One night in PACU Linda and myself received a patient from the ORs/p colon resection. It was noted upon arrival to PACU that the patient was displaying EKG changes. Because this was a fresh post-op patient, there were several immediate needs the patient required. These included surgical pain, airway maintenance, and most importantly, the patient’s EKG changes. What happened from there was a collaborative effort amongst the PACU nurses and the physicians involved to provide precise, high-quality care, that led to swift cardiac intervention in the CATH lab.
At the time this occurred, the requirement that all orders be entered via CPOE including pharmacy medications was very new and presented an even greater challenge. However, my coworkers pulled together and did not allow this to delay the care the patient received. We each took a role. One nurse was entering the numerous orders being called out by Anesthesia and the phone orders being received from the Cardiologist. Another nurse was calling lab, EKG, activation the heart alert, notifying the surgeon and contacting the CATH lab and Cardiologist. While the third nurse remained at the bedside comforting the patient, monitoring VS and making sure all medications were being given and documented. I remember specifically that entering IV metoprolol via CPOE proved to be a challenge that night. However, we pulled together and it was all done correctly.
The heart alert protocol for areas not covered by MET was followed with the help of my coworkers and the patient was quickly transferred to the CATH lab directly from PACU. Prior to transferring the patient to the CATH lab, the doctor met with the patient’ wife to update her and answer any questions she may have had. Furthermore, we willingly allowed the patient’s wife to come into the PACU and briefly visit with her husband before we left. These simple acts of communication, explanation, and compassion allowed her to be more informed with the current situation and at ease with the planned course of action.