Is nursing "care" a thing of the past?

Nurses General Nursing

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I have been tossing up whether to vent or not about this, but I'm sick of having it go round and round in my head so here goes...

A friend and colleague recently underwent major knee surgery in a private hospital. her post surgery care was absolutely atrocious and very concerning.

No PCA post op and due to persistent vomiting did not receive any relief from oral meds day 1 post op until 10pm that night when she was finally given one shot of s/c Morph. at one point she was so desperate she truly consdered asking for her vomit bowel back so she could retrieve the meds.

she was left for 3 days with out a wash and her husband had to change her vomit stained gown after >24 hours. the only time a washer came near her was when her husband was there to do it- and once when she insisted they wash her back when the badpan overflowed!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! Other colleagues and I have encouraged her to write a letter of complaint but she is now so "over it" she just wants to put this humiliating experience behind her.

I i wish I could say this was an isolated incident but my mother was a patient in the same hospital and was left on a commode, day 1 post major hip surgery, without access to either toilet paper or a buzzer for more than an hour. After calling out for attention she tried to get herself back to bed, upsetting the commode in the process. Being of "that generation" she did write a letter of complaint, but given my firends recent experience, it didn't make much of an impact.

What is going on? What has happened to basic nursing care? What about respecting the patients dignity, comfort? I am distraught!

for those of you of my generation you may remember a "film" we watched during our training... "Mrs Jones wants a Nurse". Whilst this was in many ways a parody of the demanding patient, the values and practices that it encouaged us to embrace will always be valid, as patients are still, most of them anyway, human beings with the same fundemental needs!

Are we now in a situation where all Nurses have to go through an operation themselves whilst training. ala William Hurt in The Doctor, to understand the importance of good nursing care and value the importance of the basics like mouthcare, post op washes and adequate pain relief? What has happened to empathy and compassion? Is this symptomatic of the "academisation"(is there such a word?) of nursing. Enough of Nursing theory and a little bit more of the Practice. Something I have alwys kept in the back of my mind is how would I feel and what would make me feel better?

How would you go about making sure that this does not happen again?

Specializes in Emergency, Telemetry, Transplant.

A couple of random thoughts...

1. The attack on BSN nurses was totally uncalled for and pretty rude to everyone who worked hard to earn a BSN. Also, some of the best nurses I have worked with are BSN nurses. Some of the worst I have worked with are BSN nurses. The rest of the best nurses I have worked with are ADN/diploma nurses. ADN/diploma nurses make up the remainer of the 'worst' category. (P.S why are 'nurse driven' and 'that being said' "stupid" phrases??)

2. To the individual whose father was an ED physician that was not admitted to the hospital--that is a decision of the physicians, so take it to their discussion board. That is not a nursing "care" issue.

Specializes in FNP.

I didn't address the pain medication b/c it is not a nursing issue.

Everything else screams insufficient staffing.

Stop sending nurses to these BSN programs. Chalk up one point for diploma schools of nursing!! But the BSN's know how to Google, facebook, tweet, power point and Excel! And basic nursing has been replaced with stupid phrases like"nurse driven", "that being said" and "issue".

You're right- its clearly a BSN problem and nothing else. As a BSN-prepared nurse, I read the OP's post and couldn't find anything wrong with her friends care. :rolleyes: :rolleyes: :rolleyes: :rolleyes: :rolleyes:

Specializes in critical care.
I didn't address the pain medication b/c it is not a nursing issue.

Isn't it the nurse's responsibility to advocate for his/her patients? If the patient's pain was not under control, shouldn't the nurse pursue orders for more appropriate pain meds?

Specializes in Home health was tops, 2nd was L&D.

No.. good nursing care still exists but funny thing I did discover is when I go into hospital as a patient, all the good nurses go on vacation! Must be me!

Specializes in FNP.
Isn't it the nurse's responsibility to advocate for his/her patients? If the patient's pain was not under control, shouldn't the nurse pursue orders for more appropriate pain meds?

That's a little beside the point as we have no way of knowing what the nurses in the described scenario did or did not do. Prescribing pain control is the realm of the physician in this scenario. If the OP had a problem with what was prescribed she should have advocated for her loved one herself, with the proper personnel instead of blaming the wrong people after the fact.

Wow, thank you for all the responses so far. I find it interesting that one of the replies has received almost as much comment as my origninal post.

in response: not being from the US i am not sure what all the letters stand for but that is irrelevant to my post! Surely anyone with any sort of compassion and with any sort of qualification should make sure that a patient is kept in a reasonable state of cleanliness and comfort: ie given appropriate analgesia.

No, it is not a Nurses job to prescribe meds- but surely it is to report back on the effectiveness for the prescribed analgesia and approach the relevant medical staff to review if necessary.

Regardless of how busy one might be I find it completely unacceptable that a patient who is in pain and uwashed remains in her vomit soaked gown for longer than one shift, let alone 2 days!

Re what the Nurses di was make the patient wait the prescribed time ie 4/24 before giviong her more oral meds, which she vomited again. She waited until 10pm that night before some smart RN gave her the s/c morph, which had been prescribed all the time. When she eventually got this she was screaming in pain! NOT ACCEPTABLE. I could accept the excuse of one busy shift or even a code on one of them but for two days to pass without any of these issues being addressed is too much to swallow.

I am not sure what happened in the OP's case. But I just want to say that I went to nursing school to acutally help people. I believe that 100% of my co workers also want to help their patients. But with staffing issues the way that they are. I will be lucky to actually spend any quality time with my patients. I work IMC, typically we have 5 patients. We have 2 CNA's split between 42 patients. They help when they come but for some reason, 75% of our patients are total cares, and are on drips that require titration, accucheks q4 hours, trached, vented. It is hard to do what you have to do in 12 hours, and make sure everyone is cleaned, and needs everything that they do. I don't believe that nursing is like it once was, people are sicker, and mgmt wants more work for less pay and less staff.

The situation in the OP has to involve more than short staffing, not even the basics are being met. But it's easy to blame a myriad of troubles on short staffing, it take any responsibility off of a nurse who is giving sub-standard care. And if you think they aren't out there, working right along side you, you're delusional.

My mom was hospitalized for stabilization in her final weeks with terminal cancer, she was alert but profoundly cognitively impaired and unable to move her lower body.

Four days into her stay I arrived at the hospital at 7pm after working all day, to find my mother sitting in bed, both her and the bed covered in dried tomato soup, crying inconsolably.

The pad under her had dried rings of urine.

The tomato soup had been her lunch.

Her foley cath was folded and she had been sitting on it for who knows how long.

Seven hours across 2 shifts and no one had touched her yet her bedside chart indicated that not only had she been fed her dinner (and ate 100%) that she had also receive a bed bath with HS care at the very time I arrived.

This on a low ratio medical unit in a union hospital.

I demanded that the charge nurse and the house super come to the room immediately.

The charge nurse came in, took one look at my mothers condition and went and got her nurse to come "fix" the situation. I refused until the house super got there, I also refused to hand over the falsified charting to anyone but the house supervisor.

I filed formal complaints with the hospital, the union and both the State & Feds.

We never saw her "nurse" again during the rest of her 10 day stay.

I really hope if her mother is dying she gets better care than that nurse gave my mother.

Specializes in O.R. Nursing - ENT, CTC, Vasc..

My hospital is trying to pull it together by making every person in the hospital accountable for patient attention. If we were so understaffed that patients were suffering in their own bodily fluids for that long, administrators, etc. would be in those rooms helping patients. No matter who you are in our hospital, you have to respond if you see a call light in the hall or answer a ringing phone that's being ignored. And now they allow people to work as "Helping Hands" for extra pay - you work on the floor helping get things for patients, etc. Even scrub techs in my O.R. can go in and change a patient's gown and linens and clean them up. I'm not saying we're the most wonderful place, or that everyone does these things, but this is an example of thinking outside the box and everyone communicating and helping, not thinking you're just stuck in your one position and can't do something else. ( Nurses not included because they're the ones who need the help ;) But our admin told us, if we are too good to get our hands on a patient in this hospital, we should go work somewhere else. If we have unhappy patients, it's everyone's problem, not just the nurses/techs'. Now they are trying to save money, of course, by using the resources they have instead of hiring more people, but even if we had all the money in the world to hire people, why wouldn't this be a good philosophy anyway?

Wow, thank you for all the responses so far. I find it interesting that one of the replies has received almost as much comment as my origninal post.

in response: not being from the US i am not sure what all the letters stand for but that is irrelevant to my post! Surely anyone with any sort of compassion and with any sort of qualification should make sure that a patient is kept in a reasonable state of cleanliness and comfort: ie given appropriate analgesia.

No, it is not a Nurses job to prescribe meds- but surely it is to report back on the effectiveness for the prescribed analgesia and approach the relevant medical staff to review if necessary.

Regardless of how busy one might be I find it completely unacceptable that a patient who is in pain and uwashed remains in her vomit soaked gown for longer than one shift, let alone 2 days!

Re what the Nurses di was make the patient wait the prescribed time ie 4/24 before giviong her more oral meds, which she vomited again. She waited until 10pm that night before some smart RN gave her the s/c morph, which had been prescribed all the time. When she eventually got this she was screaming in pain! NOT ACCEPTABLE. I could accept the excuse of one busy shift or even a code on one of them but for two days to pass without any of these issues being addressed is too much to swallow.

Which country are you from? I think most of the posters on here can only comment about nursing in the U.S. and these responses may be comparing apples to oranges.

What country are you in?

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