It is time for a change folks....

Esme12, ASN, BSN, RN · Mar 1, 2014

"Power tends to corrupt, and absolute power corrupts absolutely."

John Emerich Edward Dalberg-Acton, 1st Baron Acton

mindlor · Mar 1, 2014

It is not that they are corrupted or not nice people. They just feel that basically patients surrender their rights upon admission and that the patient should do exactly as they say. This is not congruent with how new grads are being taught and leads to much tension between experienced indigenous staff and the incoming new grads.....

mindlor · Mar 1, 2014

One example is that my boss wants every pt bed alarmed. Well if I have an alert and oriented 50 y/o college professor as a pt that is 100 percent participatory with our fall management program, there is no way I will insult their dignity by placing an alarm on them....I could give thousands of similar examples....

Esme12, ASN, BSN, RN · Mar 1, 2014

To be in absolute control and being punitive with the patients/staff if they don't behave...is an abuse of power.

I have to say of my bed was alarmed while in the hospital you bet I'd be turning it off.

These control power freaks...I have seen them. Administration loves them. They are for the most part Yes men in the board room. They never argue or try to use common sense. They gather all their little friends (the popular mean girls) like they did in high school or college to bully/intimidate by group mentality. It really grates on my nerves.

RNsRWe, ASN, RN · Mar 1, 2014

One example is that my boss wants every pt bed alarmed. Well if I have an alert and oriented 50 y/o college professor as a pt that is 100 percent participatory with our fall management program, there is no way I will insult their dignity by placing an alarm on them....I could give thousands of similar examples....

Just remind TPTB that every patient has the right to refuse any treatment or device. Including bed alarms on a competent individual; if they insist you infringe on those rights and place a device against that patient's will, they ought to be prepared for the ensuing complaints and perhaps even lawsuit to follow. Been there, done that, and eventually stupidity goes by the wayside. Poor staffing levels, however, are always here to stay!

BrandonLPN, LPN · Mar 1, 2014

I disagree that it is my job to provide "great customer service". They are my patients, not my customers.

LPNMary · Mar 1, 2014

Not to be petty but it's Nurse RacheD. I alwasy heard it as 'ratchet' as in 'hatchet', which is more like her character, until I was recently corrected. It was disappointing to me, actually. It took away some of the spookines of the character.

allnurses Guide · Mar 1, 2014

Not to be petty but it's Nurse RacheD. I alwasy heard it as 'ratchet' as in 'hatchet', which is more like her character, until I was recently corrected. It was disappointing to me, actually. It took away some of the spookines of the character.

"Ratched"

Emergent, RN · Mar 1, 2014

Quote from Nurse Ratched.

http://www.shmoop.com/one-flew-over-cuckoos-nest/manipulation-quotes.html

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[TD]Quote #2Admission. Everybody stops playing cards and Monopoly, turns toward the day-room door. Most days I'd be out sweeping the hall and see who they're signing in, but this morning, like I explain to you, the Big Nurse put a thousand pounds down me and I can't budge out of the chair. Most days I'm the first one to see the Admission, watch him creep in the door and slide along the wall and stand scared till the black boys come sign for him and take him into the shower room, where they strip him and leave him shivering with the door open while they all three run grinning up and down the halls looking for the Vaseline. "We need that Vaseline," they'll tell the Big Nurse, "for the thermometer." She looks from one to the other: "I'm sure you do," and hands them a jar holds at least a gallon, "but mind you boys don't group up in there." Then I see two, maybe all three of them in there, in that shower room with the Admission, running that thermometer around in the grease till it's coated the size of your finger, crooning, "Tha's right, mothah, that's right," and then shut the door and turn all the showers up to where you can't hear anything but the vicious hiss of water on the green tile. I'm out there most days, and I see it like that. (1.2.5)[/TD]
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Controlling the asylum patient through fear and intimidation begins from the moment they arrive on the ward.

i want my cigarettes - YouTube

Ha ha, here's a fun clip from the movie One Flew Over the Cuckoo's Nest.

Anonymous865 · Mar 2, 2014

mindlor, Thank you. Thank you. Thank you for saying that. You just described me, but I had the misfortune of having Nurse Racheted instead of you.

Let me preface this by saying I don't think all nurses are mean or power hungry and I don't think all hospitals are horrible. I've been a patient in some wonderful facilities and had excellent, kind nurses.

Unfortunately this year I was not so lucky. I ended up in hospital where no one knew the definition of patient autonomy.

I'm 50 something. I used to be a college professor and now work in industry. I had surgery and the nurse enabled the bed alarm.

I repeatedly insisted that the alarm be turned off. She repeatedly refused stating it was hospital policy.

I stated that I was a competant adult and was refusing the intervention. She stated that the alarm was hospital policy.

I said I had the legal right to refuse any intervention. She stated that the alarm was hospital policy.

I said they were holding me prisoner against my will. She stated it was hospital policy.

I insisted she get the resident to my room. Same story from the resident. It's hospital policy. After 3 hours (yes 3 hours!) of this I gave up and did what I had to do to get along and get released.

Once I was released I got a copy of my hospital records including nursing & physician notes. In their notes it states that "patient wants alarm turned off. Said she was refusing intervention. Said she felt like we were holding her prisoner. Explained that it was hospital policy." The notes also say I was AOx3 and had no gait disturbance.

This was the only time a nurse ignored my decisions.

Unfortunately the doctors repeatedly ignored my decisions after saying they would respect my wishes. (e.g. They performed a blood test that I had refused because it had poor sensitivity, poor specificity, gave false positives if the patient had an infection which I did, was expensive, and would not provide any information we didn't already have from more accurate tests.)

When I got out of the hospital my first inclination was just to never return to that hospital and make sure everyone whom I knew never went there. Then I realized that if I did nothing and this happened to another patient as I was sure it would, then I was partly responsible. In addition this is a teaching hospital. What are they teaching residents and student nurses!

I wrote a letter to the CEO of the health system stating what had occurred, how this was a violation of state and federal laws and listed the applicable statutes, and attached the hospital's documentation supporting my complaints.

I don't want to get anyone in trouble. I don't want to get anyone fired. I don't want a $ settlement. I do want them to change the way they treat patients. I want them to respect patient autonomy.

I made it clear in my letter that I wasn't complaining about an individual employee. I was complaining about the culture and policies created by management.

I've received letters from the CEO, CMO, and CNO outlining the specific steps they are taking to investigate my complaints, who in the organization is responsible for each of the action items, and committing to inform me of the results of the investigation and whatever steps they take in response to the investigation. If I don't get results from the hospital, I'm prepared to file complaints with the state organization that licenses hospitals, JACHO, AHA, CMS, the organization that credentials their residency program, etc. Again I want change not retribution.

Oh and you are correct; bed alarms are insulting to your dignity. They are humiliating, degrading, embarassing.

There is no evidence that alarms decrease falls or the severity of injuries from falls. There are studies that show increasing bed alarm usage in acute care settings does not reduce the number of falls.

In addition in order for the alarms to be heard by the nurse, they operate at a decibal level that is damaging to the patient's hearing.

In my case the alarm went off every time I tried to roll to my side, sit up, or just reposition myself. I had to stay perfectly still (increasing the risk of pressure sores). I was in a lot of pain and had a PCA with dilaudid. I prefer to manage my pain with repositioning, distraction, etc. instead of narcotics as much as I can. Unfortunately the bed alarm made that impossible. I used more narcotics for that 1 surgery than my other 8 surgeries combined.

The alarms also make it impossible to sleep, since the patients in the rooms around you have alarms going off all the time too. I don't know how the nurses accomplished anything. It was always at least 2 RNs (not CNAs) who ran into my room every time the alarm went off.

Sorry for the long rant. Patient autonomy is very important to me.

Please keep advocating for change. Speaking as a patient I appreciate it. If your boss gives you a hard time about alarming every patient, tell him/her the kind of trouble 1 unhappy patient can create.

One example is that my boss wants every pt bed alarmed. Well if I have an alert and oriented 50 y/o college professor as a pt that is 100 percent participatory with our fall management program, there is no way I will insult their dignity by placing an alarm on them....I could give thousands of similar examples....

nursefrances, BSN, RN · Mar 2, 2014

What Anonymous 865 posted, I was talking with someone about recently. It may be a little different but it bothered me when I would receive report and was told a patient was slightly confused, a fall risk, etc. Upon speaking with these patients I had a few who were retired college professors, engineers, etc. Two were very hard of hearing so what the nurse thought was confusion was not, they just couldn't hear worth a darn.

I had some wonderful conversations with these patients while giving them nursing care. And I am sure they appreciated having a conversation and using their minds, not hear "Here are your pills, Hon". Sorry, a little off topic but a pet peeve of mine.