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?
There are definitely some things that used to fall under Nursing Care that are now defunct. I had a patient once on a busy tele floor, a retired RN who worked at the same hospital she was now staying, who was very upset with me that we didn't have hair curlers so that I could put her hair into curlers before she went to sleep. She pointed out that she did this every night before putting her female patients to bed and was upset with what nursing had become. She wasn't much happier when I explained even if I had curlers I probably wouldn't have time put them in her now anyway.
I wonder what I'll look back on someday and be upset that it's no longer part of nursing practice. (I'm hoping it's NANDA nursing diagnoses and populating spreadsheets).
Right now, yes. I think things will change, but IDK when.
I read the title of the topic and think back to all the debates about Gene Watson and whether or not her theory is applicable in a medical model that is so dollar driven.
Her theory relies heavily on "theraputic thouch" and "caring".......the exact things that get pushed aside in a "for dollar" healthcare system. Hospitals advertise about "caring for each individual" and give off this persona of being "about the pt. first" but.......eh, we all know the truth behind that.
Staffing, lack of equipment, disconnected leadership and rising pt. acuity make anything beyond the most generic of care impossible. "Care" you ask? lol Just keeping people alive and avoiding new injuries from falls takes all your energy/effort. Then you have to document, medicate the drug seekers, listen to family complain about the cafe food.................
Where does the "care" fit in during all of this? Should I let my drug seekers go without? They are smart enough and the most able to fill out surverys......thats lost money for the hospital. Should I skimp documentation and risk loss of personal financial security? Maybe hand up on the more long winded/annoying family members? IDK.
Making sure details like making beds, keeping meals warm, cleaning rooms and all other personal touches has been ditched for a long time at my facility. Its been "a thing of the past" for awhile now. It wasn't that way when I got here.
I blame the recession for it. Truth is, nurses today (and for a long time now) have been put in a position where they have to decide "in whose eyes" they are a good nurse. Give good care........maybe not be so grand with paperwork, and the patients love you. Be great with the paperwork and your manager will have you at the top of their list, even though most patients won't. Long time ago, most nurses chose to make the patient happy and to forsake/forget the chronic critisizm from admin./managers. Thats a harder choice to make these days. The recession hit and people who didn't "hop too" at the snap of the fingers were let go. Sad part is, it was nurses who were more concerned with "caring" for patients that were let go, not the one's at the top of the managers list because they always had spotless paperwork. To choose the pt. over the system these days is a gamble many nurses can't afford.
So, since we are no longer in a position to draw the line and say "not doing that, it interupts pt. care too much", yes...........pt care is a thing of the past.
I didn't address the pain medication b/c it is not a nursing issue.
Everything else screams insufficient staffing.
I see this sort of thinking ("not my responsibility") as exactly where the caring has fallen short.
If my postop patient is not getting adequate pain relief or is unable to tolerate the form in which the med is given it IS my responsibility to see it addressed - whether that requires calling the physician repeatedly until they address it (if only to get rid of me) or taking it up the chain of command until I (and the patient) receive proper satisfaction.
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?
My hospital has that policy too but you NEVER see any staff except nurses or aides answer a light.
Right now, yes. I think things will change, but IDK when.
I read the title of the topic and think back to all the debates about Gene Watson and whether or not her theory is applicable in a medical model that is so dollar driven.
Her theory relies heavily on "theraputic thouch" and "caring".......the exact things that get pushed aside in a "for dollar" healthcare system. Hospitals advertise about "caring for each individual" and give off this persona of being "about the pt. first" but.......eh, we all know the truth behind that.
Staffing, lack of equipment, disconnected leadership and rising pt. acuity make anything beyond the most generic of care impossible. "Care" you ask? lol Just keeping people alive and avoiding new injuries from falls takes all your energy/effort. Then you have to document, medicate the drug seekers, listen to family complain about the cafe food.................
Where does the "care" fit in during all of this? Should I let my drug seekers go without? They are smart enough and the most able to fill out surverys......thats lost money for the hospital. Should I skimp documentation and risk loss of personal financial security? Maybe hand up on the more long winded/annoying family members? IDK.
Making sure details like making beds, keeping meals warm, cleaning rooms and all other personal touches has been ditched for a long time at my facility. Its been "a thing of the past" for awhile now. It wasn't that way when I got here.
I blame the recession for it. Truth is, nurses today (and for a long time now) have been put in a position where they have to decide "in whose eyes" they are a good nurse. Give good care........maybe not be so grand with paperwork, and the patients love you. Be great with the paperwork and your manager will have you at the top of their list, even though most patients won't. Long time ago, most nurses chose to make the patient happy and to forsake/forget the chronic critisizm from admin./managers. Thats a harder choice to make these days. The recession hit and people who didn't "hop too" at the snap of the fingers were let go. Sad part is, it was nurses who were more concerned with "caring" for patients that were let go, not the one's at the top of the managers list because they always had spotless paperwork. To choose the pt. over the system these days is a gamble many nurses can't afford.
So, since we are no longer in a position to draw the line and say "not doing that, it interupts pt. care too much", yes...........pt care is a thing of the past.
You are so right. I "care" for my patient and get out late every evening. The charting comes last in my eyes. I know this will eventually come back to bite me though. Out of 5 patients I had last night 3 were extremely confused and total care. Another was very demanding and would yell and get angry if things were not done right away. My other patient was a sweet lady with a CVA. I spent most of the evening preventing falls and patient safety. I wish the paper pushers would follow the nurses and aides around for a few evenings and see how hard it is to give personal touches.
Huh, I came to read this because there was a heated discussion about bed changes and baths that I was posting on. As a 3 year old nurse I can safely say that nursing is not the loving, caring, and compassionate career that I had believed it to be. I got in it for all the right reasons and I can say that I hate everything about it other than the few times I've actually gotten to do good things for the people & families I've cared for.
I'm tired of hearing one nurse say to the other that their complaints about how hard they are having to work show their lack of care. We DO have to work to hard to take poor care of our patients.
I never would want my family to be in the position the OP was in. I try to make sure that doesn't happen to my patients...but there have been those who feel like I took to long or didn't do enough. There are those who thought my care was so great that they sent me personally flowers to my floor. The second is very far in between and the prior is much more frequent.
I've struggled for the last 3 years thinking that if I just kept going this career was going to get better. That I'd eventually figure out the magical time management skills and nursing secrets to getting things done on time, documenting, and giving excellent personal care while still being able to go home at a resonable time and enjoy my life. I've changed nursing venues 3 times and yet I still feel like this career is a lie. The longer I'm in it the more callous I've become.
What I have learned is that I no longer trust medical personnel. I will be at the hospital with anyone I care about and that death is not a bad thing.
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?
The answer to your title question is "yes" but not for the reasons you think. All of the fingerpointing and comments about nursing education and lack of empathy and compassion being the cause are pointless and more importantly, they are inaccurate. It has already been pointed out that poor staffing was the likely cause. I say poor staffing is a symptom of the cause.
The fact is that healthcare values medical care, it does not value "basic" nursing care. There are several reasons:
1) Medical care is high-tech and physician-driven. There are two things our society worships: technology and doctors. Therefore, medical care takes priority over nursing care, even if nursing care is what makes the difference in how quickly and how well you get better of even IF you get better. Even nurses believe this. IVs, rhythm strips, and catheters are their masters. Ambulating patients, teaching coughing and deep breathing and turning bedbound patients is a frill that your insurance company does not reimburse for.
2)Isn't it obvious? Medical care is reimbursable. Nursing care is not. Administrators kowtow to the money first and to the regulators second. And the only reason they pay the regulators any attention is because they can affect the money. Nursing care really is only a nicety, part of the infrastructure needed so physicians can provide the medical care which pays money.
3)Nurses have not done a good job of proving that "basic" nursing care saves lives, improves quality of life and saves money. It should be obvious that preventing falls and bedsores is much cheaper than treating them but nobody has been able to draw a straight line for lawmakers, policymakers and .....healthcare administrators.
So now you know. Hospital administrators could care less that you were dissatisfied with the care. They only care if your dissatisfaction affects the bottom line.
Specializes in Spinal Cord injuries, Emergency+EMS.
My hospital has that policy too but you NEVER see any staff except nurses or aides answer a light.
our Housekeepers will answer the class especially if they are in or aobut to go into the room and will do definitely none clinical things ( pass the remote control, pass a book or packet or sweets, fill drinking glasses , get a fresh jug of water , get a hot drink - the ward kitchen is their domain anyway ) but anything clinical or they are unsure of they'll refer and defer to the Nurses
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?
MunoRN, RN
8,058 Posts
There are definitely some things that used to fall under Nursing Care that are now defunct. I had a patient once on a busy tele floor, a retired RN who worked at the same hospital she was now staying, who was very upset with me that we didn't have hair curlers so that I could put her hair into curlers before she went to sleep. She pointed out that she did this every night before putting her female patients to bed and was upset with what nursing had become. She wasn't much happier when I explained even if I had curlers I probably wouldn't have time put them in her now anyway.
I wonder what I'll look back on someday and be upset that it's no longer part of nursing practice. (I'm hoping it's NANDA nursing diagnoses and populating spreadsheets).