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H1N1 patient dilemma



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Nov 08, 2009 11:58 AM

H1N1 patient dilemma

Updated Nov 18, 2009 at 10:07 AM by Joe V

I just got home from work and I wanted to hear other views about a situation that I ran into with an H1N1 patient last night, so this is how it started.

As I was making my rounds, I walked into a patients room that was H1N1 positive. It was apparent that she was very upset and tearful, so I asked her what was wrong, she started off by telling me that she had a horrible day.

She stated that her 7a-7pm nurse only came into her room three times during the entire shift.

She stated that when she came in at 0800 she did not assess her and acted as if she was scared to be near her even though we have protective equipment to wear.

Next she stated that when the CNA came in to check her vitals and she attempted to ask her a question, that the CNA could not answer her because she was holding her breath while in the room.

She then proceeded to say that the second time that the nurse came in her room she brought her all of the meds, even those that were not scheduled to avoid having to come back in the room.

The patient then stated that she vomited and messed up her gown at around 1300 and it took her 1 hour to 1.5 hours before she got a clean gown after she had requested one several times from the nurse.

The patient also stated that no one would pick up her dinner trays, and at 7pm she had all three trays from breakfast, lunch, and dinner stacked in her room because no one would take them out of the room until the 7pm nurse started his shift.

Finally the most disturbing part about all of this is when the patient told me that when she complained of pain, no one came to address it until she called her family at home and they had to the hospital for her to get her needs met.

As a charge nurse I felt that it was my duty to try and fix the problem, but it's hard to correct something that happened during the day shift and you do not start your shift until 11pm. I reported it to the supervisor and she wrote the nurse up and stated that she was going to report it to the manager, so my question to any of you out there is this, do you think that this nurse was acting like this out of fear, negligence, or both. I also have to report this incident to the manager, but do you think that i should ask the nurse what happened before I do.


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64 Comments
No. 1
from sharpeimom
Old Nov 08, 2009, 12:21 PM

Default Re: H1N1 patient dilemma
Appalling ... Disgraceful... Unprofessional to the max...

Reminds me of how HIV positive and AIDS patients were treated by uninformed and ignorant people 25 years ago. Unfortunately though, there is sometimes no practical way to eradicate such ignorance bordering on outright stupidity. This a very fundamental conservative religious area and I've heard quite a few people state unequivocally that H1N1 is God's way of zapping sinners and I have no idea how to combat that typeof belief.

For the merely uninformed, a series of inservices might help. Not just covering the
H1N1 flu but other "scary" and panic inducing diseases and conditions. Don't hit them with all the facts at once, but rather, repeat over two or three inservices.

Kathy
sharpeimom
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No. 2
from jessiern
Old Nov 08, 2009, 12:28 PM

Default re: H1N1 patient dilemma
This situation may very well have taken place, but talk to the nurse before you write her up. Get her side of the story, especially if it is a nurse that you know well. Patients don't always tell the truth.
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No. 3
Old Nov 08, 2009, 12:54 PM

Default re: H1N1 patient dilemma
I've never understood this whole fear factor mentality. At least in the healthcare setting we have a good chance of knowing what were up against and have a reasonable chance of protecting ourselves.

I tend to worry about the people in the grocery store (and other public places) and what they may possibly be passing around!
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No. 4
Old Nov 08, 2009, 12:56 PM

Default re: H1N1 patient dilemma
I think this patient was definitely neglected but only due to ignorance. The ward manager definitely needs to know about what happened if only so that they can ensure sufficient education is provided for the staff. Only when the staff have been properly educated can any fears be abated thereby eliminating such neglect of patients. Also are staff not offered swine flu vaccines? I'm from the UK and our hospital has offered all staff free vaccines for the all round protection of patients and staff.
Either way, the only way to prevent this situation is better support and education.
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No. 5
from Zana2
Old Nov 08, 2009, 01:26 PM

Default re: H1N1 patient dilemma
Staff education....swine flu is a new one...maybe she was just plain and stupidly scared...I'd say support your staff, hear both sides before doing anything.
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No. 6
Old Nov 08, 2009, 02:09 PM

Default re: H1N1 patient dilemma
i would talk to the nurse first, there is 3 sides of every story. in this case the nurses side, the patients side, and what really happened. i feel the nurse reacted out of fear. she was holding her breath.
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No. 7
from Virgo_RN
Old Nov 08, 2009, 02:41 PM

Default re: H1N1 patient dilemma
So the nurse was written up and reported based on ONE side of the situation? Not cool. It's very possible that this did happen, but to react without first giving the nurse the opportunity to tell her side is premature, IMO. Patients do not always tell the truth, and perceptions are not always reliable. If the events described by the patient DID take place, then this points to a knowledge deficit on the part of the staff, and a need for education.
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No. 8
Old Nov 08, 2009, 03:02 PM

Default re: H1N1 patient dilemma
Originally Posted by Virgo_RN View Post
So the nurse was written up and reported based on ONE side of the situation? Not cool. It's very possible that this did happen, but to react without first giving the nurse the opportunity to tell her side is premature, IMO. Patients do not always tell the truth, and perceptions are not always reliable. If the events described by the patient DID take place, then this points to a knowledge deficit on the part of the staff, and a need for education.
I agree. I would love to get the nurse's story. Perhaps she wasn't trying to avoid the patien. Perhaps she was over-whelmed and understaffed. I wonder what else was going down on the unit that day that might have also captured her attention?
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No. 9
Old Nov 08, 2009, 03:28 PM

Default re: H1N1 patient dilemma
I hate to say it, but I have seen people avoid isolation rooms out of laziness. We have one CNA in particular who tries to get the RN to do all her work in isolation rooms because "you're in there already."

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