In the morning, Sarah Kearney was able to faintly hear pulses in a patient’s leg. Mid‑day the patient complained of new numbness, severe leg pain, and was shivering and pale. Sarah was unable to assess the patient’s pulses. Sarah quickly brought Kim Johnson, NP, and the resident to the bedside. They were also concerned about the sudden change in the patient’s condition. Additional tests were ordered and the attending notified.
When the attending was briefed on the situation, she felt it due to patient’s diagnosed anxiety history and requested previous orders be canceled and anxiety medication administered.
The labs were already drawn and processing. Results showed a drop in Hematocrit, and blood was ordered. Sarah and Kim’s guts told them something still wasn’t right. Kim repeatedly phoned the attending, then pleaded with another attending to evaluate the patient. This attending ordered additional STAT tests which revealed a large hematoma requiring emergent surgery.
Sarah and Kim’s nursing judgment, tenacity, and persistence saved this man’s life. It is an incredibly difficult situation when your gut tells you something is not right, but your concerns are dismissed. These two did not give up. When the chain of command was exhausted, they risked professional relationships and found a different chain.