Nurse Bullied: Where did I go wrong?

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This topic contains 3 replies, has 2 voices, and was last updated by Profile photo of led340a2 led340a2 3 years, 3 months ago.

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  • #16029
    Profile photo of led340a2
    led340a2
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    Scenario: Intubated/isolated burn patient is not adequately sedated. You’re the BICU LVN. You immediately disclose your assessment findings to your team RN who notes your report, yet continues to go behind you 3xs to loosen your pt’s restraints who has not successfully passed weaning parameters. You’ve called the MD with report/waiting for orders. Meanwhile, you’re carefully observing your pt when you note your pt quickly pops loose one restraint, then grabs her tube. She is a burn pt in a negative pressure isolation room. You are not wearing scrubs, but no isolation attire. How do you respond?

    #16030
    Profile photo of led340a2
    led340a2
    Member

    My apologies readers. I’m new to this app. I was unable to edit my original post. Please view edited copy below, and leave your comments. I can really use some help understanding this scenario I endured years past.

    Scenario: Intubated/isolated burn patient is not adequately sedated. You’re the BICU LVN. You immediately disclose your assessment findings to your team RN who notes your report, yet continues to go behind you 3xs to loosen your pt’s restraints. Your pt has not successfully passed RTs weaning parameters. You’ve called the MD with report/waiting for orders. Meanwhile, you’re carefully observing your pt from the ante room when you note your she quickly pops loose one restraint, then grabs her tube. She is a burn pt in a negative pressure isolation room. You are wearing scrubs, but no isolation attire. How do you respond?

    I will divulge how the scenario unfolded after a few experienced, fresh-minded nurses share their thoughts.
    Thanks in advance,
    Leslie 🙂

    #16031

    Why is a burn patient in a negative pressure room? Negative pressure rooms keep the bad germs in so the public is not exposed to small pox and other nasty bugs the patient has. A positive pressure room seems to make more sense, to keep germs out of his room so he does not get an infection.

    That being said, if he needed the ETT I would go in there regardless of sterile gown to assist with bagging until he could get intubated again. The first priority is airway, so taking care of the airway is more important than the risk of infection. If he pulls the tube out and is talking and smiling and doing fine, then you might put something on before going in …. But even still, a rapid assessment is required, so I would go in the room and take care of him, unless he was in a negative pressure room because of smallpox, then I would stay out.

    #16032
    Profile photo of led340a2
    led340a2
    Member

    Thanks Jason for your response.

    Years ago, I was negatively reprimanded by our unit’s infection control nurse for saving my patient’s airway, because I failed to put on my isolation attire before entering my pt’s room. I knew I’d made the right decision, but I was still penalized for my decision.

    I took this punishment with a grain of salt, but I was a little confused as to why i was punished for maintaining my pt’s airway. Eventually, our MD visited and wrote up a 72 hr sedation order which was much more effective. Although, I know I made the right choice, from time to time, reflecting, I attempt to make sense of my supervisory team’s response to my decision (still shaking my head, years later).

    Oh. Yes. On the BICU, all of our rooms were negative pressure, single, isolation rooms that were arranged in a semi circle around the nursing station. The air was pulled from the hallway, circulated into the pt’s room, then pulled through the system via ceiling vents inside the pt’s room outside of the hospital. No air was recirculated into the pt’s room, or into the staff’s nursing station area.

    Again, thank you for your response.

    Leslie 🙂

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