Bed Alarms are useless if you don't respond to them!

[Pepper The Cat, BSN, RN]

OK - so this is part vent/part blowing off my anger/part actual complaint.

Here is what happened to me tonight.

Background: 5 staff on evenings for 31 pts. Several high risk fallers, all with bed alarms activated. Pt in question Mr B actually had a fall last night when he got up and bed alarm was not activated.

Event:

I am changing my pt's attends - doing peri care, etc. Just as I finish, I hear a bed alarm go off.I am not assigned to any of the pts with bed alarms so I make the assumption that the nurse resposible for that pt will be responding. However, I quickly finish up, clean my hands and head in the direction of the alarm that is still going. I see no signs of the other 4 people on with me. I get to room, find pt out of bed - I silence the alarm so pt can hear me better and attempt to get him to stand (he is out of bed, hanging on to side rail). He won't release grip on side rail so I can lower it and get him into bed. I hold him for about a minute, figuring the nurse assigned should be responding to bed alarm by now (silenced or not - she should be following up!). NO ONE comes. I cannot reach Mr B's call bell because it is on the far side of the bed - between mattress and side rail - no one could have reached it. Pt in next bed does not speak English and does not understand when I tell him to ring for nurse.

So I start to yell. Help. Help. Name of nurse assigned to pt. Visitor from other side of room comes over (our ward rooms have 4 beds, but there is a wall that goes down the middle so it). I ask her to go find a nurse. Meanwhile, Mr B is starting to slide down. I don't have enough room to lower him safely to floor, and he will still not realease grip so I can lower side rail and get him to side of bed. Finally, nurse assigned "A" comes in. We manage to get him safely back to bed. She says "I didn't hear the alarm". I think to myself, well no S*** Sherlock but hold my tongue- I just tell her shes needs to listen better. I go to nursing station and find the other 3 nurses in the back room charting. And 4th computer is open, so it is clear that is where "A" was. I lost it - it hits me that they didn't respond because they were busy, they didn't respond because they were sitting in an area where they couldn not hear bed alarms, etc - plus they had the TV on. I went in and said "if you are going to sit back here you need to LISTEN better. The bed alarm was going and I was screaming for help and none of you heard me!

They just look at me and one said "well, A did come out" (I still don't know if A heard me yelling, or if the visitor yelled because visitor told me she couldn't find anyone at first).Then I really told them what I thought - I told them the pt could have been hurt, I could have been hurt. There was no need to hide in the back room when there were at least 4 computers available in the nursing station when they could hear bed alarms, etc. I also pointed out that two of them also had pts on bed alarms and they needed to be listening for them!

I guess I made my point because they did come out but I am still just livid about it all.

I know some of you will probably tell me that I am over-reacting but I maintain my stance

Bed alarms are only effective if they are RESPONDED to RIGHT AWAY! If you have a pt on a bed alarm, you need to be listening for it all the time! and even if you are not assigned to the pt on a bed alarm and hear one, respond.

Alright. Vent/rant over.

I should add that they did apologize sort of. One did come up later and apologized again. She is a new grad so I did feel a little bad about blasting her but maybe she learn something from this!

[Do-over, ASN, RN]

Amen!

I station myself as near to my rooms as I can - you know, so I can see the call lights/hear IV pumps/respond timely to bed alarms, etc. Wish others did too...

[Pepper The Cat, BSN, RN]

Some people think I'm anti-social cause I chart in the nsg station instead of the back room. I've pointed out repeatively that a) I can hear bed alarms/pump alarms/ pt's yelling better and b) during visiting hours it gives a better impression if visitors can SEE you.!

[Do-over, ASN, RN]

I prefer to chart at the nursing station, although at times it is too crowded/noisy/social and I can't concentrate. However, I can sit in the med room and still hear what is going on in my rooms (alarms, anyway). So, I can be "anti-social" too, but more because I avoid some groups simply in order to get my stuff done.

[Bortaz, MSN, RN]

Good for you for letting them know how you feel. My greatest pet peeve in nursing so far is nurses ignoring alarms on pumps, monitors, etc., and not going to check on the baby. We recently got these horribly loud new monitors that, on an "urgent" alarm (whether really urgent, or just a false alarm) will not stop alarming even after the incident resolves unless acknowledged by a human. That of course means someone has to get up and go look at the baby and them turn off the alarm. It took the lazy wankers no more than a week to learn to tune them out and stop checking on them when they sound. They now just ignore them and let them continue to blare (in two places, bedside and main monitor at nurses station). I wear my legs out going from bed to bed to bed checking on all the alarms.

We have signs all over the walls insisting on SILENCE PLEASE, but it sounds like a frigging war zone with alarms on 30 babies all beeping, bleeping, and blonking. It got so bad one night with a sick 23 weeker that the doc made us remove the monitor from the room and bring in an old, controlable monitor that was less loud.

I've kinda gone off topic, moved from lazy nurses to too loud monitors, but really I think they are both an issue that needs to be resolved ASAP. My next step is to write it up as a risk, since the LOUD NOISE IS DETRIMENTAL TO A NEONATES HEALTH!!!!!!!!!!!!BONK BONK BONK HONK BLEEP!!

Uh, sorry...

[joanna73, BSN, RN]

I agree with you Pepper. They need to be in a visible area for visitors, bed alarms, pumps, wandering patients. You aren't keeping a good watch if 3 of 4 staff are sitting in a back room and can't hear. I would have said something also, and not cared in the least what your coworkers thought. Patient safety comes first.

[Guest296136]

I was just made clinical supervisor on my unit for night shift and one of the major problems is falls. I have been put in this position to "fix" the issues on the unit. A major issue is that when the bed alarms go off it is always the same few nurses running into the rooms, while other staff sit on their butts even if it is their patient. With the new medicare laws we don't get paid if patient satisfaction and safety issues are not addressed and this is based on our HCAP scores, which have fallen this past year. Maybe these nurses will start to run when the bed alarms go off if it means they won't have a job otherwise. I have my work cut out for me, many have been on this unit for 20+ years and are set in their ways and their chairs!!!!!!

[Do-over, ASN, RN]

I truly don't understand how people can tune out the IV pump alarms. I can't walk past a room with the pump alarming, BUT if I have already been in to fix it once (and it isn't my patient) I will tell the nurse "So-and-so's IV is beeping and I've already been in there to try and fix it..."

I wonder if some folks understand that if the pump is alarming then the patient is not getting his or her IV fluid, or insulin, or heparin, or cardizem, etc. etc. etc. Kind of a big deal, no?

Not trying to make myself out as super-nurse, because I am nothing of the sort, but somehow I never have time to sit and read a novel, or play computer games, etc. Which is just as well, I do prefer to keep moving as the nights seem to go faster. However, there is plenty to keep me busy with my own assignement TYVM.

[Do-over, ASN, RN]

Good for you for letting them know how you feel. My greatest pet peeve in nursing so far is nurses ignoring alarms on pumps, monitors, etc., and not going to check on the baby. We recently got these horribly loud new monitors that, on an "urgent" alarm (whether really urgent, or just a false alarm) will not stop alarming even after the incident resolves unless acknowledged by a human. That of course means someone has to get up and go look at the baby and them turn off the alarm. It took the lazy wankers no more than a week to learn to tune them out and stop checking on them when they sound. They now just ignore them and let them continue to blare (in two places, bedside and main monitor at nurses station). I wear my legs out going from bed to bed to bed checking on all the alarms.

We have signs all over the walls insisting on SILENCE PLEASE, but it sounds like a frigging war zone with alarms on 30 babies all beeping, bleeping, and blonking. It got so bad one night with a sick 23 weeker that the doc made us remove the monitor from the room and bring in an old, controlable monitor that was less loud.

I've kinda gone off topic, moved from lazy nurses to too loud monitors, but really I think they are both an issue that needs to be resolved ASAP. My next step is to write it up as a risk, since the LOUD NOISE IS DETRIMENTAL TO A NEONATES HEALTH!!!!!!!!!!!!BONK BONK BONK HONK BLEEP!!

Uh, sorry...

Some nights it sounds like the midway at the state fair, or a casino - especially with the new bi-pap machines...

[debRN0417]

That's the problem with alarms of all types...too many alarms...not enough nurses. After a while you tune them out. It is frustrating.

[turnforthenurse, MSN, NP]

An alarm should always be loud enough so someone can hear it at all times. I don't care if they are my patient or not, if I hear a bed alarm go off I go running into that room!

[fuzzywuzzy, CNA]

I'm a CNA in LTC and boy, do I hate alarms. I can't stand that screaming noise in my ear all day- stresses me right out and agitates a lot of our residents too. One of our units has 30 residents on it, and 23 of them are on alarms.... this means a pressure sensor on their chair, an alarmed seat belt, a magnetized alarm that clips to the person's clothes, and motion detectors at the foot of the bed. Some of them also have baby monitors in their rooms and we are expected to lug the clunky receivers around all day as well, listening to everything the resident says or does along with a hefty dose of static. AND several of our residents have to be "checked" every 15 minutes and their whereabouts documented, so we have timers going off as well. Can you say OVERKILL? These alarms go off when a resident stands up unassisted. But they also go off when someone wiggles their toes in bed, when they shift in their seat, when they roll over, and when they reach out toward a tissue box or glass of water. They go off every time a staff member stands a resident up for toileting or ambulation or rolls them over in bed to be changed. Many times, they go off when no one is even in the room! Enough is enough! I would say at least 75% of the time an alarm is unpleasantly screeching, it's not because a resident is self-transferring. I can't get through caring for a single person, EVER, without being interrupted at least once by an alarm. Sometimes no one runs to them right away because one aide is in the bathroom with a resident and can't leave (because they're on alarms too), and the other two are in the middle of a hoyer transfer and can't drop everything and go running either. But heaven help you if the DON is around when this happens because if it does, you're a horrible aide no matter what you were in the middle of! And for some reason we are not allowed to unplug the alarms even when the resident isn't in the chair, or bed.