentral.proquest.com/lib/qut/detail.action?docID=313801Created from qut on 2018-03-21 22:04:04.Copyright © 2010. Cornell University Press. All rights reserved.Set Up to Lose, but Playing to Win · 15I hit the phone and called Tucson Poison Control. The official Italked to agreed that a thiocyanate level should be ordered. We gotthe specimen, and guess what? Its toxicity was leading to my patient’sloss of consciousness. Feeling elated that we found a potential reasonfor my patient’s unresponsive state, I called the surgeon to report thetoxic level. I heard silence, then his calm reply: “Thank you. Pleaseturn off the nipride and watch the BP.” I turned the nitroprussidedrip off. My patient woke up within hours.When the surgeon came to see the patient, the patient was sittingup in bed, with eyes wide open and stable neurological status restored. The surgeon cracked a smile of disbelief and appreciation, andsaid, “Brenda, thank you,” while meeting my eyes.As a nurse, I felt proud that I questioned the status quo and challenged a colleague for the benefit of safe patient care. I earned therespect of a cardiothoracic surgeon. I received hugs from my patient’swife. Most important, I protected my patient.. . .Brenda Carle, RN, BSN, PCCN, is a Clinical Educator of ProgressiveCritical Care Unit and Central Monitoring, Tucson Medical Center, Tucson, Arizona.When Chicken Soup isn’t Enough : Stories of Nurses Standing Up for Themselves, Their Patients, and Their Profession,edited by Suzanne Gordon, Cornell University Press, 2010. ProQuest Ebook Central, http://ebookcentral.proquest.com/lib/qut/detail.action?docID=313801Created from qut on 2018-03-21 22:04:04.Copyright © 2010. Cornell University Press. All rights reserved.
- Assignment status: Already Solved By Our Experts
- (USA, AUS, UK & CA PhD. Writers)
- CLICK HERE TO GET A PROFESSIONAL WRITER TO WORK ON THIS PAPER AND OTHER SIMILAR PAPERS, GET A NON PLAGIARIZED PAPER FROM OUR EXPERTS