Listen to your patient.

I am doing my Cardio thoracic placement at the moment. I was treating a 78yo old lady during the week and she was 7 days post CABG. She had a rather tough time post op and had stayed longer in ICU than most. She was beginning to do well and was amb short distances (15-20m) although it was hard to get her motivated to do so.She was not keen on ambulating or doing anything herself according to the nurse staff. On day 8 I went to treat her and she said she was too tired and fatigued to do anything. Based on past documentation and objective analysis-Obs-sats/hr/bp/RR and general obs there was nothing evident to suggest that this lady should not get OOB and amb other than she not wanting to get up. With alot of persuasion she got up and went for a walk however after a rest break on a chair she was unable to get up out of the chair. All sats were stable and there was no reason for her to require more than x1 assist.I got a nurse to help me with the patient and we brought the pt back to the room. The patient was very frustrated and could not understand why she could now not get up.

Next day when I went to see this patient for a tx session, she was afebrile and tachycardic.She was sent for ECG and Cxr. This just highlights the fact that yes we have learned alot over the last 2 years but sometimes criteria or regimens have to take a back seat to what the patient is telling you. This lady was obviously not feeling well and although no harm was done it shows that sometimes you just have to listen.

Michelle