Complain to whom? Anyone?

[LuvMyGamecocks]

I knew when this was brought up to me that I would likely need to seek the advice of the wonderful people on this forum.

A little history...

My grandfather is 72, has COPD, diabetic, about 150+ lbs overweight, has arthritis....the last round of CHF was about two years ago. He was admitted to hospital about a week ago c/o weakness, was found to have lost 50% of his kidney function. He has not been able to keep an IV in for more than a day, and the man has hematomas covering one arm. 2 days ago, he lost feeling in his right leg and is unable to stand. Doc ordered a CT scan, but haven't gotten results yet.

Problem...

I took my 4 and 5 year old to visit this past Saturday, found needle caps on the floor, empty dressing packages, little pieces of equipment all over the floor. I cleaned up what I saw.

My grandmother went to visit after church Sunday to find the room in such a way that she wondered if someone accidentally turned the trash can over. She said his clothes and bed linens were covered in dried blood (she had just seen him the day before), he had not been bathed in a couple of days.

Also, the nurse "supervisor" went into his room Thur. night and asked,

Nurse: "Do you really want your breathing tx at night?"

Grandfather: "Well, the doc ordered it every 4 hours, didn't he?"

Nurse: I don't know, I'll check. Do you want it if he did?

Grandfather: If doc says do it, I'll do it.

Nurse: Huffs out of room.

Question...

My grandmother is very upset, but only thinks a resolution will come with her response in the "Customer Service" survey after he goes home???? That can't be right????

Realizing that you can't give medical advice, is there another thread or site that talks about expectations for these comorbid diseases. Given the numbness in his leg, COPD, diabetes, arthritis, loss of kidney function...will he go home?

Thanks, all!

[jmgrn65, RN]

call the hospital Patient relations department and/or speak to the Nurse Mgr.

[tvccrn, ASN, RN]

You might see if the facility has a patient advocate.

tvccrn

[LuvMyGamecocks]

Are her concerns legit? She doesn't want to make waves when he's in what seems to be a delicate balance.

Is there any kind of article/website/book/ANYthing that talks about the comorbidity of his diseases?

Thanks!

[MrsWampthang, BSN, RN]

To answer the first part of your question, you have every right to address your concerns about the condition of his room, bed, etc to the powers that be. Start with the charge nurse and keep going up the chain until you get your concerns addressed to your satisfaction.

To answer your second question, you, your grandmother and mother (if she is close to your grandparents) need to sit down with the doctor and ask him to be brutally honest with you about his chances of leaving the hospital and have him talk to your grandfather if he is able to understand. Also, if your grandfather is still able to make his own decisions, then please discuss with him and your grandmother whether he wants to be intubated in the case that he goes into respiratory failure. I don't know what his code status is but this is another issue that you should address with him if he is able. Does he want everything done, does he want intubated etc? Have the attending doctor present for this discussion and then, get it in writing and put in his chart. The facility probably has a form for the attending doctor to fill out and sign that states what is to be done in the case of him arresting. Make sure all family members know about this document.

The reason I say that is that I see so many patients come into our facility that have had trachs placed or coded because family members did what they wanted and not what the patient wanted. I have seen so many patients whose bodies were kept alive because the family wouldn't let them go. The patient was no longer truly alive but their heart was kept going with medications and their respirations were kept going with the ventilator.

Anyway, good luck with everything, and take care.

Pam

[pickledpepperRN]

I am so sorry your family is going through this.

Regarding his medical condition I think you and your grandparents should talk with his doctors.

If the room remains dirty and/or you think one or more staff are trying to get out of doing ordered treatments I think you first report to nursing and hospital administration.

I am so sorry your family is going through this. If still unacceptable you can report to a regulatory agency.

South Carolina Hospital Regulations - http://www.scstatehouse.net/cgi-bin/query.exe?first=DOC&querytext=Hospital&category=Regs&conid=2603190&result_pos=0&keyval=73

Report hospital violations to- S.C. Department of Health & Environmental Control

2600 Bull Street

Columbia, SC 29201

[phone]

To send e-mail - http://www.scdhec.gov/administration/contactus.asp

How to complain to the Board of Nursing - http://www.llr.state.sc.us/POL/NURSING/index.asp?file=complaint.htm

[LuvMyGamecocks]

Thank you for your replies. We thought the last episode of CHF was going to be the end, but he got through it, did all the physical therapy that he could and was up and walking within 6 months without a walker or cane. I asked my grandmother last night if there was anything she needed...she said, "No, just your prayers."

It's a sweet story, really. My grandmother divorced him 41 years ago because of his drinking. He moved to San Antonio and stayed there until 2002. Lo and behold, they remarried in 2002, after 38 years apart!

I asked you all about this, because I feel like I'm in the middle. I want to support the nurse's efforts, but I'm discouraged about what's happening. Does that make sense?

Anyway, thanks so much for your replies!

[pickledpepperRN]

I'm praying for them.

It is truly a sweet story.

[TazziRN, RN]

Don't support the nurses' efforts if they're not doing their jobs. I'm guilty of not picking up little things I drop on the floor either, but the bloody sheets is inexcuseable. So is what he was asked about his neb treatments and the lack of bathing. These are all issues that need to be brought to someone's attention, because his healing could be delayed, or he could deteriorate unnecessarily. Talk to his doc about the medical issues, ask to talk to the house supervisor/pt relations about the other stuff.

[SmilingBluEyes]

So sorry you are going through this. I agree, seek redress from the patient advocacy representative. Failing that, take your concerns (which are very legitmate) up the chain to the top, until you reach satisfaction.

Also regarding his health/disease processes, the very best person(s) to see would be the health care provider taking care of him. Ask this person, who has access and understanding of Grandfather's medical history, all the questions on your mind until you are satisfied you understand everything.

Bless you for caring. So many people out there have no one to advocate for them.

[Cattitude]

don't support the nurses' efforts if they're not doing their jobs. i'm guilty of not picking up little things i drop on the floor either, but the bloody sheets is inexcuseable. so is what he was asked about his neb treatments and the lack of bathing. these are all issues that need to be brought to someone's attention, because his healing could be delayed, or he could deteriorate unnecessarily. talk to his doc about the medical issues, ask to talk to the house supervisor/pt relations about the other stuff.

yes ,bloody sheets are inexcuseable. let's also look at all sides. i know as a previous night nurse, i frequently had ,q4 hr. neb orders which could be prn from 12 midnight - 6am so pt. could sleep. maybe the nurse was asking for this reason?? just playing devil's advocate.

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[color=#483d8b]i've also had pt's refuse bath's. did the op ask grandpa if he was offered to be bathed? make sure of all of this before going to the nurse manager/pt. advocate, then definitely voice your concerns. i wish the op and family well, addressing all your issues during this tough time, is trying. good luck!

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[TrudyRN]

I think it might be best to talk directly with the nurse who, it sounds like, did not give an ordered treatment. Yes, she might have not wanted to wake him but he was already up! She apparently did not know the orders.

I would start with her directly, so as to avoid getting her in trouble immediately with the bosses. Just preface your talk with niceties and then honestly say what your concerns are.

As for the slop, dropped items on the floor could cause a fall and they, of course, look bad but they are not the top priority of a very busy staff. You might want to pick your battles and let this one go as long as your loved one does not suffer harm.

Bloody sheets - I guess I'd wonder how much blood and what was it from?

I wish all of you the best.

As for his prognosis, only God knows. But do ask the doctor. Prayers for you all to be strong and sensible and comforted in this hard time.