Patient complaints

[am4182]

I am not sure if this is unusal but it seems that in the hospital I work at I have had more patient complaints then I ever had before. The latest was a person who complained of SOB, tingling and a feeling of chest pressure. I checked vital they were ok, (unmonitored floor), I continued to monitor the patient and then called the doctor. The MD had me call the hospitalist. They came to see pt. ordered, chest x-ray, ct, blood gases, more blood work, ekg.

Everything was negative. However in the morning a second troponin was slightly elevtaed. An EMT with the family began telling them if the nurse, hospital knew what they were doing they would have known it was an MI?? I spoke to the MD later she said the only basis for considering this an MI was the troponin, no other test exam backed this up.

A complaint was made to the nurse manager stating I did nothing for the pt. Xrays, ct, abg, ekg etc. doesn't strike me as nothing. However the hospital chooses not to back staff rather tell the family that they will need to talk to the nurse. A second complaint was that the pt felt they didn't get adequate care at night, nothing specific, they never named a nurse but the nurse manager decided that since I had cared for her one day I must be the guilty party. I am a relatively new nurse and new to this floor, are these types of problems common at all hospitals? I alway thought I got along well with patients... I'm not sure anymore.

[UKRNinUSA, RN]

I want to know who I complain to about PITA patients and relatives. Who can I report them to? I have fantasies about turning up at their workplace and putting THEM through the ringer, like they do to me.

fantasy conversation:

"You really don't want to make me go look at your face sheet. You really wouldn't want that. I'm giving you a warning. Your first verbal warning.............and we all know what happens after that..................YOU DON'T WANT THAT, DO YOU? NOW, QUIT YOUR WHINING AND BE NICE!

Aaaaaahh, if only.....................

[Mulan]

I want to know who I complain to about PITA patients and relatives. Who can I report them to? I have fantasies about turning up at their workplace and putting THEM through the ringer, like they do to me.

fantasy conversation:

"You really don't want to make me go look at your face sheet. You really wouldn't want that. I'm giving you a warning. Your first verbal warning.............and we all know what happens after that..................YOU DON'T WANT THAT, DO YOU? NOW, QUIT YOUR WHINING AND BE NICE!

Aaaaaahh, if only.....................

Absolutely!!!

:roll

[Simplepleasures]

We bust our butts for these people, and it just makes me very, very angry when they attack us for stupid stuff. Then, of course, there are the sweet pts who make it all worthwhile, but still!! Oh, well, I guess until they fix the system (and I *am* holding my breath on that one ), we'll just have to document like we love it! Chart EVERYTHING!!!!

SO, who is "they", its US who are going to have to fix the sysytem, "they" are continuing to complain, job hop, cave in and do the unethical thing when their jobs are being threatend by the management,close their eyes to any REAL way to fix the system. Are "we" so overwhelmed by the day to day horrors of our jobs that we have nothing left over in us to fight with? Does anyone think that maybe this is JUST the position that the corporation wants us in?I really think that all nurses, even CNA's should seriously think about malpractice insurance, your hospital or nursing home will try their darndest to point any blame toward the staff. And if it isnt the hosp/ nursing home that will get you,or the new nursing home abuse lawyers it is the Department of Justice.Oooo, it IS scary out there and it doesnt appear to be getting any better.:chair: OR, can it ?

[Sheri257]

I'm just a student, and it's already getting to me. There's always one patient riding the call light, all day long. The more you answer it ... the more they abuse you. I'm starting to understand now why nurses don't answer call lights ...

Then, even when you do wait on them hand and foot all day long ... you walk in the next day to discover they've complained. Why? Because you're the only one they remember since you were the only one was actually there helping them. The nurse who didn't bother to answer the call light doesn't get dinged because they weren't around long enough to be remembered.

:typing

[UKRNinUSA, RN]

I gave a patient's relative the sharp end of my tongue the other day after I heard her say to her (stable) mother, as the cardiac monitor alarmed (for no good reason other than artifact) that she needn't bother calling for a nurse as they wouldn't come to help you even if you dropped dead in front of them.

I happened to be within earshot of her comment, attending to a patient. I told her that she was incorrect, that everybody had been working hard on that particularly busy day and if she needed any help I could and would help her. She mumbled that it was just the EKG leads and then sheepishly sat down and shut her mouth.

It was totally AWESOME!

[miko014]

Where I work, there are usually 3 techs on the unit, but there are 2 separate wings that are separated by a little lobby area and the elevators. That means that someone has to be "split" between the two sides, and you can bet that that person is never on the side where they are needed. It's not their fault, it's just that they can't be in 2 places at once. I know, they used to ALWAYS put me on the split when I was a tech. Anyway, one day (when I was a tech), I had been stuck on one side for most of the morning. I finally went over the other side to a pt who didn't need complete care, but she wanted it. All she did the entire time that I was bathing her, powdering her, washing her hair (yes, I did!) and basically catering to her every whim, she was berating me. She was saying things like "the help around here is terrible, you people don't even deserve to have jobs", and "this is the worst service I have ever had, how dare you wait so long to take care of me?" (it was probably about 10:30am), etc. I was almost in tears, and I am not a crier at all. But do you know what I did? I let it go! I would NEVER do that now! I would (and have) put people in their place, but I guess I was too meek back then or something. I didn't even tell my boss, and I know for darn sure that she would not allow that kind of behavior. You just can't make some people happy, but that is no reason that you should be fearing for your license or your finances. It's a...I think the term is "stinging injustice" to have people who have no idea what we actually do treat us as their slaves.

[GardenDove]

I agree, documentation is vital. I want to point out that every study indicates, however, that bedside manner is the best way to avoid complaints and lawsuits. I can speak personally from the perspective of having never had a patient complaint against me in my 13 years of nursing. I'm known in my hospital as having a very good bedside manner.

I think kindness and diplomacy can cover a multitude of sins.

[erroridiot]

If they have the right to exaggerate or falsely accuse me of something, then I have the right to let them know how I feel about it. That usually kills all unfounded complaints.

How would you let them know about your feelings? This could be very emotionally charged - especially if they have done some harm to you as a nurse.

[Gromit]

Geeze, where to start? I absolutely hate the whole 'survey' thing - the last facility I worked at, they lumped in the question "how would you rate your food?" in with the nursing part of the survey -(what, do we need to start cooking for 'em too??) We were required to make sure every patient filled out the survey -EVERY DAY (so on a five day stay, the patient will have filled out the card 5 times) -I left that place for other reasons, and have never really looked back.

An EMT thinks you should have known it was a heart attack. Well, EMTs do a fine job doing cpr, basic bandaging, and transporting patients. I was an EMT -thats what started my medical career. WE never got any training regarding blood tests -no ambulance had a lab. I then became a paramedic -and the training was better -but was (obviously) suited to field-based emergencies. We had a cursory overview of cardiac-lab tests -not enough to actually understand 'em (and I feel safe in saying that none of us in the class ever DID understand 'em) -again, no ambulance had a blood lab -but we did learn how to read rhythms, sao2s and the like. As an EMT, I certainly never felt like I knew enough to secondguess someone with 2 or more years of schooling under their belt.

I've rarely ever used a sharp tongue to patients or family -though at times I may have felt like it. One time I had a patient who was a doc (very nice guy, excellent patient -which is kind of rare in of itself) but his wife would call all hours of the night, repeatedly, because she "didn't like the way the monitor looks" (all of ours are hardwired monitors, bedside and at the nurses station) and the waveform she didn't like was actually the saturation monitor. She never believed me when I told her that if the patient moves around a bit, the pickup has artifact -and that if there REALLY was a problem, other things would be happening) -never have I wished more that I could turn off the screen at bedside, and leave the one on at the nurses station. Poor guy never did get any rest because the wife kept waking him because of the screen.

I told her we 'treat the patient, not the monitor' -and got written up for it.

Whatever. I really liked the patient, and kept taking him as part of my assignment.

The other time (that comes to mind) was a morbidly obese woman who had been on our floor forever, and we had FINALLY managed to wean her off the ventilator, -she had begun to GAIN weight -I walked in on her eating pizza from pizza hut. After confronting her about it, she admitted that her husband was smuggling it in. I repeated the floor rules to him (absolutely NO outside food for the patients -ours is a strictly controlled floor) and when he said that she kept asking him to get it for her, my comment was that if he wanted to help her die, to please do it when she got OFF of my floor.

She was very angry with me -until I explained to her that the only reason I was being (as she put it 'rude') was because I cared. I told her that I remembered when she came ONTO our floor, was with her during one of her codes, and I was proud of her progress and proud to have been a factor in it -and I viewed it as an insult to myself and fellow staff members that she would choose to undermine our efforts to get her well enough to leave.

She became one of my favorite patients -up until I went into CHF myself back in april. Haven't seen her since (been on "light duty" since I came back, and haven't worked on my old floor since -but I expect to be back by the middle of december).

Ugh. I rambled. Sorry.

[Antikigirl, ASN, RN]

oh okay..guess you nurses now can go ahead and order all these tests and re-test if they feel that it is in order? not that i am aware of!

hey, did the emt venture to remember that a high triponin level can signal other things, and is just one of the tests for mi or cardiac damage? triponin can be high in other cases and that is why a ck or ck-mb is used to be more specific for mi!

triponin levels can also be elevated in cases of myocarditis, congestive heart failure, severe infections, kidney disease, dermatomyositis, and polymyositis.

here is some info you may also find interesting: "increased troponin concentrations should not be used by themselves to diagnose or rule out a heart attack. a physical exam, clinical history, and ecg are also important. some people who are having a heart attack will have normal troponin concentrations, and some people with increased troponin concentrations have no apparent heart injury." (labtestsonline.org/understanding/analytes/troponin/test.html).

obviously this pt and the family have no idea of how things work in hospital. you don't get all mad at the rn for things an md is to do or didn't do! they should have asked to speak to the md and if they are not satisfied should have made a complaint towards the md not the rn! i am sure that was the start of their complaints..and once you start talking about complaints with people..they get bigger and more blame to hand out..that is human nature!

sorry this has happened to you...stick to your guns, this was not your fault and not your blame! you monitored the pt carefully, and one...he should have been on a monitored floor if there was question...and two, you are an rn not his md!

[Noahm]

I work on a ward that is an old nightingale ward. We have 15 beds down the left hand side of the ward and 15 beds down the right side. Basically you can see all 30 patients at the same time.

There was a cardiac arrest around 11PM once. It was sudden and unexpected. Patient was to be discharged the following morning. The curtains were drawn around the patient but it would have been pretty obvious to the other patients what was going on.

The patient in the bed across from the code wrote letters of complaint about how "traumatic" it was for her to have to listen to all the noise and commotion at that time of night. She wrote her doctor and asked him to deal with "his nurses" and said that it was "disgusting" that we allowed this (a cardiac arrest) to happen on the ward because it was very disturbing for her. She placed direct blame on the nurses for this. ***? We would like a new ward with private rooms as well!!

I know that the lack of privacy on the nightingale wards sucks for everyone but what could we have done?

The doctor and the complaints department basically told her to p*ss off. They told us not to worry about her.

It is still very hurtful that patients often seem to want to lash out and hurt at the people who are trying to help.

[Antikigirl, ASN, RN]

Oh yeah...and that whole call bell thing and complaints...I never tell a patient that I have other pts or I was working on a serious probelm...that makes many of them feel they aren't important to the nurses, and we all know that patients do feel they are the only patient...so I simply say...

"I was unavoidingly detained, my appologies for your wait...".

That seems to bring an aire of hospital, professionlism, and reality to the patients mind...that I am a nurse and I will get detained from time to time. I also..after my initial assessment say...

"and if you need something, please hit the nurses call light, and I or someone else can assist you if I am unavailable at that moment." That tends to help them realize that I can become busy but I still care about them.

Seems to work so far...of course there will be those folks that will never be happy..but oh well, not much I can do about that!