Last Saturday, I have had the most shameful experience so far being a student nurse.
My patient is a 10 year-old male with a provisional diagnosis of T/C CNS Infection. He has body weakness, episodes of vomiting and he was very irritable. However, he still is conscious, coherent and oriented in three spheres (person, place and time).
During the shift, I took his Vital Signs, I noted that he had fever with a temperature of 38.2C so I performed Tepid Sponge Bath for my nursing intervention, then I rechecked his temperature after 30 minutes and it was 36.8C. I took his blood pressure though he is just a pediatric because of his episodes of high blood pressure. True enough, I noted 120/90 mmHg for his BP and it’s really high for his age.
For about 5 minutes later, a medical intern (or is she?…hmmm I don’t know) rechecked my patient’s Vital Signs, she copied the temperature I got but she, on her own got the cardiac and respiratory rate. Here comes the problem. When the doctor checked his BP, at first she didn’t got it because of the patient’s constant movement and noise and do she pumped again. I observed what she was doing, she pumped at 140 mmHg then release. She read the measurement and relay a 140/100 mmHg reading.
I was shocked. REALLY SHOCKED.
What the HELL happened there? I was really definite of my reading few minutes before. The mother was also shocked because I said to her that her child’s BP is just 120/90 mmHg. I didn’t take any move.
The doctor explained that the other doctor endorsed that the patient has consistently high blood pressure since admission, he even had a reading of 160/140 mmHg (as far as I can remember). At the back of my mind, I was battling with her statements I mean, that BP reading was before the client got medical management for his condition. If she could review the chart, which I thoroughly reviewed, his BP now was ranging from 110-130 systolic and 80-90 diastolic.
She even tested for Kernig’s and Brudzinski’s sign roughly. She didn’t asked the patient face to face if he experienced nuchal rigidity even if he can answer it directly, she just asked the patient’s mother to do it for her. What’s the point right? What kind of assessment was that?
Minutes after that “i-don’t-know-what-kind-of” doctor, the mother approached me. She said “Minuto lang ang nakalipas, sabi mo 120/90 lang, ngayon ang taas na…” I just said in a low tone of voice, “yoon po talaga ang nakuha ko… 120/90 po talaga yon…” then I left.
If ever I’d be assigned to the same patient again next week, I don’t know if I still have the face to render care to him. I was on shame at the same time I was pissed.
FEU Student Nurses are trained to get Vital Signs accurately without altering the results (well at least for my group). It is our forte considering it is what we do almost all at the time during clinical rotations especially if the hospital is benign (non-toxic) with matching NCP and Drug Study making. It has become our routine and our specialty. Sad but true. To be questioned in what I know I do best is a big slap on my ego.
I reported this incident to my clinical instructor and she just said “Hayaan mo yang mga yan, mga insecure lang yang mga yan. Ganyan talaga yang mga yan.”. I still can’t move on with what happened. I just said “Sige, kaysa naman yung doktor yung mapahiya, ako na lang kasi estudyante lang naman ako…” even though I know I am right.
Altering Vital Signs is crucial for the well-being of a patient. It can kill. If you would refer to my previous post.
I hope health care providers will possess the virtue of veracity because it is life that we are dealing with and not just a toy which you could by another if broken.
