Another vent!

Specialties Emergency


Today I was called into the nurse managers's office. She had received a complaint from the director of a nursing home. They had sent us a patient several weeks ago with a head lac 2nd being pushed out of her wheelchair. I was not the patients primary nurse, but due to the patient being confused, I had redressed the head lac 4 times. She pulled it off several times. I also helped change her 2 times. We CT'd her head and the doc sewed her head.

The time line was as follows

*arrival and triage assessment 0900

*2nd nurse assessment 0915

*doc assessment 0925

*to CT @ 0955

*back from CT 1015

*from 0945 to 1115 head lac redressed 5 times, bed changed 2 times. VSx2, pain assessment, RN assessment...etc.

*doc sewed lac at 1130

*called for ambulance transport back to NH 1200

*discharge with ambulance crew 1330

The complaint was that we didn't take good care of her. They stated she was incontinent of urine when they received her back at the nursing home (perhaps that happened on the ambulance ride home). The main complaint was......we didn't feed her lunch!! I couldn't believe that was the major complaint. Has this person ever been to an emergency room. I believe that same day we have 2 MI's and a resp diff. that had to be intubated...and we didn't feed her lunch. I understand that she needs to eat, but she had a family member with her (who was obviously the person who complained about us) and that person never said anything about food, or offered to feed her. The patient was non-verbal.

Has anyone else out there ever received these kind of complaints? Am I over reacting by getting upset about this? We don't have the time and really don't have the staff to feed the nsg home patients that come in. Luckily admin. is on our side and luckily I(we) documented well.

Specializes in 5 yrs OR, ASU Pre-Op 2 yr. ER.

This is our ER's policy:

After asking about the last food eaten and around what time it was eaten:

If the person is elderly and/or diabetic and in the ER, they are REQUIRED to receive a meal at the same time the pts. in the rooms do. They are also to receive a snack at the same snack time of every pt. there.

Reason why i know this is because occaisionally in the evenings i'll get called to ER to feed someone.

Another reason why i know this, we were getting so many complaints about a rt. coming back to the NH without lunch that the VP started this new policy.


48 Posts

That's a great policy in a perfect world and a perfect ER. Our policy is....if you or your family asks for food, you get it. Otherwise we are stretched too thin to feed all the nursing home patients that we hold everyday.

My point was...we provided the EMERGENT care that the patient needed (in the Emergency Room) and the only complant the nsg home could come up with is....she wasn't fed lunch.

Specializes in 5 yrs OR, ASU Pre-Op 2 yr. ER.

I was just saying that's was reduced our problem.

Didn't matter if they were just there for an hour or less, either.


9 Posts

I work in an ER and I have to say if someone wants food and asks for it and they can have we will get it for them. But it is hard to get tray service to our dept so we have sandwhich boxes that we can give them. I always find it really funny that they come to the ER usually by ambulance and the first things that they need are food, to pee and to have a BM.


106 Posts

Tell me now, I'm dyin' to know, did she laugh when she read the complaint, so that after a few minutes of shared hilarity you could have a cuppa together?:chuckle

The best patient complaint I ever heard was from Mrs. Richpiggie. It seems that Mrs. Richpiggie had been involved in an MVC and had to spend some time on a stretcher in our ER. While she was lying there she heard some doctors and nurses laughing and joking. Mrs Richpiggie was highly offended that such behavior should occur in such a serious place as an emergency room, and she told our director about it in writing.

What truly amazed me was not only that the director had the charge nurse read the letter to all ER staff in report with a straight face, but that NOBODY else in the room even smiled. I think I had to leave report early that day, (to laugh in private) and I think it probably led to my decision to work some other ER. :roll

Specializes in ER, ICU, L&D, OR.

Mary Catherine relax, and consider the source, it came from a nursing home.

What you should be upset about is your supervisor didnt stand up for you and tell that nursing home supervisor off.

Now the next time a nsg home sends someone with a fever of 105 and incontinent of urine and they dont even give tylenol for the fever. Call the health department for Adult protection services and report them

I have done this many times. It is terrible how low our nursing home industry has sank.


1,093 Posts

i am sure that she was comletely clean when she came in....and had eaten a full breakfast?!?!?! and i am positive that you all had plenty of staff and extra hands to sit there and feed miss rip the bandage off....i am sure that would have been really easy to feed her....

HA! from now on when a pt comes in from said nsg home and is not completely clean etc....WRITE IT AND THE NURSE UP....they will get the message...


475 Posts

I'm not sure when the ED became all things to all people, but it certainly happened. On a recent busy weekend, one of our administrators(a nurse that sits in an office) came to our ED to "visit a pt"(jolly good time to have a visit w/ someone.) Without going into all the gory details, we were swamped. Nurse

Sitsonbutz fired a memo to our NM the next day, saying, of all things,"The ED was MESSY!" And we also let a psych pt "roam the halls in a WC!" (No psych beds were available IN THE ENTIRE STATE) Gee whiz, Nurse Sitsonbutz, I guess we should have just tied the psych pt up or something. (The pt had a sitter that stayed w/ him at all times, but the pt was calmer when he could be out of his room sometimes. He was not constantly in the hall.) Our NM then POSTED the memo!:rolleyes:

BadBird, BSN, RN

1,126 Posts

Specializes in Critical Care.

If that patient had been admitted, it would be quite possible that she would have been NPO overnight. Most doctors would order that due to the head injury, confusion, agitation; you don't want aspiration pneumonia on top of other problems. The incontinence problem is ridiclious, she could have peed right before arriving at the NH. The fact that the nurse manager even read that to you and not taken a opportunity to educate whomever from the nursing home complained is beyond me.


652 Posts

And we wonder why nurses are fed up ??? I think I'll stop doing cpr on this pt and go feed someone..geez..shame..justa shame :/


814 Posts

Sometimes no matter what you do it is not good enough. You know you are working your hardest to give good patient care. If you need more staff to perform feeding assistance then she should provide a staff member for that duty. Seems to me she could solve this problem easily. I doubt the NM will see it that way. The expectation is probally that you should split into 2 people to get everything done.

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