H1N1 patient dilemma

yes very much agree, you have to get the nurse's reason and try to validate it too since H1N1 is new maybe she(nurses on that duty) dont have yet right knowledge regarding precaution on this case..then you can talk it over with the supervisor and manager at least in this way you can help that nurse at the same time performance will be improve in that hospital..god luck

Try too highly paid administrators, too little money left for adequate staffing and especially trained supervisors who know how to spot inadequacies...... If nurses don't stand up for patients, who can't stand, who will? The courts?

Try too highly paid administrators, too little money left for adequate staffing...... If nurses don't stand up for patients, who can't stand, who will? The courts?

Dear Friends


The only way to fix this problem is complete knowledge about disease and nurse should know how he protect from any such disease without fear. whenever such disease arise the administration should made arrangement regarding this.

thanks

PremSingh(jaipur-India)

Two issues here, and I'll get the petty one out of the way, since it's one of my pet peeves: Write ups. In my previous position, my main job was patient transport, but other duties included emptying wastebaskets in the patient rooms, restocking supplies in the pt rooms, and passing meal trays. (Kind of a weird job description, but it had a few plusses. But I digress...) So, once I was told by the housekeeper who came each evening to empty the large trash containers that he would have to "write me up" because the wastebaskets weren't empty before he came, which meant he would have to come back after they were, or leave the "dumpster" full all night. Another time, a dietician was going to "write me up," because a dinner tray was sent to our floor for a pt who had transfered that morning to a different unit and wasn't taken to the right unit. I'd thought it was one of the several others sent for pts who had been discharged from the hospital, I didn't know about the transfer until I checked with the clerk.
So, this whole "write up" business ticks me off, because there are two people in the hospital, my manager and director, who can write "me" up by putting a letter of counselling or reprimand in my file. Anyone in the facility can do an incident report, any time anything occurs which is out of the ordinary course of practice. So the dietician could have, and should have, done an incident report on the undelivered tray, which had an impact on pt care. Of course, it was not her place to assign blame, and one of the issues that would have been addressed was why it wasn't going to the correct floor. (I did learn, for my part, to find out which pts were gone and which were moved.) The housekeeper was just full of it, but he could have done an incident report, and then carried it out with the rest of the trash.

In the OP's situation, it sounds like a report was made of a patient complaint and followed up by the manager. In my facility, that would be appropriate--it would be the manager's role to determine whether the nurse was to blame. The OP was responsible only to report that the complaint occured. That said, it did sound in the original post that the poster felt the nurse was to blame, so a judgement was made--and I'm inclined to agree with it. It does sound like the patient did not get appropriate care. But I also agree, that shouldn't go in the nurse's file without hearing her side and investigating the details.

As for the H1N1--(hiny--I love it!) I had two different pts in ISO for it, last weekend. One on my unit, and one the next night when I floated to a different unit. And yes, it is a bother having to gown and mask every time you go in, and yes, I didn't make many trips that weren't for a purpose. Actually, that's true of my other rooms, too. But I've learned that patients in isolation, especially airborne, do get lonely, so I try not to get too gung-ho about combining trips. They can't see me smile under the mask, but at least they can see me. As far as not being all that sick, the first was admitted for pneumonia secondary to the flu, so sick enough, although progressing nicely. The second had asthma, so, again, potentially pretty unstable, although she was also doing well. (Both were clear in all fields, at least with the disposable stethoscope. The scope isn't as good as mine, but good enough to hear anything bad.) The first one was cleared on Sunday, so I got to pop in and say hi without a mask.

I've seen this pattern with other pts in airborne, whether for rule out TB (almost always ruled out), chickenpox, or shingles. It's a pain to put on all that PPE, and rare to have time to do it just to socialize. Can't really count on the aides. They're busy, too, and likely to ask the nurse to get vitals "while you're in there." With the recent H1N1 outbreak, phlebotomy isn't doing draws on those patients and dietary leaves the trays outside for us to deliver and pick up. It's a pain, but I guess they didn't have enough vaccine for everybody, and in any case I can see keeping the number of people in and out to a minimum.

Still, if you aren't willing to care for sick people, health care is probably not the best place to be.

UNACCEPTABLE!

I'm hoping you've actually solved this problem by now but just to add my bit and rest your mind assured that responsibility relies on you (to safeguard the patient's interests and ensure no other patienst suffers this neglect), accountability relies on the nurse in question (to deliver efficient holistic care with UNCONDITIONAL POSITIVE REGARD) and ignorance has no place in nursing!

As we all know, according to the professional code of conduct, we owe the patient the duty to always act in their best interest. If this nurse caused harm through ignorance and negligence, I'm afraid she's responsible for worsening the patient's hospital journey and making her feel exactly like the virus she's got: left in a sty; surrounded by her own bodily fluids, in pain etc.

If her duty was breached due to fear, we work as a team for so many reasons; could she not have asked any of her collaegues for help? Were the masks out of stock? How would you feel if that was your relative?
If I was in your situation, yes, I'll speak to the nurse to ascertain the rationale behind her lack of interaction with the patient (busy? short-staffed or emergency? none of which I'll accept).
And yes I'd fill an incident form because now it's not just what happened but what you did when you found out what happened.

Yes, nurses are busy. Yes nurse are short-staffed. Although to err is human, there is no room for neglect and hard as it may may seem at work sometimes, we must all remeber to treat each patient as an individual not a means to an end!

Solution- revision on knowlege of virus and care of patients with viral infections!

HOPE THIS HELPED CLARIFY WHAT YOU KNOW ALREADY
Good luck