I feel so dumb.
I had a 19 y/o patient who is in psychosis and has pretty severe anxiety. He was originally in special care but was moved up front because we needed more room for other patients. His heart rate has been trending upward and at the beginning of my shift it was 149. I wanted to keep an eye on it so I checked it right before shift change in the morning and it was 170. I asked him if his chest was hurting, if he felt short of breath, and if he felt light headed and he said yes to all of it. I immediately went and told charge and she told me to get a manual pulse on him. I could barely feel it because it was so thready. Then, his nose started gushing blood. I pressed the call light and had my charge nurse come to help me assess him. She ended up having him bear down and that helped to bring it down to around 115ish. I feel so stupid because I feel like all of this could’ve been prevented had I told the charge nurse about the 149 heart rate when I first started the shift. He hasn’t been eating anything for anyone and hasn’t gotten out of bed. He doesn’t make his needs known. He didn’t verbalize any of his symptoms to me. We’re on an inpatient psych unit so we aren’t technically medical like a med-surg floor and his room is far away from the nurses station. My chest hurts and I feel stressed and stupid because I feel as though I could’ve done more and honestly I just feel like a horrible nurse. I recognized the trend but didn’t do anything about it..