Monday, May 4, 2015

On my unit critical thinking isn't all it's cracked up to be

One has to wonder whether my colleagues have any critical thinking abilities.

When a patient falls and hits their head/neck/back (in any which manner) off the wall or the front of the counter in the bathroom and loses consciousness.... #1 move would be to NOT MOVE THE PT!!! Yet the ONLY voice of reason was I. WTH is that shit?!

Thankfully I'm a pretty bold person and I point blank told the other several nurses that were there that we weren't moving the pt but that I needed assistance to keep his neck and head in proper alignment while straightening him out from his slumped position. Once that was accomplished we set about to put the pt on a back board then transport the pt to the bed so they weren't on the cold floor anymore.

I put forth that we should call a code but no one would listen to me - including the charge nurse - she said that since the pt was awake (any by NO means alert!) that it wasn't warrented... ya right! The pt wasn't answering questions and had lost consciousness. We had no idea whether the pt had had a stroke or seizure or anything else.... I thought it was foolish.

So I stayed with the pt ensuring that he did not move his head until the physician came. About 10 minutes later the physcian showed up and the pt was coming around. Neurologically not all there, not answering questions very well. Pupils were not equal and one was sluggish - now I have NO idea if this is a change but it certainly isn't normal!

The physician thankfully sided with me so a C-collar was applied and a head CT was obtained as well as x-rays to clear the spine and check whether any ribs were fractured. Wonderfully, all was cleared and believe that the loss of consciousness was infact a seizure.

I seriously question the critical thinking skills of the people with whom I was working with - and some of them are seasoned nurses. Such a shame!

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