Babies uneccessary death!!

[RN92]

i posted this in the peds section....but every nurse needs to read this story of a child who died while in the hospital of dehydration,despite the mothers concerns - it will make you a better nurse. a written version of her speech to the residents at johns hopkins can be found at www.josieking.org/speech.html. we have got to quit being so defensive when pts or pts families ask questions regarding their care. if they question what you are doing - stop- and explain to them what is going on and why you are doing what you are doing.

[CHATSDALE]

horrible story...i have had pts with iv infusing and they questioned me if they should be eating....they had "heard" that if you had iv that that was taking care of nutritional needs....i would hope that mom in this incidence was not withholding food/drink from little one...

[Chevelle]

I am with the above poster...absolutely speechless...

[cindimc]

lord help me, this will be on my mind for days to come, unbelievable:o

[RN92]

I wonder how much the doctor/nurse relationship (or lack of) played in this case? The hospital investigated (of course). They found that, although Josie couldnt keep liquid on her stomach, was having diarrhea and vomiting (probably wasnt wetting her diaper very much)- the intake and output records on her nurses note didnt reflect any of this. Nurses note reported good/average I and O's. Also, the nurses should have been reporting her change in status to the Doctors (temp of 102). The hospital sited the lack of communication between the different Doctor groups caring for her. The Josie foundation is trying to implement standards where, for instance, every discipline makes rounds together. The doctor, nurse, respiratory, etc meet together to talk about pt treatment frequently. Where I work - every am, the pts md,nurse, rt, etc all give report together.

When I was fresh out of nsg school - I hated calling doctors - they can be very rude, and difficult to work with. I dont think twice about calling them about a pt problem,now. Its not my fault they went to md school and opened a private practice. Thats why they get the BIG BUCKS!!

[jemb]

Thanks for the link. I did a google search too and found quite a bit of extra info. I still don't understand how no one noticed her diarrhea or reported her thirst. It sounded like the mom and the doctors had a good relationship, too, so it is odd that mom didn't say anything to the docs when they rounded.

I hate teaching hospitals!

[KRVRN, BSN, RN]

The diarrhea was probably masking the fact that she wasn't uriniating much. Their outputs are probably measured by weighing the diapers. Apparently no one realized that she wasn't taking in (or keeping down) much fluid and was passing more diarrhea than urine. The left hand didn't know what the right hand was doing. Her little body compensated for as long as possible and then dumped. So sad.

[SugarMagnoliaMom]

Thank you so kindly for posting this link. I am incredibly moved and think I will always have this in mind when I am in nursing school and beyond.

Thank you.

[caroladybelle, BSN, RN]

And who was supervising her when she got the burns????

[RN4NICU, LPN, LVN]

And who was supervising her when she got the burns????

good point - that is the beginning of the dehydration issue - LOTS of fluids are lost with burn patients.

I didn't want to get attacked for pointing out that the grieving mom disregarded completely the possibility (actuality) that SHE had involvement/fault in this tragedy as well, but I'm glad I'm not the only one who noticed. :chair:

Accidents happen - at home, at work, - people make mistakes - parents, doctors, nurses. Sometimes bad things happen. No one is guaranteed tomorrow...

[ZinnianWolf]

I am still a nursing student, but I thought that for burn patients, besides pain the other big concern is keeping them hydrated bucause of the loss or damage to the skin. I don't understand why she wasn't hooked up to an IV to maintain her fluid volume if the doctors wanted her to be NPO. Even though I still have sometime before I finish school, I can pick out a number of errors that were made. They were things that should not have happened! I can honestly say that this story has me almost speechless, and confused at how so many people missed so many basic care things. Stories like these stick in my head and remind What Not To Do, and remind me that sometimes you just have to go back to the basics to solve a problem.

[surfnese]

thanks for taking the time to make all of us aware of this. i am a rn student, a mother of 3 beautiful grown sons, and a soon to be grandmother. this story scared me to death. i printed this story and will share it with the 62 rn students from my college. reading this reinforces one of the best guidelines in my nursing. listen to your patient, and in this case, the patients voice- mom. first above all else they tell us things we cant see or feel. being a patient advocate is one of the things my instructors have done a wonderful job in explaining to us. putting it to practice will be a priority in my nursing, this is so sad. my first gift for my new grandbaby will be a copy of this story and a bath thermometer.

thanks

[KacyLynnRN]

It doesn't surprise me a bit that this happened at a teaching hospital. I work at a teaching hospital and often a patient has inpatient med service (which are the interns/residents) seeing them, as well as any specialty docs (cardiac, neuro, renal, GI) as well as their admitting doc (usually an internist or family doc) and it seems like none of these docs ever communicate with each other! I can't count the # of times that docs write duplicate orders (because they really don't know what the patient is getting) or write conflicting orders. (such as IVF on a renal pt. already in fluid overload) I feel like their lack of communication with each other makes the environment ripe for errors. What's the lesson here? Communication needs to improve in teaching hospitals. period! If it were better, maybe this whole tragedy would not have happened.