12 Aug


 New nurse Jane gets report from the night nurse. “Pt came from the ED around 2am. Admission orders include keeping the O2 sat above 94%. Dx-Acute Exacerbation of COPD. PMHx-COPD etc…..”

Night nurse tells nurse Jane that the patient has been on a non rebreather getting 100% O2 since 2am.

New Nurse Jane is still under the loving, protective care of experienced nurse.

Jane tells experienced nurse the situation.

Nurse Jane assesses patient. The patient is short of breath on the NRB, worse than that. The patient can not even answer any questions. The patient can not talk.

The patient looks like a fish out of water.

The patient has a respiratory rate well over 30 breaths per minute and fatigued.

Somehow Intensivist appears out of nowhere. (i think experienced preceptor called as soon as we got out of report)

ABGs are drawn by the RT stat.

Charge nurse notifies the ICU that we are coming up with patient.

In the ICU while giving report to the nurse there: I see in my patients room: Nurse gives versed. The curtain is drawn. I see Legs rising off of the bed and slamming down again.

Legs rising off of the bed.

And down again.

Legs rising off of the bed.

And down again. 

This patient was hypercapnic with a pCO2 greater than 70. The patient was tired, fatigued and could not go on much longer in that respiratory distress.

I went back to floor…relieved that my patient was stabilized in the ICU.



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