Horrible hospital experience!

[southernbeegirl]

My father had a radical prostatectomy yesterday morning. The surgery went great! The doc said there didnt appear to be any mets and he was able to save the 2 nerves. wonderful news!

The surgical experience was a positive one for my dad and us as well. You couldn't have asked for any better.

then daddy was transferred to the floor...

As we walk into his room, we hear a lady talking down to him like he has dementia. When we got in the room, she immediately said in a horribly rude tone "you need to go outside until i am done!".

um okey dokey...so out in the hall we go, with my sister and i (both nurses) looking at each other like "wth?".

The surgery was a traumatic event for us all, as you can imagine. My mom kind of lost it in the hall and cried to me "i just want to see your daddy and know that he's ok. why wont she let me even see him? whats wrong?". (we hadnt seen him since he went in to surgery)

I told her that she was his wife and she could go in the room if she wanted but that my sis and i would stay out in the hall to give the staff space and time to get him admitted. So I walk my mom to the door of the room and the nurse is coming out of the room at the exact same time. She again tells us we "cant" go in there. I tell her that my mom is very upset and needs to see him to know he's ok and that she will sit out of the way but that she needs to be in there with him. At this point, the nurse puts her arm on the door and physically blocks my mother from going in the room!

I'm not saying she just told her not to go in there...she literally blocked the door with her body and arm and told my mother that she would NOT be going in that room. my mom tried to open the door and the nurse grabbed the door telling her "i told you to stay in the hall, you are not going in that room!".

at that point i told her "look, my mother is his wife AND his POA. if she wants to go in the room, she can. she will NOT get in your way but she is going to sit in there".

the nurse literally rolled her eyes, huffed a big sigh and stomped off.

o m g

As she is coming back down the hall, I am standing there looking at her and she stops and says (and i quote) "do you have a problem??". (in a total confrontational way!)

if i didnt before, i darn sure did now!

I told her "yes, i do. I dont appreciate how you spoke to my mother". and she tells me "well thats the way we do things here, get used to it". OMG!

By this time, he'd been on the floor for over half an hour. When the RN brought him up from surgery, she told us that daddy was in a lot of pain and that she'd just told the RN that he would need pain medicine.

So I ask her why he hasn't had pain medicine yet. She tells me "he will have to wait until i get his paperwork finished".

At this point, i'd had it! I asked to see the supervisor. Again, this nurse rolled her eyes, huffed a big sigh and stomped off!

so now she's physically kept my mother from going in the room, told me thats how they do it there and to get used to it and now says daddy cant have pain medicine until she does his admission charting even though the nurse from surgery told her he needed pain meds right away and even though my daddy was laying there crying from the pain.

I waited for 45 minutes before the supervisor came to the floor to speak with me. Another nurse was the one trying to get the supervisor for me because daddy's nurse refused. The supervisor was doing "rounds" where you ask the patient how their food and service is. ok..your nurse is getting physical and you don't think it's important. gotcha! so after 30 minutes of waiting and 3 pages to the supervisor I had had it and asked her to call the House supervisor. The house supervisor refused to come up and told me to wait for the supervisor!

at this point i feel like i'm either in the Twilight Zone or I'm being punked.

She eventually comes and assigns another nurse to daddy. ok great. problem solved. thank you.

Well, the pain meds they were giving daddy were NOT working. Finally, around midnight the 11-7 nurse comes on. by this time my sister was crying (she stayed with him) because daddy was in so much pain. So he tells my sister that he is going to give dad the "whole" dose of morphine. Within one hour, daddy was out of pain, relaxed and his UOP increased to 150cc. (he had only put out 50cc since surgery)

He tells my sis that the order is 4-10mg, titrate as needed.

The other nurses had been giving daddy 4mg but then never came back in to assess pain control!! If they had, they would have known that dose was not working. So my dad suffered for 9 hours until this guy came on shift on nightshift.

Then they had a fire drill at 3:30am. Ok...training is important. but in the middle of the night? but even that I could see. except the fire alarm malfunctioned and went off for 30 minutes.

This afternoon the doc decided to let daddy go home. 4 hours later, not one soul had been in his room except the lady that brought his lunch. My sister finally asked the nurse at the desk if he would be discharged soon.

they didnt even know he'd been discharged! his chart hadnt been touched since the doc put it in the rack!

I absolutely could NOT believe how bad his care was! If it had only been that first, rude nurse then I could have just chalked that up to her being a rude person. Instead, most of his care was horrible!

It's unbelievable that the care was exemplary in the surgical dept and then horrible on the floor.

I am totally disgusted tonight.

[ChristyRN2009]

Some of the completely inexcusable and definitely termination worthy behavior from your nurse may have come from the RR nurse telling her that the family has medical professionals in it. I know I always try to pass it on in report if the family is a heathcare worker because in my experience, it can create problems. Its rarely a plus. I'm just saying, that nurse should be fired (and really every nurse who subsequently ignored you etc) but perhaps that's where the problem started. And I will say that 4 hours to wait for discharge is not a big deal. I bet that nurse knew about it but just didn't want to admit to you that she hadn't had time to do the 10 things that have to be done before discharge yet (or just as common, the doc wrote the orders incorrectly or didn't fill out what he/she needed to so he/she was being chased down). Hospitals are a business, they want to turn over beds asap, no way would the nurse not know a doc had written discharge orders. So for that, while you should complain because to you it was yet another distasteful experience in a long line, in reality its likely there was a valid reason for that.

ETA : Forgot the most important part, I hope your dad has a short and uneventful recovery!

[southernbeegirl, BSN, RN]

The surgery dept didnt know that we were nurses. The doctor didnt even know. He didn't know until after surgery and i asked him about mets and he asked me. I hadnt planned on telling anyone because i know how i dread it when my patient's families are nurses.

as for all the paperwork,etc that has to be done before a pt gets pain meds...i call crap. i work in LTC and have worked med surg. I've had the EMTs tell me the patient is in terrible pain and i'll be darned if i do all the paperwork first, i just look at the orders and get something.

I wish that he'd had better pain control when he hit the floor too. but the fact remains that he didn't and was in obvious pain on arriving to the floor.

i'm shocked that 4 hrs to wait for a discharge is not a big deal. my first husband practically lived in the hospital and in all those 10 years, we never waited for 4 hrs to d/c.

not coming back to reassess pain control in a patient that was in excrutiating pain to begin with is inexcusable to me....whether it's my dad or someone else's dad. IMO, there is no excuse for that.

that nurse used her body to physically keep my mom from the room and then told me to get used to it. IMO, nothing can excuse that.

i've been a nurse a long time and i would NEVER treat someone the way she treated my mother and i damn sure have never let anyone lay there in pain like that without calling the doc. i wish i'd been there that night but i had the job of taking care of mom and getting her home. my sister was afraid to make them mad and wouldnt ask why they didnt come back.

sorry to sound so hateful and defensive. i just got home from taking care of daddy all day, i'm missing the best game of football my stepson has ever played (he got MVP of the game, woohoo!) and im exhausted.

to the med surg nurse that posted that long post full of excuses for the care. like i said, ive worked med surg too. all i can say right now is i hope YOUR dad is never in the hospital and gets treated like mine did. like i said, ive been a nurse a long time so i understand all that can happen. but at some point, the excuses need to stop. not having time to go back and reassess pain in a patient in obvious pain?? no excuse for me. i can see not making the time to go reassess after a pain pill for something routine but not making the time for someone that was climbing the bed from pain? inexcusable, IMO. no matter who the patient was.

i'm not going to write the letter until next week since i work the next few days. i really do want to take care to praise people as well.

[JomoNurse]

ok, this is just MY opinion. I think you were completely out of line to run the show and tell the nurse what was going to happen. you were there as a visitor, you were not there running the show. i think it was rude of you not to give her the time to transfer your father into his hospital bed first. you could have explained to your mother that this as normal. we never allow family members in the room while were transfering a patient from a gurney and getting him or her settled into the hospital bed. it only takes a few minutes. but like i said, i think you were totally out of line to say how the show was going to run when you weren't the nurse in charge. sorry if this offends you.

the attitude the nurse gave you after that is inexcusable and i hope she gets fired.

[Fiona59]

And as we all know, every story has three versions, the families, the floor staff, and reality.

[crissrn27, RN]

The patient (or the family, if the pt is in too much pain/distress/confused, etc) is who is supposed to "run the show". The nurses in the OPs post couldn't run anything except maybe the Colgate comedy hour.

[emnicams]

I have to second (or third, or fourth) that the RR nurse should never have sent a patient to the floor in pain. She says he was maxed out on pain meds but is telling the floor nurse he needs pain meds right away? That doesn't make any sense. Sounds to me like she just was ready to hand your dad over to the floor.

I won't make excuses for any of the poor care your dad received. I'm sorry he had such a crappy experience

[Ayvah, RN]

Sorry to hear about the way things went for your family. The nurse should not have done a lot of the things she did like block the entrance, and it sounds like management did not really listen or address your concerns properly.

I know you are very upset about this all, and you should write a letter. Kimmie's post above is not a line of excuses, its really a cry for help, that med surg floors are chronically understaffed (and in this case, had a couple poorly chosen staff to begin with), and that some of the processes are in great need of change.

I hate it when a person comes to my floor from surgery because I am prevented from getting them quick pain relief. The chart is gone during surgery so when they come back, hopefully I am not in the middle of something that I can look at the new orders, and then hopefully the clerk is not busy so they can put the orders in while I assess the patient. When a patient goes down for surgery at my hospital, every medication order is wiped from their chart, so everything has to be reentered according to the orders when the chart comes back to us. Then the pharmacist has to approve those medications, then there has to be a second person on the floor who checks medication orders to ensure they are correct, then it takes another couple minutes for the system to cross over to the pyxis so that I can remove medication. We can not override pain medication, so there really is paperwork that I have to do in order to access medication for the patient. I always explain to the patient and the family that there is a process to get the medications the first time, but after the patient is fully established in the computer then medications can be accessed quickly.

We greatly rely on the PACU nurses to make sure the patient's pain is manageable, and our PACU staff does a great job with that. In my limited knowledge of PACU, they can give more pain medication, more often than the floor can. If the PACU nurse felt that she gave 'all she could', then she should have immediately contacted the doctor for a different type of pain medication to give. Telling the family that the patient needed pain medication as soon as they got to the floor is not acceptable. While it sounds like that nurse was nice about it, perhaps she was new, because we don't have strict limits on most of our pain medications, as sometimes we give enough, even on the floor to "kill a horse". Your dad simply should not have been in excruciating pain upon arriving to the floor, and you should include in your letter that the PACU staff member perhaps needs an inservice or something. But again, the PACU nurse sounded nice and she probably didn't realize that the floor does not have easy initial access to pain meds like PACU does.

So please also include in your letter that some of the processes, or staffing levels need to change, and, that further education should be given to the staff about pain management. Giving these concrete examples might lead to some real change. The patient/family do have a strong voice and hopefully the outcome can be very positive! I wish the best for your dad's recovery.

[Virgo_RN, BSN, RN]

the nurse that brought him up from recovery told me they'd given him all they could. i think he probably was "relatively" relieved. that was the feeling i got from talking to her when she told me almost apologetically that they'd given him all they could. that was the impression i got from her. you could tell that she really cared. she told me not to worry, that she'd told the nurse he needed pain meds right away. i assumed so that they could get him started on meds on the floor and hopefully between what they'd given him and what the floor could give him he would get better pain relief? i wish i remembered her name too. she was wonderful! you know how you can look at someone and know they truly care? that was her. she even hugged us.

She may have been nice, but she dropped the ball. That drives me absolutely bonkers, those nurses that know they can get away with providing substandard care as long as they are "nice".

[southernbeegirl, BSN, RN]

She may have been nice, but she dropped the ball. That drives me absolutely bonkers, those nurses that know they can get away with providing substandard care as long as they are "nice".

i've never worked surgery or had any surgery so i didn't know she should have made sure he wasnt in pain. now im pist at her too, lol.

[diane227, LPN, RN]

Because I have had to deal with such situations myself, this is what I do. At the first sign of trouble, I do not wait. I ask to speak to the charge nurse immediately. I let the charge nurse know exactly what my expectations are in very specific terms. If this does not occur, I have no further conversation with her. I go to the phone in the room and ask the operator to call the supervisor and have him/her come up immediately. I request that family be allowed to spend the night in the room because I am uncomfortable with the level of care. I explain again what my expectations are and at that point I explain what my next action will be which is to go to the media. I explain that I feel that my relative is not receiving a proper standard of care and will go forward with making a formal complaint with the JCAHO, Board of Health for the State of _______, and will call the news media immediately and request that they meet me in front of the hospital.

If they threaten to have security remove me from the property, I request that they do this immediately so that I can immediately call the media to explain to the public that I have been removed from seeing my father/ mother etc. Trust me, this will get their attention. I have had to do this and my problem was resolved. You might also request that they move him off that floor completely. Trust me, the hospital administrator does not want to see the family members of a patient, in tears , in front of the hospital, crying because their family member is getting poor care. In addition, you need to get the name of the nurse with whom you had the first interaction and report her to the board. This is simply unacceptable and should NEVER be tolerated under any circumstances. If someone did this on my floor, I would take action immediately to see that this did not happen again.

[kimmie4476, ASN, RN]

Thanks AYVA, you hit the nail on the head regarding the intent of my post. I was most certainly not making excuses for the attitude, just trying to show the process of when a patient is returned to the floor and why the meds can be slow in coming which is why we make sure the patient's pain is controlled BEFORE leaving PACU, as well as yes, making a plea for lower nurse-patient ratios to keep things like this from happening again.

[suanna]

By all means I would make an appt to speek to at least the ADON at the hospital. When you get the appt ask to have the floor manager for your fathers floor be present if possible. The blocking of your mothers access to your father was unwarranted and could border on criminal behavior. As to withholding pain medication (without good reason- dropping resp, change in LOC, confusion...) that is an offence that in my state (Ohio) could cost a nurse thier licence before the BON. I would make that point to the ADON and ask exactly what action she is taking- if you are not satisfied- you take action- with the BON.