Do I Say Something When They Call or Just Let it Go?

[flashpoint]

I was recently hospitalized for a lap chole. The procedure went very well and I am feeling great...I almost feel ready to go back to work. I have some concerns about things that happened after the procedure that I'm not sure if I should mention or not (they are going to call me today to do a patient satisfaction survey over the phone).

My blood pressure went up a lot during the procedure. Certainly no one's fault, but it did. Since my blood pressure went crazy, they had me on a cardiac monitor throughout my stay.

When they transferred me to my room (I had to stay overnight), they put me on a monitor that is apparently new and unfamiliar to most of the staff.

My rhythm seemed to be normal sinus initially, but then switched to what appeared to be atrial flutter a few minutes after they put the monitor (not just a portable telemetry box, but a huge bedside monitor) on. The nurse just stood there looking at the monitor and said, "I've never actually seen anyone in flutter before." I checked my radial pulse, which did not correlate with what the monitor showed. I asked if she needed to adjust lead placement and she said that she thought the leads were placed properly. I also asked about changing monitors and she said that she didn't think there was another monitor available.

The nurse did a 12-lead EKG, which showed a normal sinus rhythm and left the monitor showing what appeared to be flutter waves in place. The monitor alarmed every two minutes due to the flutter waves, so she showed me where the "silence alarms" button was and told me to feel free to push it.

After about four hours (and walking in the halls with an IV pole and a cardiac monitor) I took the monitor off myself and asked the nurse if she could please get it discontinued since it wasn't showing an accurate tracing anyway. They then brought in a portable telemetry box, which showed a normal sinus rhythm throughout my stay.

My question is...do I mention the cardiac monitor when they call today? There was no harm done, but it was really frustrating to have to either listen to the monitor alarming every two minutes. It is also pointless to have a monitor in place that for whatever reason isn't showing an accurate tracing.

Other concerns I have are...

The night shift said I had I/O ordered, the day shift said I did not. When I worked there, policy said anyone with an IV was automatically on I/O.

I only saw two nurses wash their hands.

I got coffee on my tray for every meal even though my surgeon (per my request) ordered no caffeine (including decaf coffee or tea).

Since I was on telemetry, they couldn't let me close my room door unless there was a nurse in the room with me. Even with ear plugs, I couldn't sleep because of all of the activity in the hall and the call lights going off all night. I didn't sleep much at all...maybe an hour or two.

The nurses were all very nice. I did get very kind and compassionate care. They did an awesome job of making sure my pain was managed and other than the things mentioned, I was very happy with my care. I just found some things to be very frustrating. I'll probably mention the cardiac monitor, but leave the rest alone.

[BelgianRN]

And they say nurses make for the most difficult patients ^^.

I'd certainly mention the monitor. At the very least the staff must get more proficient with its use if it is going to be of any use in their care. Some basic troubleshooting could help.

The other things... Why bother? No harm was done. And on the hand washing I hardly ever wash my hands inside the patient area, mostly because I find it dirty to wash my hands above the same sink I use to wash them ^^. I'll leave the room and go straight for the sink or the alcohol dispenser in the hallway outside so I don't disturb my patients more than needed.

I would suggest them to get a stronger signal for your telemetry because that's just crazy you can't close the door. At least if the reason was signal clarity. If you code while on telemetry, opening of the door to get in won't make the difference.

[flashpoint]

I certainly wasn't trying to be a difficult patient. I was a little concerned when she told me the monitor was showing atrial flutter...and I was annoyed when they simply left the monitor in place and went about their day. I would never just tell a patient to push the mute button to silence the alarms. There were enough alarms beeping without adding one more to the mix.

Excellent point about the handwashing. When I think about it, I don't wash my hands in the patient's room much either...LOL.

[NicuGal, MSN, RN]

I'd bring up the monitor, heck I would have to the unit manager before I left. Obviously they didn't know how to use it and that is a huge deal. And patients should never ever be told to silence a monitor! I don't care if you are a nurse or not.

If they were going to touch me and I wasn't sure if they washed/sanitized, I'd say something.

[netglow, ASN, RN]

I don't think there is anything to report except the lack of a tele monitor that worked. It happens. Looks like you got an EKG to check things due to the monitor fail, and you were NSR. You might say you are concerned that there were not enough to go around, but, it's not like admin doesn't know this - cheap for a reason.

Other than that, I guess you have never been a patient. It's not a picnic, but I think you had a smooth ride.

[FORTHELOVEOF!!!!]

I would mention the monitor, just to let them there know there is some teaching that needs to be done regarding how to operate it properly. The other stuff just seems like little things (not the washing hands part) I wouldn't complain about. If you are concerned about their hygeine I would say something about that for sure, but I never wash my hands in the rooms either, I use the alcohol outside the door.

[GitanoRN, BSN, MSN, RN]

without a doubt i would voice my concerns in the matter, simply because you caught this while being a patient and your astute assessment of the situation made you questioned their delivery of patient care. pursuing this further, i always think what could happen if this situation persist without being addressed, worse scenario pt. goes home with a new dx. and a set of medications that could possibly complicate their present condition. needless to say, since it still bothers you, i would bring it to their attention. lastly, i'm glad that you have recuperated..wishing yo the best always...aloha~

[BostonTerrierLover, BSN, RN]

I would TOO voice the concerns you feel strongly about- it will only INCREASE future patient satisfaction, and better outcomes. Just be careful, and pick your battles.

On the things that were done for your safety, I am sorry for the inconvienence, but "suck that part up!" They kinda need to know if you were trying to make a "back door discharge!"

Hope you feel better now, and Get Well Soon!

:redbeatheBoston

[cally527, RN]

I would mention the monitor, and the coffee. If dietary mistakes are being made, they need to know about it in order to fix the problem. Not everyone had the self restraint not to eat or drink something that the doctor has restricted.

[nicurn001]

There is no point having a monitor if you cannot work it or ignore its alarms , so that should be reported .In the end the nurse did the right thing re. the monitor ie. replaced it ( hopefully she reported the faulty monitor ), but only when you said you would dc monitoring otherwise .

[Altra, BSN, RN]

OP, especially given that you had some familarity with the hospital as you had previously worked there ... is there a reason you didn't work out these issues with your nurse(s) right then and there, in a more give and take fashion?

[HouTx, BSN, MSN, EdD]

I would mention the monitor, just to let them there know there is some teaching that needs to be done regarding how to operate it properly. The other stuff just seems like little things (not the washing hands part) I wouldn't complain about. If you are concerned about their hygeine I would say something about that for sure, but I never wash my hands in the rooms either, I use the alcohol outside the door.

I disagree completely regarding the priority of issues here - my area of clinical practice is ICU.

WASHING HANDS is the highest priority in this case.... I have personally experienced the death of family members due to nosocomial infections contracted in a hospital setting. Even though the technology attached to a patient may seem to be more important and handwashing is relegated to 'ho-hum' status, the likelihood of a problem for the patient is far greater from infection than from rhythm disturbances.

Hand washing is not a "little thing".