Published Oct 5, 2002
I work in a short stay unit. I also do the preop phone calls and interview patients prior to surgery. We do a lot of peds patients for a dental service. We have three anesthesiologists, only one of whom pre medicates the kids. We just went thru a big mess about three months ago where she decided to premedicate the kids, so we developed standards and a protocol. She agreed to this. Meant she had to see the kids and do a history and physical on each kid before we could medicate them. Now we have a new charge nurse and the anesthesiologist went to her and is demanding that we change everything. This charge nurse is very soft spoken, quiet and CAVED. So now our kids are coming in 4 hours before surgery so the anesthesiologist can see them. These kids are NPO after midnight, then subjected to being in the hospital for day surgery for an 8-10 hour day. I think this is unreasonable. When I approached the charge nurse she said
"well, we have to try it." I was shocked. She also said "when we get enough complaints from patients, maybe she will change her mind (the anesthesiologist)." The charge nurse is also hoping that the other two anesthesiologists will begin premedicating the kids, too. I really doubt that will happen. But
who is the patient
advocate here? My objection is not heard. The other staff don't seem to have a problem with this.
What would you do?
When I make the phone calls to the parents of the peds patients the parents have a fit to have to bring in their child 1-1/2 hours early. Now I have to tell them to bring their child in 4 hours early.
I would like to find out how other hospitals do this. Or should I shut my mouth? This makes me very frustrated.
eieiyo, i can sympathize with you. i think we have all been in your shoes at some point. you are correct in asking who is the patient advocate - you are. doesn't this charge nurse have a supervisor? i see this kind of stuff with the elderly crowd too. MDs send a 92 yr old who is contracted, bedbound, confused, tugging at the diaper - for a PICC line !!!!!! he pulled his other out and put it in his diaper. not a good candidate - infection wise. so yeah we called the doc and said no veins - send for port/SVC. hang in there - it almost always passes, but sometimes it gets a little worse, berfore it gets better. pardon the typing - im tired. take care of yourself frankie
Thanks for the moral support. Our charge nurse's superviser is brand new in her job at this hospital. She is on overload. She
is aware of the whole deal. She even thinks it's okay to have the
parents in the OR or PACU. I told her that it takes away from my
primary responsibility which is the child. I have worked in PACUs
where the family comes in. You spend all your time talking to the family, explaining what you are doing, hard to focus on your patient I am adamant about not wanting family in either place.
Just trust us to do our job taking care of your family member.
Didn't mean to rattle on. Don't get me started!!!!!!!!!
As a Mom and a nurse who has been through 9 myringotomy surgeries, a few OB surgeries, and uncountable ER visits with my kids; when I insist on being in the Pre-op holding area and the PACU it's got nothing to do with you or a lack of trust in your abilities as a nurse and EVERYTHING to do with my being the mom. No matter how good you are at your position, there is no way you can offer the same emotional comfort to my child as I can as the mom. It has been my experience that there is a place for parents/family members in Pre-op and PACU: the child recovers more quickly because he/she is not scared to death. Just as an aside, the same holds true for adult patients- my mother insisted I be there for her hip surgery, she came out of anesthesia faster, and was more calm. Please don't discount the importance of emotional comfort in the recovery from surgery.
It sounds like the process does not work, not that the charge nurse is a wimp.
It sounds like your charge nurse is advocating for her patients to be pre-medicated, and in doing this, longer preadmit times might be neccessary.
My other thought would be why, does a patient, who is receiving pre-op meds, require a history and physical. Couldn't the surgeon who scheduled the surgery write pre-op orders for anxiety medication, that would be given on admission to the child............
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