- Category: Health , Life , Profession
- Topic: Nursing , Experience , Myself , Work
On a typical day in the Med-surg/Oncology/Hospice floor, I was entrusted with the care of three patients. At the start of my shift, I received a report on a 78-year-old male who was suffering from chronic gastrointestinal (GI) bleeding and epigastric pain. Despite being admitted as a "full code," I was reassured by his youthful appearance - he appeared no older than 55 - and a smile that flashed across his face upon our meeting. From that point on, I became his favorite nurse. Without delay, I commenced treatment by initiating his IV, administering his morning meds, providing oxygen support and evaluating his lab reports and endoscopy results. With a recent history of cancer and ongoing treatment, multiple ulcers in the GI tract were the source of his chronic GI bleed and epigastric pain. With a hemoglobin level of 7.5, a transfusion of blood was ordered. Recognizing his Italian heritage, I met with his wife and daughter who had journeyed to New York to visit him. Throughout the day, he grasped my hand tightly as I administered IV meds, detailing his struggles with debilitating belly pain. At 10 o'clock, I administered PRN Oxycodone PO, just prior to lunch. Upon my return, I observed him sleeping in his chair, having not eaten his tray of food. Although I attempted to awaken him, he did not respond. Lethargic and unable to be roused despite my efforts, his wife informed me that he had 'slept like a baby,' unknowingly revealing that he had experienced opiate toxicity. Sensing his wife’s anxiety, I advised her to remain calm while increasing his oxygen flow and contacting my preceptor for further advice. My preceptor and charge nurse immediately called for Rapid Response Team (RRT) to deal with the suspected opioid toxicity. While waiting for the RRT, I promptly produced a copy of my patient's medication administration record (MAR) and most recent lab results. Upon arrival, the RRT and floor MD examined the situation comprehensively. After I relayed the patient's medical history, current medications, lab results, and recent vitals, the MD confirmed opiod toxicity and ordered the administration of Narcan. With my preceptor administering the Narcan, I explained to his wife what was happening and how we intended to remedy the situation. Within 30 seconds of receiving Narcan, the patient regained his senses, opened his eyes, and exclaimed, "Why are there so many people in my room?" Everyone breathed a sigh of relief, but began implementing plans to prevent similar incidents from happening. I re-examined the patient and took his vitals, which returned to normal. The MD adjusted his order and thanked the team for quickly detecting the ailment. We transferred my patient to his bed and allowed him to eat his meals in peace. His wife was pleased with the way our team had successfully responded to the crisis. I reassured my patient that he would not suffer such an experience again. At the end of my shift, I returned to his room to bid farewell. His face lit up, and I stayed with him for an extra 10 minutes. The following day, MD confirmed that he had responded well to the blood transfusion therapy, stabilized and was ready to be discharged. Although he had not returned to the hospital since, I still remember our experience together.