Hands off my vent!!

Changing vent settings? Jesus you have some bold family members. I get super possessive. I don't care how you're related - that patient is mine while they're under my care. That picture is perfect, that would be me

Oh HELL NO!!! If I have "handsy" visitors, I always lock my Alaris pumps on the back so they can't do anything to them.

Even if you have MD next to your name and you are an adult brain surgeon...if your kid is in my PICU -- hands off!

It's been a while for me but - do they make tamper-proof machines YET?!?!? .

Maybe some really smart nurse or RT could invent some kind of cover-plate or screen that locks?

I would be calling security. I work for a hospital that can and will ban visitors for interfering with patient care. I fortunately have not had this issue yet.

It's been a while for me but - do they make tamper-proof machines YET?!?!? .

Maybe some really smart nurse or RT could invent some kind of cover-plate or screen that locks?

There are lock out buttons and plastic face plate covers. I've seen them in pediatric home care to prevent helpful siblings or other visitors from trying to help if the nurse had to step away for a second.

Seriously, right? I don't know how any reasonable adult can think that this is ok.

On my unit, I think this problem results from a) private rooms, and b) patient satisfaction scores. With private rooms, families generally try to pull this crap while nurses are out of the room. I have literally had the discussion, "Why is my intubated patient on 21% FiO2 when I left him on 26%?" "He didn't need that much oxygen." They see us do something (not knowing the assessment, considerations and precautions that go into the decision), and somehow assume it's ok for them to do it when we're not looking.

When we find out that this is happening, families get a "gentle but firm" (quoting management) talking to from the nurse, managers, and medical team, because god forbid we get a negative HCAHPS score. Even if it puts the patient in danger. Even if it means they keep doing it again and again. Meanwhile, we get scolded if we "make the families feel uncomfortable." I guess with that mentality, I shouldn't be surprised that the problem is getting worse.

I LOVE the idea of equipment these magical locks that you speak of....

Maybe all the equip should have the protective shields as standard issue.

I know in LTC we had problems with O2 concentrators freq. Less of a prob with IV pumps except for folk who 'silence' them (and feeding pumps).

Yes! I'm so glad I found the lock on feeding pumps and IVS. Especially after one mom programmed the feeding pump to NOT go off when it was supposed. She filled bag to the top and set amounting infuse as 999 mL. With continous rate at 40 mL/hour and a bag of 500 mL....

And got mad because we ran out of formula a week early. Actually accused nurses of taking it home. Naturally the manager got involved.

IV pumps....I made a family mad because I WANT my pumps to beep when I have back to back infusions (why do all the dailies seem to be at 9 pm?). Anyway, I locked that bad boy after it didn't beep when I expected it. They turned off my Zosyn drip and my Vancomycin infusion. I ended up restarting both IV sites because they clotted off. Real helpful because they shut off neighbor's IV too. Annoying back light! Don't bother asking me to shut it off, just let me find my Heparin drip had been off for over 2 hours! Another RN and I were working together and she did my round since another of our patients needed a CT (one of us had to take them since we had no transporter). She thought I turned the back light off....we didn't catch it until we were checking intakes.

Since then, I'm glad they made a new locking system and we have to lock ALL medicated drips. Surprise! My antibiotics became medicated auto-lock.

We had a home patient that came in with respiratory issues. Family turned up humidifier heater to 6 (usual is 2) and had stuffed cotton wadding in all the ventilator holes not taken up by tubing. Vent overheated and shut itself off. No one heard alarms because they had also turned them down and one of the holes was where the alarms were sounding. Water had actually backed up about a foot on each side of the overflow cup! They were in unit when I left because they kept getting worse so they called RRT.

We had a home patient that came in with respiratory issues. Family turned up humidifier heater to 6 (usual is 2) and had stuffed cotton wadding in all the ventilator holes not taken up by tubing. Vent overheated and shut itself off. No one heard alarms because they had also turned them down and one of the holes was where the alarms were sounding. Water had actually backed up about a foot on each side of the overflow cup! They were in unit when I left because they kept getting worse so they called RRT.

What!!

I personally would complete an incidence report/notify my manager for each occurrence.

Yep! I've seen a lot of crazy come from homes. One of my coworkers texted me that they finally got readings from the vent. Family had changed settings. I guess they forgot about that being possible. I think the patient had more issues than we thought....I mean, family changes settings, let the vent over heat, turned off alarms, and they were also breathing through water.

I didn't see it, but a buddy told me she went in to troubleshoot a vent in a home and it wasn't working because roaches were inside it and mice had chewed through the cord. The tubing was growing it's own petri dish of microbes that were visible. That patient died after they got to the hospital.

IV....I did have a patient who was told they could go home after they got their dose of Vancomycin that day. I started it and got called away for an emergency. About 20 minutes later, I went back for their emergency. I ended up sending them out from the nursing home I was at as a traveller. The patient turned the IV pumps off, took the tubing out and gave themselves a free flowing 500 ML bag of Vancomycin and their entire flush bag (about 900 mL). Over about 10 minutes or less. They had a PICC line. They were red! And in some respiratory distress from the fluid overload. They bought themselves a week stay in the local hospital instead of a trip home. That was before anyone came up with locks or automatic stops if you take tubing from the IV pump.