I was recently hospitalized for a lap chole. The procedure went very well and I am feeling great...I almost feel ready to go back to work. I have some concerns about things that happened after the procedure that I'm not sure if I should mention or not (they are going to call me today to do a patient satisfaction survey over the phone).
My blood pressure went up a lot during the procedure. Certainly no one's fault, but it did. Since my blood pressure went crazy, they had me on a cardiac monitor throughout my stay.
When they transferred me to my room (I had to stay overnight), they put me on a monitor that is apparently new and unfamiliar to most of the staff.
My rhythm seemed to be normal sinus initially, but then switched to what appeared to be atrial flutter a few minutes after they put the monitor (not just a portable telemetry box, but a huge bedside monitor) on. The nurse just stood there looking at the monitor and said, "I've never actually seen anyone in flutter before." I checked my radial pulse, which did not correlate with what the monitor showed. I asked if she needed to adjust lead placement and she said that she thought the leads were placed properly. I also asked about changing monitors and she said that she didn't think there was another monitor available.
The nurse did a 12-lead EKG, which showed a normal sinus rhythm and left the monitor showing what appeared to be flutter waves in place. The monitor alarmed every two minutes due to the flutter waves, so she showed me where the "silence alarms" button was and told me to feel free to push it.
After about four hours (and walking in the halls with an IV pole and a cardiac monitor) I took the monitor off myself and asked the nurse if she could please get it discontinued since it wasn't showing an accurate tracing anyway. They then brought in a portable telemetry box, which showed a normal sinus rhythm throughout my stay.
My question is...do I mention the cardiac monitor when they call today? There was no harm done, but it was really frustrating to have to either listen to the monitor alarming every two minutes. It is also pointless to have a monitor in place that for whatever reason isn't showing an accurate tracing.
Other concerns I have are...
The night shift said I had I/O ordered, the day shift said I did not. When I worked there, policy said anyone with an IV was automatically on I/O.
I only saw two nurses wash their hands.
I got coffee on my tray for every meal even though my surgeon (per my request) ordered no caffeine (including decaf coffee or tea).
Since I was on telemetry, they couldn't let me close my room door unless there was a nurse in the room with me. Even with ear plugs, I couldn't sleep because of all of the activity in the hall and the call lights going off all night. I didn't sleep much at all...maybe an hour or two.
The nurses were all very nice. I did get very kind and compassionate care. They did an awesome job of making sure my pain was managed and other than the things mentioned, I was very happy with my care. I just found some things to be very frustrating. I'll probably mention the cardiac monitor, but leave the rest alone.
Yeah, like PP said, it could have just been artifact, and the nurses just did not recognize that. Or, possibly, you could have briefly been in a-flutter, but once they did the ekg, you were back in NSR, and remained in NSR for the rest of your stay. Sounds like the nurses either need an EKG strip refresher or monitor refresher. But, if they're not comfortable with the monitors as the director said, then, an in-service needs to be done pronto. That's only mildly important for a tele floor lol. Or maybe it's just that one nurse that needs extra training. You don't tell a patient to silence their own alarms, ever.
Sounds like those tele nurses dont know a whole lot if they've never seen flutter before. Or how to silence/lower the alarm on the bedside monitor. Sheesh. I would have been extremely ticked about that more than anything.
Been there,done that, ASN, RN
7,241 Posts
Your monitor was showing ARTIFACT!!
The nurses were not trained enough to know that.
You have other valid observations... but that is HUGE.
I wouldn't bother with the survey. I would call the manager and make them aware that the staff is in dire need of training.
Somebody is gonna get hurt.