mindlor, Thank you. Thank you. Thank you for saying that. You just described me, but I had the misfortune of having Nurse Racheted instead of you.
Let me preface this by saying I don't think all nurses are mean or power hungry and I don't think all hospitals are horrible. I've been a patient in some wonderful facilities and had excellent, kind nurses.
Unfortunately this year I was not so lucky. I ended up in hospital where no one knew the definition of patient autonomy.
I'm 50 something. I used to be a college professor and now work in industry. I had surgery and the nurse enabled the bed alarm.
I repeatedly insisted that the alarm be turned off. She repeatedly refused stating it was hospital policy.
I stated that I was a competant adult and was refusing the intervention. She stated that the alarm was hospital policy.
I said I had the legal right to refuse any intervention. She stated that the alarm was hospital policy.
I said they were holding me prisoner against my will. She stated it was hospital policy.
I insisted she get the resident to my room. Same story from the resident. It's hospital policy. After 3 hours (yes 3 hours!) of this I gave up and did what I had to do to get along and get released.
Once I was released I got a copy of my hospital records including nursing & physician notes. In their notes it states that "patient wants alarm turned off. Said she was refusing intervention. Said she felt like we were holding her prisoner. Explained that it was hospital policy." The notes also say I was AOx3 and had no gait disturbance.
This was the only time a nurse ignored my decisions.
Unfortunately the doctors repeatedly ignored my decisions after saying they would respect my wishes. (e.g. They performed a blood test that I had refused because it had poor sensitivity, poor specificity, gave false positives if the patient had an infection which I did, was expensive, and would not provide any information we didn't already have from more accurate tests.)
When I got out of the hospital my first inclination was just to never return to that hospital and make sure everyone whom I knew never went there. Then I realized that if I did nothing and this happened to another patient as I was sure it would, then I was partly responsible. In addition this is a teaching hospital. What are they teaching residents and student nurses!
I wrote a letter to the CEO of the health system stating what had occurred, how this was a violation of state and federal laws and listed the applicable statutes, and attached the hospital's documentation supporting my complaints.
I don't want to get anyone in trouble. I don't want to get anyone fired. I don't want a $ settlement. I do want them to change the way they treat patients. I want them to respect patient autonomy.
I made it clear in my letter that I wasn't complaining about an individual employee. I was complaining about the culture and policies created by management.
I've received letters from the CEO, CMO, and CNO outlining the specific steps they are taking to investigate my complaints, who in the organization is responsible for each of the action items, and committing to inform me of the results of the investigation and whatever steps they take in response to the investigation. If I don't get results from the hospital, I'm prepared to file complaints with the state organization that licenses hospitals, JACHO, AHA, CMS, the organization that credentials their residency program, etc. Again I want change not retribution.
Oh and you are correct; bed alarms are insulting to your dignity. They are humiliating, degrading, embarassing.
There is no evidence
that alarms decrease falls or the severity of injuries from falls. There are
studies that show increasing bed alarm usage in acute care settings does not
reduce the number of falls.
In addition in order for the alarms to be heard by the nurse, they operate at a decibal level that is damaging to the patient's hearing.
In my case the alarm went off every time I tried to roll to my side, sit up, or just reposition myself. I had to stay perfectly still (increasing the risk of pressure sores). I was in a lot of pain and had a PCA with dilaudid. I prefer to manage my pain with repositioning, distraction, etc. instead of narcotics as much as I can. Unfortunately the bed alarm made that impossible. I used more narcotics for that 1 surgery than my other 8 surgeries combined.
The alarms also make it impossible to sleep, since the patients in the rooms around you have alarms going off all the time too. I don't know how the nurses accomplished anything. It was always at least 2 RNs (not CNAs) who ran into my room every time the alarm went off.
Sorry for the long rant. Patient autonomy is very important to me.
Please keep advocating for change. Speaking as a patient I appreciate it. If your boss gives you a hard time about alarming every patient, tell him/her the kind of trouble 1 unhappy patient can create.
Quote from mindlor
One example is that my boss wants every pt bed alarmed. Well if I have an alert and oriented 50 y/o college professor as a pt that is 100 percent participatory with our fall management program, there is no way I will insult their dignity by placing an alarm on them....I could give thousands of similar examples....