little things can sometimes not be so little

(bit late internets been on the blink)
On my cardiopulmonary placement i was on a general medical ward, so this encompassed a wide range of patients. I was seeing a patient who had come in with an exacerbation of CAL and everything was going well and she was improving with each session. when it came time for the patients discharge i was going to see the patient for the last time and make sure she could do her exercises and also give her a home exercise program including upper limb exercises and lower limb exercises. When i went in to see the patient it was first thing in the morning as the plan was for the patient to be discharged by midday, I did a brief subjective with the patient and all was well except the patient said she had experienced a sensation of a 'dead' hand when she was having a shower and due to this she had some increased breathlessness as she relied on her other arm, when i saw her however it had resolved. The patient tried to brush this off as nothing as i think she was keen to get home. The patient kept trying to convince me that it wasn't an issue and that she was feeling fine.

On palpating the radial pulse i noticed slight irregularities which had not been present on previous occasions. I immediately notified her nurse and also the doctors of what had happened when i saw her. The the nurse and doctors performed an ECG and it turned out the patient had suffered a Transient Ischemic Attack when having her shower. With this being the case it was now not appropriate for the patient to be discharged. As well on further questioning from the doctors it turned out the patient had suffered similar occasions before however had just brushed them off.
From this situation it shows the importance of taking everything into consideration as even though the patient was ready for discharge from her initial problem at admission the new event had changed this. Also with the patient trying to brush it off as nothing it shows the importance of listening to every detail that the patient gives you and even if they say it is nothing from your informed judgement you should make the decision of what if any action needs to be taken, in this case it was notifying the doctors and nurse.

SO ANYTIME NO MATTER HOW SMALL SOMETHING SOUNDS OR IF A PATIENT TRY'S TO PLAY DOWN THE SIGNIFICANCE OF SOMETHING, THERE IS A CHANCE THAT SOMETHING MORE SINISTER IS GOING ON, SO IF NEED BE NOTIFY OTHER HEALTH PROFESSIONALS OR TAKE THE NECCESARY ACTION AS IN CASES LIKE THE ONE I DISCUSSED ITS BETTER TO BE ON THE SAFE SIDE.