Hospital Patient Care

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I have a question. 

I recently had a spinal fusion surgery. Fourteen hours of anesthesia and positioned flat for 24 hours due to a CSF leak. It was a nightmare. The hospital nurses appeared at my bedside to administer medications and type on the computer mounted in the room. That's it. 

Not once did a nurse ask if they could help me get comfortable, like put a pillow under my knees or bring a warm washcloth so I could wipe my face. No one offered to help me brush my teeth. I had to ask for a glass of water, since no IV fluids were running due to the nationwide shortage, but no one helped me drink it. Lying completely flat, I couldn't reach the water. No food was provided. After two days, when I asked if I was missing meal trays I was handed a menu and told to call nutritional services; apparently meals are delivered to order, but no one informed me. I felt like a wounded rat in a trap.

When I became a nurse a long, long time ago, patient care meant more than meds and charting. I understand hospital nurses are overworked and units are woefully short staffed. For this reason, I am resolved that no one I love will be a hospital patient without me or another family member at the bedside. 

Is this just the way it is in hospital nursing? 

This, obviously, is not the kind of care that a nurse would hope for their patient to receive. It sounds quite ridiculous without even attention to food/hydration. 
 

The reasons and the blame, however, deserve to be spread far beyond the nurses. Most all of us would like nursing to be more than giving meds and typing on a computer. Recently I was reading a different post here on this forum and someone used the analogy of a full bucket of water. You can go ahead and try to keep filling the bucket more, but water IS going to overflow and fall to the ground. It really sucks when things start to go by the wayside...none of us were taught that is acceptable. The problem is, lots of forces have simply kept the faucet on and NO ONE is getting additional buckets or trying to create diversions to help with the flow. That isn't the bucket's fault and whoever says it is is either woefully ignorant or intentionally misleading (I'm not saying that you are saying that; but plenty do. I realize you're sharing your experience and rightful disappointment). 
 

I know how things are and I definitely would station someone with my loved one if they needed to be hospitalized. 
 

best wishes on your recovery ~

Specializes in Med Surg.

Since covid, my hospital lost almost all the experienced nurses, then more turnover, was staffed with travel nurses, and finally this Summer, we are fully staffed for the first time with 90% new grads and new PSAs. I am the old nurse with 4 years experience. I'm sure that any of the new nurses and new PSAs would not have offered much since they are new but if you asked them they would have done all of your or your family's requests. It has been six months. I'm sure that they will good nurses and PSAs but they are all still learning. It is a work in progress. Our charge nurses make an secret code announcement at 5 pm to remind all the PSAs to check on patients to refill waters, make sure they are comfortable, and any last requests. Our managers, lately have been asking all the patients if the PSAs offered baths,  call lights answer, etc. Our PSAs only get 5 patients so they have more time for baths and comfort. Last year they had 12-15 patients each. We are finally fully staffed, and have been getting highest customer service and quality points since covid. I always go with my family if they go to the hospital since I know that if the unit is short staffed then the care is not the same. So you should always go with your family and check. You never know. 

Thank you for your responses, JKL33 and Bluepen. I absolutely understand the bucket analogy, and the fact that the root cause of having no awareness of patient comfort lies far beyond the floor nurses. It was encouraging to read Bluepen's description of how staffing and patient care is improving. 

We were called "nurse's aides" in 1974, and team nursing was practiced. Each of us  had 5-7 patients to provide baths, change beds, do vital signs, pass water and trays, assiste patients with meals and help to the bathroom or bedpan. A few LPNs passed medications and performed dressing changes in addition to basic bedside care. The RNs took off orders, charted, and managed the care provided. When I was in nursing school in 1975, team nursing was on its way out and primary care was praised as being the best model. I soon realized primary care was great in theory, but when a nurse is overextended and has too many patients, "comfort" takes a back seat. Bed bath? Help someone brush their teeth or drink a glass of water? Who has time for that?

Bluepen, it sounds like the nursing leadership where you work is attempting to establish a different culture--helped, of course, with better staffing. Good for them. 

Thank you, JKL33, today I am a month post-op and slowly improving every day. I'm doing my best to mentally turn away from the memory of what was, frankly, a horrific hospital experience. I want to practice gratitude for life-changing surgery and a pain-free future.

And if I never see the inside of an operating room again, that will be just fine with me.

 

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I'm  doing my best to mentally turn awa y  from the memory of what was, frankly, a horrific hospital experience.  I want to practice gratitude for life- changing surgery and a pain- fre e future.

In addition to all of ^ that, if you haven't already I do think you should provide feedback on your experience. If your complaints was that no one applied lotion and gave you a 15 minute back rub I would tell you those days are gone, but to not be offered basic comfort measures or food—to say nothing of hydration—is not acceptable.  

Specializes in orthopedic/trauma, Informatics, diabetes.

I am so sorry that happened to you! I work on an ortho floor and while we don't get a ton of spine pts,, all pts should be repositioned, bathed, ADLs offered. That's unforgivable. 

Last time I was in the hosp and was not treated well, I had  a non-emotional conversation with the charge nurse before I was discharged. I didn't want them to know I was a nurse but one of the PACU nurses saw it in my chart somewhere. 

I hope you gave feedback to not only the unit, but also your surgical team. ❤️ 

Specializes in orthopedic/trauma, Informatics, diabetes.
Bluepen said:

Our PSAs only get 5 patients so they have more time for baths and comfort.

Wow! That's awesome. What is the nurse ratio?  I have new job and we actually have some aides and most of them are amazing. Our pt ratio is usually 4:1 Aides are 10:1, At my old job we were lucky to have 1-2 aides for a 37 bed SD unit. 😞 

Specializes in Med Surg.

We are 1 nurse to 1 PSA with 5 patients. 

Specializes in Research & Critical Care.

The unfortunate thing is even if you provided feedback to the hospital, administration would take that as a sign of poor nursing without considering the factors that lead to it.

They focus on the bottom line and start cutting from other departments so the bedside nurse becomes environmental, PT/OT, IT, etc. PCA hours start getting cut back so there's less help and more to do. Staff nurses sick of the increased workload and getting treated like just another body leave and those spots get filled in with travelers who can sometimes care less and new grads who are willing to learn but inexperienced and overwhelmed.

BUT if it's one of theirs, you're told they're a "VIP" and are expected to give them special treatment. Really, it's just the treatment every patient in the hospital should be given.

Profit before people.

Specializes in OB.

I'm really sorry that happened to you.

Over the years I've been a patient a few times.  I agree with some of the others, you need to write to management of that unit and explain to them how you were treated.  Things don't change until management understands things from the patient perspective.  

You should have been given finger food; you could have recovered on your sides, too, not just flat on your back; did your doctor check in on you?  did he/she not realize that you were uncomfortable, and that you hadn't eaten?  Unfortunately, I've seen some younger nurses who just go into nursing for the money ... we've had some where they just don't care about cleaning up their patients or the rooms, and that's just not how we (on our unit) take care of our patients.  They usually don't stay with us long.

Advocate for yourself, and for future patients.

Specializes in Oncology (OCN).

I'm so sorry this happened to you.  I hope once you've had time to recover from your surgery you will have the opportunity to reach out to hospital management and share your experience so they can hopefully take steps to improve.  

I've been hospitalized multiple times this past year for pneumonia. (3). I contracted severe Covid in July 2020 from work and went into respiratory failure (in ICU then required home oxygen for 13 months & periodically thereafter.). It did a number on my lungs and I was left with interstitial lung disease & mild pulmonary hypertension.  I have preexisting autoimmune disease (RA) that we thought was in remission but since Covid it has been uncontrolled, even with biologics.  The biologics and steroids (initially for my lungs, now for adrenal insufficiency) mean I catch anything & everything (even when careful) and my lungs are most susceptible...all of which equals frequent pneumonia.  Anyway, every time I've been hospitalized it amazes me how infrequently nursing assessments are done-like hardly ever.  I can see not doing a complete head-to-toe assessment if pressed for time-although you can do one pretty quickly-but to not do even a quick focused assessment specific to my diagnosis? Hardly any one listened to my lung sounds! (But I'm sure they charted they did!). My first admission the only ones who actually listened to my lungs-or even brought a stethoscope in the room-were my PCP and one night-shift nurse.  I had hoped bringing it to management's attention might have a positive effect but unfortunately, two subsequent admissions over the next few months didn't have any different results.  (I live in a rural area with only one hospital to choose from unless I want to drive over an hour away.). It's really scary.  Now, I was awake and alert enough to speak up and tell them had there been a problem but what about patients who aren't?  
I definitely agree with what others have said, I would not let a loved one be alone in the hospital.  And if I were under anesthesia or in anyway incapacitated I would request a family member or someone be with me.  It's just too scary out there anymore.  

Donna Hansen said:

You should have been given finger food; you could have recovered on your sides, too, not just flat on your back; did your doctor check in on you?  did he/she not realize that you were uncomfortable, and that you hadn't eaten? 

Thank you for your input, Donna. I got out of the PACU around 2200 and was moved directly to the inpatient unit. My doctor saw me that night, of course, and didn't see me again until the following night when he released me from CSF leak flat positioniong. I'm haven't worked in spinal surgery and had no idea I could move from my back. It would have been so much better if I'd been helped to turn from side to side a bit. After many hours of agony I asked if it was OK to bend my knees and the nurse said yes. Had someone made an effort to help me get comfortable with different positioning I think I would have cried with relief. My doctor cared that I was in pain...but they're not around much, are they?

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