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I had a patient come back to me after cath lab one afternoon. Her old stent was blocked; the stent itself was stented. She returned with her sheath still in place. A few hours and one ACT lab result later, I pulled her sheath. She tolerated it well, and the site looked great. She still had another four hours to lay flat with the extremity straight. I checked in on her frequently. No problems.
I was giving report to the next nurse when she called complaining of chest pain. She described mid sternal chest pain radiating to her back. I medicated her and returned to the station to find her cardiologist sitting there. Great, I thought. I’ll go ahead and notify him in person of her current status. If he hadn’t been there I would have immediately ordered a stat EKG and paged his nurse with any changes and/or continued pain.
He waved me away, saying “Just give her medicine.” As I started to walk away, he called out to me and said, “Don’t come to me unless its important.”
I went ahead and ordered the EKG – standing post cath orders, after all. I let the next nurse know what he had said, and I documented my notification and his comment to just medicate her. I didn’t add the rest of his statement; I wanted to do so, but I was sure it wasn’t appropriate to include.
I was standing there thinking the worst case scenario could be a re-occluding stent or new blockage from broken plaque particles.
His worst case scenario is a nurse bothering him with something so trivial as severe chest pain post cath.