I am really beating myself up.
I work at a center with profound and severly mentally retarded children and adults. They don't talk. As a nurse its up to me to some times figure out whats up.
I'll admit the communication in this place sucks.
I found out yesterday that One of my residents has been loosing her hair. A LOT of hair. The first shift nurse told me the day shift supervisor asked her Dr if he wanted to order a TSH level to test her Thyroid. He blew it off (He's a real ass) and didn't order it. I instantly recalled she had had a large wt loss recently. Another Dr was due in that night so I said I would talk to him.
First I had to argue with MY supervisor. i told her about the hair and wt loss, and said I wanted to ask the Dr for a TSH level. She got pissy and told me she was sick and tired of asking this Dr for everything on her time. I said I WOULD ASK. And she kept yelling at me any way.
What ever. I asked him when he got there. I'm not the type of person to just let things go. I want answers and I won't let any of my kids suffer needlessly.
So, he agrees, after I give him the story that a TSH is a good start. He then asks what else? (He likes to quiz me...I've only been a nurse for 2 years, he's a great teacher.) I hemmed and hawed, then he said, "Well, Lupas."
I almost fell on my ass.
She has the butterfly rash on her face.
KICK KICK KICK KICK KICK.
Now, in my defence, she was started on a new drug back in the spring and had a severe allergic reaction to it (or what we thought was an allergic reaction) and she broke out in a bright red, raised rash from head to toe, some of it actually scared, and her face never really cleared. I always just associated that redness to that!
Any way, the Dr ordered a SLEW of bloodwork. All the while I'm kicking myself in the ass. As soon as he left I pulled out my book, flipped to Lupas for the sympoms
Urine retention-Check--KICK
Rashes -CHECK--KICK KICK
Occasional Low body temp-CHECK--KICK KICK KICK KICK
Oh, how I hate myself today.
I guess I shouldn't be so hard on myself. After all, no one else thought of it either. And the day shift LPN and RN never bothered to MAKE her Dr order even the TSH. I'M the one who ARGUED with MY supervisor, and essentially went over her head and talked to this other Dr even though she didn't want me to. I guess that has to say something?
I'm still kicking myself. |