BelleKat 2,901 Views
Joined Apr 29, '08.
Posts: 316 (60% Liked)
I did work with a very bad nurse who just seemed to hate all aspects of being a nurse.She didn't care about people,she was inattentive and careless,she made many mistakes. One pt who was critically ill and had just been extubated she got out of bed at the end of her shift and although he had an aline too she left the cardiac and aline alarms off so the next shift essentially goes into a dead man's room who was still getting a jet neb(nice touch?) and was flatlined and beyond help. They go all out full code,they were all feeling terrible that this new nurse had slipped up like this and that she would be devastated but when she came back in the unit after she was dressed she just shrugged like "so what" when they told her.
I also followed her with a 18 month old child who was orally intubated but was to be trached in the am. This child drooled and securing the tube was a pain and it needed to be closely watched. The child was active in a crib and the nurse hung the majority of the vent curcuit outside of the crib so the weight would use the side of the crib as a fulcrim and essentially whip the tube out of the babies mouth It happened three times on her shift!!!!
I got report and went in there quickly and saw that it was ready to happen again,I called RT to retape,I sedated wee one and placed the vent curcuit in a way where it didn't pull on the tube just in time to get a call from the attending begging me to not let her get extubated again. I told him if I had to stand there and hold it in I would. The baby was fine and went to get trached the next morning,no more mishaps.
They never seemed to punish her or sanction her,her attitude always sucked and my heart fell if I saw her outside to get report on a difficult pt because I knew she would not work hard enough for the pt to do well. Complicated burn pt are incredibly busy and unstable and so much depended on the nurse picking up clues to notify the dr so these issues could be addressed or the pt could likely die that shift.
I remember being so upset when I came in that night to hopefully take my pt again and she was dead.
I pretty much lost heart for it after that. This nurse was a BSN and I think that's the only reason they kept her,the dept heads seem to love her. She's probably CNO somewhere perpetuating her particular "style of nursing".
I hope not,maybe she went into Real estate.Gee I hope so.
Wow,didn't mean to write a book.
I really don't know of any situation where unplugging the vent alone would cause it to stop working unless RT had silenced ALL alarms and there are many redundant alarms ie low pressure,high pressure on O2 and compressed air,normally there would be so many alarms it would be impossible to ignore along with the pt's monitor alarms as he was bradying down.
I mean I've heard something like this too but I suspect it was very long ago before all the safety mechanisms(like the early 70's?) or it is urban lore.
Where I've worked with critical ventilated pt the alarms are set so tight that if the pt just coughs heartily the high pressure alarm nearly blasts me out of the room.
I did hear of a RT who d/c'd a vent on the wrong pt and he died,that was in the 80's I believe.
I use them to unscrew tight IV connections and I've found them useful in emergencies such as when my confused pt reached up and tore his new hickman in half above the clamp. (We weren't allowed to restrain him until after this). They weren't sterile but clamping the line seemed like the sensible thing to do to prevent either hemorrhage or air embolism.
They came in handy.
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