Lack of Care with my Child

meownsmile, BSN, RN · Dec 31, 2007

Although yes it sounds like there was some less than attentive care i dont know that i would go take your daughter out of the hospital until you speak with the doctor and he discharges her. If you walk with your daughter before she is released you may lose any chance of insurance covering her stay at all. Her doctor may not see her anymore which may be a problem if she had certain special needs medically. Dont be hasty. I suggest you speak with the nurse manager of the unit, speak with the doctor and air all the grievences to them. Then ask the doctor to write the discharge for your daughter to go home where you have skilled care for her. If there are issues you dont feel are resolved or answered then maybe a call to the state would be in order and they need to take a look at their staffing. Noone should go into a hospital with an understanding they are shortstaffed. That is no excuse for shoddy care.

**canoehead, BSN, RN** · Dec 31, 2007

Re the IV sticks- the kneejerk response is that of course a child shouldn't have to deal with that much pain, of course they shouldn't have been so cruel. I've been the nurse trying to start an IV of a child that desperately needs it too many times to say that. It is the LEAST favorite job for me. I'm a good IV starter, but when we can't get a kid I wonder should I have gotten someone else sooner, or I think the person I asked to help lost a good site that I would have gotten if I'd only tried one more time. SERIOUSLY, if the doc says it is needed no one wants to stick a child more than once. In your case the doc clearly didn't have his/her act together. I would be angry too, but keep in mind next time that you can demand they stop and give her a break, or do only one stick at a time. If she is ill often perhaps a port would be nice to have.

You left at 5pm, your husband came in an hour later, and urine was spilling out onto the bed, and there were signs of skin breakdown? If it all happened in an hour there are some serious issues, and nursing is only a part of it.

Kymmi · Dec 31, 2007

Your daughter is not able to speak for herself therefore you and your husband need to be her voice and advocate. I think you need to speak with the nurse manager of the floor and let him/her know just how you feel regarding her care. I also think you need to speak to the MD and find out if she is able to go home and get him to officially discharge her if you feel that you can provide the care she needs at home.

leslie :-D · Dec 31, 2007

as a parent, i'd be going nuts with that kind of care.

as a nurse and parent, i would have never been as tolerant as you've been so far.

a stat meeting is indicated w/the md and the nurse manager.

it is important the powers to be, know of your discontent, and why.

get the name of the nurse mgr now, so you can f/u in the a.m.

if s/he is not available, demand to see the director of nsg.

heck, even go to public affairs w/your concerns.

trust me, they won't want the publicity.

wishing you and yours, some much needed healing and closure.

leslie

TazziRN, RN · Dec 31, 2007

Do NOT take her home unless she's been discharged....if you sign her out AMA and something happens, you cannot blame the hospital for discharging too soon. If you really want her out of there and the doc won't discharge her, is there another peds hospital/unit in your city or nearby? If yes, you can ask that she be transferred. Insurance may not pay for the transport because it would be a lateral transfer rather than one to a higher level of care not available where she is now, but you can do it.

I agree with the others: the first thing you should do is speak with the nurse manager of the unit. Not the charge nurse, the manager. If s/he is unavailable then ask for the director of nursing. If s/he is not available, ask for the Chief Operating Officer. If that person is not available the next words out of your mouth should be "In that case I will be calling the local news station and newspaper."

Weeping Willow · Dec 31, 2007

Wow, that sounds like a lot of sticks, especially if they did not put in a special type of IV line when all of those failed. I'm glad you have a picture. A lawyer might be interested in it, certainly the Nurse Manager of that floor and the MD and the Director of Nursing will be. Get pictures of the sores on her bottom, too. And you and your husband should write all of these things down for your own records before you forget them. If you sue, they will be very important. If you need that hospital, you might want to think twice about suing, of course, as you would be reluctant to go there in the future. I know your heart is hurting over the terrible care your little daughter got and I'm really sorry you all have to suffer so much. I'd say not to leave without her doctor ordering the discharge. Make sure you talk to the nurse who was assigned to your daughter, too, and show her the sores from the urine. Do get her side of it. She might have been swamped with critically ill patients. Not that that will necessarily help you excuse her but at least you will know what was going on.

I assume the care was poor because the nurse and aides were overworked but that is not necessarily so. I'd be really curious to see the staffing records before assuming that the nurse and techs assigned to her care weren't just lazy or terrible time managers. They all need some inservicing about how to care for their patients, it sounds like to me.

Your insurance company might want to know about this and might be able to help somehow, like withholding payment to some degree. Howeve, make sure you are not responsible for it, either, before you talk with the insurer, since care was apparently not given.

I think if you raise a little Cain with people who are up high enough, the entire bill will be zeroed out. Maybe an Administrator, CEO, COO, someone like that. Not that the bill is the entire issue but not having to worry about it might help some.

I hope your family is soon well again and wish you all the best.

Kymmi · Dec 31, 2007

I really see no legal recourse in this case because in order to actually claim malpractice a permanant injury must have occured. I know I know....anyone can sue for any reason but in most attorneys will not accept cases that do not involve big $$ because it costs so much to try a medical case that it turns out to not be worth the time involved and big $$ cases only occur with permanant injuries.

DDRN4me · Dec 31, 2007

First, let me say that I hope your daughter is doing better.

Secondly, I understand that you and dh could not be there all of the time; but as a nurse who has spent many years caring for kids with disabilities; I know that sometimes parents who are used to private duty nursing have a hard time when they dont get that kind of care in the hospital.

dont really get why they stuck her so many times... and did not try a picc. maybe you could ask her primary doc to check into that and leave some standing orders with you for next time.

as far as the " soaking diaper and gt feeding all over", I can see the gt feed becoming dislodged and soaking everything, it has happened to me in homes and i am sure it has happened at yours. I understand t hat you are frustrated and suggest that you talk to the nurse manager and the primary md; also your agency. perhaps you could get a sitter for her ( or have her nursing hours covered) the next time she is in.

best of luck and I hope she is feeling better.

PoppaD · Dec 31, 2007

I TOLD all of them that she was a difficult stick. They proceeded to stick her about 20 TIMES...

As a parent I am sure that it must have been traumatic for you and your child to have been stuck so many times; however, as an ER RN I know that often a sick patient...especially a small sick child can be very difficult to obtain IV access and/or successful venipuncture on. The fact that you "told" them that she is hard to stick does not make the RN's task any less difficult.

At one point, they had 3 people trying to stick her at the same time!

If three RN's were sticking your child simultaneously in the ED the question that should be raised here in this forum is just how sick was this child at that time? It sounds as if she might have been critically ill.

Finally they gave up and that is when I became furious since it was OBVIOUSLY not needed.

I am curious as to why you think that it was not needed. Your child was admitted to a PICU with PN...IV access and multiple lab draws would certainly be indicated. Should she have been stuck 20 times...I honestly cannot say because I was not there...but it sounds like this child needed some sort of IV access fast. BTW...I would expect her to be bruised having been stuck that many times.

"...my daughter had pulled her oxygen away and wrapped it around her neck, her g-tube feed has completely leaked all over the bed, her diapers is soaked with urine and coming out all over the bed and that her alarm is going crazy. He proceeds to take the oxygen completely off, clean her up, put a new diaper on (btw, her little bottom is bleeding from sores)..."

I hope that this scenario did not play out as you have described it as a result of neglect. I do know that pt's will remove their oxygen...they will urinate and it sometimes will soak the bed...and g-tubes do become unconnected...in as little as 5 minutes or as long it takes for things to happen. At this point, we do not know if the RN was trying to keep the kid in the room next door from crashing, or if he/she was outside smoking...or anything else in between the two...

I hope that your child recovers...and that you will think about attending Nursing School. It ain't as easy as it looks.

babynurselsa, RN · Dec 31, 2007

I am sorry that your little one had such and ordeal.

Please remember that if she was ill enough for admission to the hospital, much less the PICU then she did need the IV. I have never worked in a facility that a picc would have been available in the ER.

I am sorry that she was a mess when your husband arrived. I would have a difficult time believing that her bottom broke down in the hour that you left until your husband arrived. Feeding tubes get dislodged, I am sure that it has even happened at home. I would hope that the periods of time between checks isn't too long. I am not there and cannot venture to guess.

Just because your husband took off the oxygen does not make it dc'd.

Did your husband speak to your childs nurse while he was there? You do not mention this.

Can you arrange to have your private duty nurse with her while she is inpatient? THe more bedside advocates the better. Obviosly your litttle one is very active in her bed being able to dislodge her feeding tube, and wrap her o2 tubing around her neck. This may be helpful.

Speak with the unit manager in the am, also speak with her physician. Have your concerns addressed.

Good luck to your family for speedy recoveries.

BeachBayNurse · Dec 31, 2007

I totally agree with babynurselsa. All of the mess pertaining to the wet bed and feeding tube could of happened in less than five minutes. Perhaps, it might have been good to call the nurse right then and there to show him/her and that way if it happened again and you had to complain, there would be some evidence. I see it all too often that because of underlying factors patients get subpar care. However, when the patient/family finally blows a gasket, the nurse that happens to be on that shift gets the brunt of it. All this results in is the nurse thinking the family is crazy and the nurse manager will have no idea that this came from days of neglect.