Autopilot- a Medical emergency

Whilst recently on an orthopaedic outpatients prac  in a secondary hospital i had settled into the sleepy ward where patients were put on pathways and each day the plan was already dictated for you. Each day was much like the one before it and i had flipped over to auto pilot. A normal day on the ward saw me having 4 TKR patients to see for the day. The first we were conducting a routine day 1 where we were walking the patient to the shower. Prior to treatment the patients obs had been checked and medically the patient was stable. On entering the bathroom the patient reported he felt slightly dizzy. This being a completely normal response when a patient gets out of bed day one we calmly told the patient to make his way to the shower where he could sit. After his next step the patient began having a TIA where his left hand was gripping the crutch and his right arm had gone into a flexor synergy and right side of his face drooping. My supervisor who had seen this before grabbed the comode chair and we guided the patient onto it the nursing staff hit the emergency button but no one came so we rushed the patient back into his room and four of us lifted him into bed. The instant that the patient was supine the patient returned to normal and sat up in bed asking how he got back from the shower and why there were so many people in his room.

A few minutes later the medical team strolled in to see the patient chatting to us in bed and asked why the emergency button had been pressed. We explained the situation but they were unable to comprehend the seriousness due to the patients normal appearance. For all of us that had experienced the situation we were extremely angry that the medical team were not able to see the seriousness of the incident that had just happened. For me as a student i was amazed at how something that is so routine can change so quickly, dizziness and nausea post surgery is very common and it is impossible to have picked the situation unfolding this way.  My supervisor assured me i had done nothing wrong the patient was stable prior to the intervention, dizziness is normal could have done nothing to prevent the situation from occuring.

This was a huge situation to show how routine this environment can become for everyone, the medical team strolling in demonstrated their casual response to a medical emergency. As the ward is in a secondary hospital where there are very rarely complications, people are slow to react in an emergency. There was no crash cart, people finished what they were doing and then slowly made their way to the room where the alarm had sounded, everyone was on autopilot.

This situation has made me realise that no matter how comfortable you are with what you are doing and how routine it becomes, each situation needs to be treated as a separate experience. It has show me the dangers of autopilot.