A vent thread for patients- what can we do better?

Meds should be checked for accuracy long before coming into the patient's room to hang them...

Yep I agree. All meds in Oz ARE double checked by 2 RNs before going into the patient's room.

Our instructor was telling us about an incident by a RN who had 2 (or 3, can't remember) PCAs to change. She had already checked all the pre-mixed bags agains the patient's charts with another RN - but because she didn't turn on adequate lighting in the patient's room, quickly hung the wrong narcotic bag for a patient. The patient was allergic to this particular narc, anaphylaxed out and nearly died. The RN apparenly admitted later she was rushing and hadn't turned on the overhead light. The private hospital I worked at made it policy that only ONE NARC PCA bag could be taken out for one patient at a time, and that you could not hang more than one at a time. Also the o/head light had to be turned on, no matter what. And 2 RNs have to be there when the bag is checked again and locked into the pump.

No mistakes had happened again in that hospital, I was told, since that policy was introduced.

Overall what little interaction I have had on the patient side has been very positive. With one glaring exception. Please, if a pt presents to you saying she is in severe arm pain and you tell her it's not broken and to go home, at least do a d@mn x-ray. Just because I'm young doesn't mean I'm drug seeking, maybe my arm really does hurt. Having my PCP tell me 6 months later that there is now permanent damage because no one caught it initially does not help things.

My advice is....please be sensitive to your patient's religious or non-religious views. I'm an atheist. Last year when I had my daughter, the L&D nurse asked me what my religion was. I was in pain and didn't want to debate (telling people you're an atheist is always an invitation to debate) so I told her non-denominational. That wasn't good enough for her, she kept going on and on. Jewish, Muslim, Jehovah's Witness. Finally I said I'm atheist.

Well, you would have thought I told her I had a body under my bed by the way she reacted. She asked me what do my parents and my husband think...I told her I'm a grown a$$ woman and don't need their permission to be atheist. Then she asked me what my husband is...he's Christian. She asked me do I believe in Adam/Eve and all the other biblical stories...I don't. When my husband came back up to the room, she kept giving him dirty looks. I told him it's because he's married to a sinner atheist.

The next morning, there was no progress with my labor. Guess who was my nurse again? She told me that god would protect me. Then she said "oh that's right, you don't believe in god." If it weren't for my husband calming me down, I would have ripped her a new one.

That's my message to other nurses...your religion may not be someone else's. Please be tolerant as I am when I did bedside. I had patients of ALL religions and respected every one of them.

That's just not a bad nurse, that's an idiot. Please tell me you reported this?

I posted earlier but I totally forgot to mention this horrid situation, probably because it didn't happen in a hospital:

A couple months ago I had 2 wisdom teeth removed. I wasn't scared at all, I'm fine with dentists and I've been under before. I was at an oral surgeon's office and there was a nurse prepping me for the general anesthesia; she started my IV and set me up on the monitor and stuff. So the doctor comes in and starts the anesthesia and I'm quickly out.... Then I wake up, but they're not done yet. I'm just starting to become conscious... I start moving my eyes - they're the only thing I can move. I'm looking around desperately trying to make eye contact with someone, the nurse, the doctor, trying to somehow communicate HEY I'M AWAKE I'M NOT SUPPOSED TO BE AWAKE! Eventually I start making some noises. All of a sudden the doctor is like "Can you feel this?" and now I'm making louder sounds "AHHHHH AHHHHH" (I had no idea they gave me a local anesthetic too, while I was under) I can definitely feel something. I start to panic, realizing they are cutting my tooth in half inside my mouth. I'm making more noise and I hear the doctor say, all frustrated "I can't get this done while she's screaming like that". Well I guess at that point they knocked me out again.

I wake up and the nurse is there. I remember the terror of what just happened... I have a full blown panic attack, hyperventilating and crying. The nurse says to me, in an annoyed voice "Stop crying, you're scaring everyone in the office." I ask her what happened, why did I wake up in the middle. She just says "you had a reaction to the anesthesia so we had to stop it." WELL THANKS SO MUCH FOR LETTING ME KNOW THEN. Before I leave the recovery room, the doctor comes in and explains what happened a little better - my O2 was dropping dangerously low and they stop the anesthesia for a while so I would breathe. Now I know it's probably just as much the doctor's fault as the nurse's.... But they were both in the room and the doc was the one trying to use the power tools in my mouth. That nurse could have talked to me, said "Hey we know you're awake, we had to stop the anesthesia for a little while. Don't worry, we gave you a local too and you won't feel anything." It would have been nice if she just kept repeating that until it sunk in for me, so I would calm down. And then to yell at me when I wake up and I'm upset? I was terrified! It could have been easily prevented just by talking to the patient like they're a person, not a sack of meat laying in a chair. Ugh, what a witch.

And THAT is why I will never go under in a dentist's office! NO no no way. I've had my right side teeth removed.. it was not a traumatic or harrowing experience and both the teeth were surgicals. My lefts will come out this year and I will do if fully awake again.

n.d.y., In a couple situations, my fellow nurses and myself have chosen to turn on the light in the room rather than work by flashlight. (Believe me, I can do everything short of starting an IV in almost pitch blackness.)

One: A parent complained the nurse left the door open when she came in the room at night. So the nurse complied, and turned on the room light since she couldn't use the hall light.

The BIG reason: Parent complains we aren't ever coming in at night. You do that, we're going to make sure you KNOW we were there. And that's usually by turning on the light.

I can do just about every thing I need to do in a patient's room either by hall light, bathroom light, or flashlight, BUT I turn on lights at night to give meds. I have to practice my rights of med administration, all of them, day or night. If a patient complains that I woke them up to make sure that they could correctly ID themselves then so be it. I will also not give meds without education. I humbly explain that this is all done for their protection. They grumble, and complain, but let me tell you, med errors have not happened *knock on wood*, patient's can ID an adverse reaction, our Avatars have gone way up, (because at my facility we all do it), and I have gotten 27 letters, cards, or comment cards from former patients or their families saying that I made sure that their safety was a priority and that they learned a lot, oh and I got them the extra gingerale without blinking an eye. I have won awards at my facility, in multiple departments...Somehow I dont think I am the minority doing turning on a light. I just try to turn it around to a positive.

Meds should be checked for accuracy long before coming into the patient's room to hang them. The really efficient, considerate nurses carried a flashlight and were able to do very well by light of the bathroom for that last check and scanning the arm band. There was nothing done he/she could not see adequately to do with reduced and/or more focused lighting.

Getting adequate sleep when caring for a child who is terminally ill, in isolation (bone marrow transplant), still trying to work because all the bills were still there and then some and also still trying to raise the ill child's two younger siblings trumped the nurse's need to do things "by the book". If the sick kid's mom insists on use of a flashlight or the bathroom light, the nurse can simply document that when documenting meds if it troubled him/her from a liability or safety standpoint. Fortunately we had long term relationships with these nurses and it wasn't a problem.

It may be the policy at some hospitals that you must turn on the overhead light but I have not experienced that. It wasn't the policy at the private hospital we were at. I feel this is a case where book learning does not take into consideration all the consequences of being rigid in practice. He was sick and hospitalized for most of 18 months. Getting four hours of uninterrupted sleep made us all better able to cope with what was happening. The nurses who were holistic enough to include family needs in their plan of care were so very appreciated. And those who weren't were given the opportunity to care for patients who had mothers less vocal about the need for sleep than me. That only happened once and yes, it was an agency nurse who, by what you say, was probably following her agency's rules.

The awesome nurses that were there through my son's illness are the reason I am graduating in December to be one myself. I was simply stating what was appreciated from the other side of the bed, not casting stones. I appreciate where you are coming from and commend your desire to be safe.

for iv meds you should always assess the site and you need light for that.

Great thread, we're all patients at some time!

I have a major problem with staff who don't tell me their title. "I'm Suzy" doesn't tell me anything. Suzy the housekeeper? Suzy the lab tech? Suzy the --? Wearing a badge is just too much trouble?!

I may think of more later

DeLana

I have been a patient many times. Things that annoy me,

#1 thing, not pulling curtain or shutting the door or saying "no worries, you aint got nothing I haven't seen before." when I am modest. I don't care that you have seen 100 boobs a day, you haven't seen mine.

2) Having attitude that I need help with something because YOU told me I am not allowed to do it on my own and I need to call you. Do you think I am not mortified enough that I am a very independent person and now I am vulnerable and have to depend on others for my care or that I have to use a bed pan. Believe me, if I had it my way I would do it all on my own. It's extremely humiliating and embarrassing and I don't need your obvious attitude that you have to help. I try to never push my call light because I hate being a burden and I hate depending on others, but I am not allowed to get up to go to the bathroom and I really have to pee, I have fluids running in at 125 and "drinking my water" like you keep telling me I need to do so by golly I can't hold all that in for 12 hrs to avoid you having to be bothered.

3) Please don't come in bashing your co-workers or telling me about your b/f that is cheating on you and so on. I lose a lot of respect for someone that will bash co-workers in front of patients or customers when I am out in public. It's not ok no matter where you work.

4) Please acknowledge I am a patient and not just the vag/hys in room 68. When you come in the room to do your tasks you can smile and say hello and not act like a robot or not even make eye contact like I am not even in the room.

I think those are my biggest ones and I make sure I am aware of these things when I provide my care.

Great Canoe, not only do we have to deal with patient invading us, now we have nurses griping about nursing care.... from nurses!

Not going to share horror stories, this is a puke on the shoes thread. I liked my shoes. For every nurse complaint it equals a patient complaint, because we were patients! Do as each of us has always said, use the chain of command, speak up, become educated and accept nothing less than quality of care.

Yikes, that educated nurses have put up with poor nursing and never have spoken up! I'm just not feeling your educated, knew better complaints.

Sorry nursing peers, never tolerated substandard care, simply because I was a "patient". Never tolerated it before I was a nurse and was simply a patient.

People in every interaction in life can do us wrong, only if we allow it. To hear nurses allow it, has sickened me:smackingf

This thread is going the wrong way fast!

My bad care came before I was a nurse. When I would feel intimidated in a medical setting because of such bad experiences and stereotypical judgments. Those bad experiences molded me into the kind of nurse I wanted to become and made me pursue nursing.

Listening to patient complaints (especially from nurses) is not a bad thing IMO. It would do us some good to self reflect and be open to things we can do better. Things we might not even realized we were doing.

I have to clarify something here and be picky.

We were taught during our training at night to ALWAYS turn on the main overhead light, or the reading light to do medications; I remember our lecturer going on about this one point and stressing it. It is too easy to give the wrong medication when u can't see properly. That might be the reason why some nurses turn on the o/head light.

I've worked in some private hospitals where you must turn on the main light at night to do meds - I was told as an agency nurse to do this, irregardless of what patients wanted.

It's very rare I ever turn on a light. I check the meds before I leave the med room, I have written down what meds are due when and then we scan the patient and then scan the meds. There is enough light coming in from the hall with the door cracked (when people aren't roaming the halls on my unit to worry about the privacy issue) or my eyes are well adjusted that it hasn't been a problem. Sometimes I will use a penlight or the lite from my cell to read a label to double check an IV rate if it's to dark to read.