Catherine (catseurat) wrote in cynical_nurse,

keeping the census up

I work in a subacute rehab, and it's a slow time of year. We have to call the DON or ADON before sending any patient out to the ER, since we can supposedly treat most things in-house.

So last night I have my guy with stage IV cancer with mets, gtube, fairly non-communicative, very supportive family - who wants him to live forever. Hence the FULL CODE status. So he starts to get loopy, combative, O2 sats in the toilet, won't keep the O2 on, develops +4 edema to all extremeties, BP 70/30, and the family is insisting we send him out. So we do.

And I call the DON to let her know, and all she hears is "FULL CODE" and tells me we should have treated him here (sure, I'll push some lasix to get rid of the edema AND the BP), and then says, "and if he codes, well, then you could send him out."

I'm trying to think how I would chart that so the family's lawyers treat me kindly as they remove my license.

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