Today I’ll share some thoughts on one of my own experiences as a nurse on the lives of others. I’ll admit, I’ve not been in the position of having a patient in critical condition that needs life saving measures during my shift. However, there have been several instances over the course of my career where I’ve been able to proactively identify events that could have led patients or people down a less optimal pathway for their health.
These events are where I’ve found myself feeling the need to intervene on the patient’s plan of care. In the instance I present below, I helped drive a new plan of care for a patient based on information provided by way of a telemetry monitor, a technological support tool to help guide health care professionals in their practice. assessment of the patient’s or person’s condition combined with some form of technological support tool for the benefit of the patient helped drive a new plan of care.
This scenario was when I was caring for children with cardiac conditions. I remember I was working on a night shift. Night shifts always gave me anxiety because I felt as though I was constantly racing against the clock. The telemetry machine and tape was constantly producing new tapes to be reviewed of a patient’s ECG monitor. Every few passes by the nursing station each nurse would take a turn and review the tapes to make sure nothing alarming passed through on the monitor.
On this night, during one of my ECG tape reviews, I noticed something abnormal on the tape of one of my assigned patients. The tape should have reflected a *paced* rhythm but it did not look like one. A paced rhythm is one that depicts a patient that has a pacemaker. The tape looked like it could have been artifact (e.g., noise) but I wasn’t confident enough in my review. I called the physician and had him look at the tape. He was the surgeon and he then called the medical doctor for review. I told them that they needed to determine who was responsible for evaluating the tape to ensure it was ok. That was the last I remember from that night and that tape.
The next night I came in for my second shift that week. The surgeon approached me and thanked me before I started that night. I learned that there was an issue with the pacemaker not performing appropriately because of what was found on the ECG tape. The team had the patient reevaluated during the day and resolved the issue that had been identified from the tape. I remember walking into that patient’s room that evening to say hello and I was greeted with thanks. The patient’s parents expressed their gratitude for the work that I had done the previous night. Yes, they had to stay an extra night, but were more than willing to do so to ensure that the pacemaker worked properly for their child.
I’ll never forget that moment of finding that tape. I wasn’t sure of my interpretation so I asked someone else. I am so grateful that I did and to see what resulted from my inquiry was reinforcement. Sometimes you need to trust your gut instinct. In nursing, they sometimes refer to this as intuition. Some scholars will write about this as an expert level nursing practice. However, I think we all have intuition after some repeated experiences and efforts.
We, nurses, need to trust our feelings and make sure we share them. After all, we are the ones that are with the patients around the clock. Secondly, there are instances where we can leverage technology to support our practice. In this case, the telemetry tape did that for me. Of course I needed to use my critical thinking skills. However, had I not had access to the tape, the event might have been missed and potentially resulted in a different outcome.
