Drama

A woman had been on our floor for what seems like weeks. She had a history of bipolar disorder, I believe, and she required a 24-hour sitter because she was very confused and would pull at lines and things like that. She often called people nasty names. Sitters are an annoyance, even though they ultimately protect a patient's safety, because they're not provided by the hospital. You have to take someone out of your own staffing to fill the need. That means that you're usually short-staffed when there's a sitter case on the floor. Anyway, as I recall, this patient had had a hip replacement, but the site got infected so they removed the hardware. She was being treated with antibiotics and laid around with no hip joint. On the night shift, while helping to reposition the patient, one of our techs discovered a large pool of blood at her hip site. We ended up calling a code because she was quickly bleeding out. All of a sudden, she became remarkably lucid and was screaming, asking who was going to intubate her, where anesthesia was, etc. A doctor in the room tried to distract her and calm her down, at which point the patient started demanding who that doctor was. When the nurses tried to distract her from that, she started yelling, "No! Who is she? Black glasses, blonde hair. Black glasses, blonde hair!" No one could help but chuckle at the change in the patient's mental status despite the emergent situation.

One of the scarier things that's ever happened to me was when I was taking care of a man with Parkinson's disease. We'd had a very calm morning when I received orders to basically quadruple the amount of the drug he was getting to treat the Parkinson's. I suspected that this was an error, so I paged the doctor to clarify the order. Even though it took a while to receive a response, I confirmed that the new order was correct. Clearly I wasn't the only one to think the order was strange because the pharmacy didn't approve the order for hours. The lack of their approval prevented me from taking the pills out of the medication dispensing machine, so I was stuck. I called the pharmacy to find out why they didn't approve the drug. They said they were waiting to hear back from the ordering physician because the order seemed to strange. I told them that I had spoken to the physician and it was correct. I gave them the physician's pager number to try them again. The order ended up getting approved, and I gave the next dose. About two hours later, the patient went completely unresponsive. His vitals remained fine, but because no one could figure out what was going on, we sent him to the ICU (where, by the way, they continued to give him the drug according to the same order). He ended up getting discharged the following day after waking up and having no problems. He said he remembered the commotion, but wasn't able to respond (I can't imagine anything scarier...). I spent the whole day in agony, thinking I had made the wrong decision to give him the drug despite all my efforts to verify the correctness of the order, but I'm just glad he ended up being fine.