How much trouble am I in?

not2bblue · Dec 8, 2015

Would I have startd the IV? Maybe. But even with lack of sleep, I don't think I would have sat there for that length of time just watching them "forget". And I would hve told that nursing instructor that the student could not try unless she promised to do it if the student missed. And if she didnt then you would call the school to complain. I would have been at the nurses station explaining politely but loudly that I never wanted the nurse in my husband's room again since she didnt know how to care for him. And I would have picked up tr phone to call the nursing house supervisor if the charge did nothing. In truth, you had MORE leverage in that situation since you worked there and knew the process. You will probably be fired. Youmay be called before the board. I don't wish that on you but it is realistic. Lesson learned. Since he is a frequent flyer, if you get lucky and only lose a job, you know what not to do next time.

blondy2061h, MSN, RN · Dec 8, 2015

You could always just deny that you did it

This! "Oh yeah, a nurse from another unit came up and put it in. She said you callies her because you were having trouble? Not sure what her name is or what unit she works on. Brown hair. Average build. Excellent IV skills."

blondy2061h, MSN, RN · Dec 8, 2015

I'm sorry, this is a really unfortunate situation. If you don't mind, please keep us updated with what happens.
Also, if your husband is hospitalized a lot and a hard stick, has he considered getting an implanted port? I know its not possible for everyone but it might be good to look into.

It's not really up to the patient. I need IV's frequently and it takes about 6 tried every time. I've begged for a port. No go because there's no scheduled need.

blondy2061h, MSN, RN · Dec 8, 2015

dumb question- why didnt the pt's nurse get an order for IM or SQ dilaudid, or at least PO??? usually when I have some one who is having acute pain we have a backup available. If not, we call the doc ,explain the situation, and they rarely give us a hard time about modifying the order , or giving a 1x order until access is reestablished.
I really wonder about the competency of the pts assigned nurse. "oh, I forgot?????"
Im sure we'll start seeing more of this as hospitals drive nurses away and have to rely on new grads to staff them.
unless I am wrong , and the pt insisted on IV only. well thats a different story.

I'm guessing the type of nurse that ignores an infiltrated line and let's someone go without IV access for 6 hours isn't the type to rush around getting orders for alternative solutions. Plus, he was on IV fluids as well.

Ruby Vee, BSN · Dec 8, 2015

I probably wouldn't have started an IV on my family member unless the charge or house sup gave me permission. That being said, I have let nurses that work in my hospital start an IV on their family if they were a hard stick.
Also, some people do not have an option to go to another facility. When I had insurance through the hospital I HAD to go there if they provided the services I needed or it wouldn't be covered.
My guess is (and this is just a guess) that the wife, even though she was only looking out for her husband's best interest, got on the nerves of the nurse by "hounding" her to pretty much just do her job. Which the nurse sucked at honestly. I would've been grateful for her starting the IV, but the husband's nurse probably wanted something to complain about to take the focus off of her negligence.

I wouldn't badmouth the husband's nurse that much. There may have been a lot going on that we don't know. There is always more to the story. I'm not sure she sucked at her job or that she was negligent. The story isn't complete.

CathRN · Dec 8, 2015

SHOULD you be in trouble? I would say no. WILL you be in trouble, unfortunately, probably.
I was in the ED with my mom, who was curled into a ball because of pain and nausea (mom is a cancer patient). The nurse couldn't get her port to flush, hadn't drawn up the pain meds and zofran. I said, "here, please, let me do it." Fixed the port while the nurse drew up the meds. The nurse's response: Thank you so much for helping me! I feel so bad! I have family members all the time in the hospital who often know more about making long term IV's work than any of the nurses, especially in oncology. They do this all the time.
I would have started the IV too, after asking the staff if I could. If they say no, then they better get one in STAT or I'm making a huge stink!

My mother was a heart transplant recipient, had implanted medi-port due to being a hard stick from so many previous surgeries prior to transplantation...Anyway.......when I would take her for her checkups, the lab staff are not allowed to access any type of port (they are not nurses) and mom refused to be stuck. This major hospital asked me if I was a nurse, mom replied for me and from then on, the lab would ask me to access her port and draw the labs. Did I feel comfortable? No. Did I do it for my mom? Yes. Did I talk to her Dr about it? Absolutely! He also wrote orders for me to access and draw labs for her. I drew the line when they asked me to change her Foley! There were parts of mom I just didn't need to see!

Jolie, BSN · Dec 9, 2015

I think we can all agree that the OP restarting her hubby's IV was not the best course of action. And we have read many posts chiding her for not "going up the chain of command." While that may have been helpful (then again, maybe not), why is everyone here putting the responsibility for rational thought and action on the shoulders of the patient's wife?

Is it not the responsibility of the staff nurse to notify the charge nurse if s/he is unable to provide necessary patient care in a timely manner? Is it not the responsibility of the charge nurse to be aware of the status of patients in his/her unit, and to ensure that they are receiving appropriate care? Is it not the responsibility of the house supervisor to make regular rounds and inform her/himself of patient care challenges requiring additional assistance and expertise.

Sadly, this thread reminds me a bit of the one posted by the nursing home care coordinator who frets that bringing home made Christmas treats and cards for staff members may result in potential liability and/or offended staff members. Since no good deed goes unpunished these days, by all means, let's hang the fully licensed and capable family member who, unlike the assigned staff, effectively and safely addressed the patient's substantial needs.

AdamantiteEnigma · Dec 9, 2015

The dilaudid could have been given through other routes.

This was my question also.

If IV access could not be achieved - why wasn't another route utilized?

And, OP, did you only speak to the staff at the point of contact, or approach charge nurse/attending/rapid response?

This is really odd to me.

RNNPICU, BSN, RN · Dec 9, 2015

I have been thinking about this post for a while now.... I think the big thing here is the OP was not in the role of a nurse but of a wife. She needs to be seen in that role. She was not just a nurse from another floor coming and visiting patients off the clock. She was a wife visiting her husband.

For all of the people advising OP to follow chain of command. She was not the nurse for her husband. Especially if she is tired, exhausted after her shift. Most of our patients and families do not follow chain of command. many of them have also done outrageous things, silencing alarms, turning off IV pumps, silencing ventilator alarms. The OP was in wife mode, I think by starting the IV, it gave her something to do to try and help her husband. If she was not an employee at this facility, and the supplies were all out, and she started it, they would talk to her, give her numbers of people to talk to, etc. As the OP did, many families do keep timelines of incidences. Most families do not escalate to Charge, etc, they are not expected to.

To the OP.. just stick to the facts. I hope it works out for you. if you were a non-employee nurse, they would have people come in and talk to you and have things smoothed over, explain to you that there are people who you could talk to if you are not satisfied, etc.

Jolie, BSN · Dec 10, 2015

Thank you, RNNPICU!

You said very well what I meant. I agree wholeheartedly!

eieiyo · Dec 13, 2015

We had a small town hospital that my whole family, i.e. mother, step dad, brother would be treated at. The care was so bad when My daughter went in for an open chole she called me crying. They were trying to pull her out of bed by her arms. She was in pain and they wouldnt give her pain meds. Well. I showed up and stayed in her room until she was discharged. Also when my first grand daughter was born she was hospitalized with failure to thrive. I was there and noticed that her iv had infiltrated and her entire hand was swollen. I turned off the pump and went to find the nurse. She said "just a sec" but I said no her hand is purple, you come now! We got really good cares then. Sometimes ya gotta do it yourself

edmst · Dec 13, 2015

I would have started the IV too, after asking the staff if I could. If they say no, then they better get one in STAT or I'm making a huge stink!

Why do nurses all of a sudden forget what it's like to be a nurse when they are not on the clock - dealing with needy pt's yet the pt's are chatting up a storm on their cellphone, pt's only complaining of pain once you walk in the room, complaining of abdominal pain and n/v only to find the pt eating greasy fast food brought by family members, drawing blood, cleaning pt's? If the pt and spouse let it go for 6 hrs, it is not "stat". "Stat" is for emergent/life threatening situations. Seriously, you would have made a huge stink when OP herself admitted she and her spouse let the pain last for 6 hours?