My horrible hospital stay. What would you do?

[Carebear77]

I'm so upset. Tell me what you would do.

I had my gallbladder removed yesterday and was kept overnight which I was glad b/c I was in a ton of pain and the Dr had dilaudid Q3 and vicodin Q 4.

I asked my nurse for pain meds this am she said she would give me the dilaudid that was at 10:30. At 1130 my aid walks in and says she gonna take out my IV b/c I'm d/c. I say well my nurse was gonna give me meds. So she leaves the room and comes back and says they won't do the IV push med b/c you're d/c. I was like umm ok. But I asked an hour ago. So I say can I get my pill at least and she says ok. Well the 2 of them (nurse and the aid) were walking out of my room and I heard the aid say " she ant in pain, she is just fine, she keeps changing her story she is just drug seeking" they were saying some other things but I couldn't hear it all. I'm so shocked and mad. How dare them talk about me like that. I'm not a piece of crap who is here to use drugs.I was in so much pain (still am on a scale of 0-10 I am about an 8).

I swear I wanted to run out there and go off on them. But I'm in too much pain. I just don't understand people. I got their names. If you were me what would you do??

[Altra, BSN, RN]

I agree that the comments allegedly made, within hearing distance of that patient and probably other patients and visitors, were very unprofessional.

A couple of things ...

In my experience, yes aides/nurse techs take out IVs.

In 2 of the 3 hospitals where I have worked it has been policy to keep patients on bedrest for 4 hours after administration of IV Dilaudid. The nurse may have walked out of your room, intending to give you a PRN dose, only to discover that you were up for discharge. At that point the game changes, because you may be leaving short of the 4-hour mark, and I cannot fault him/her for making the decision not to administer the Dilaudid. It would have been best, of course, if he/she would have come back and explained this, and offered p.o. meds if there were still orders to do so. (these orders may have been discontinued simultaneously with the order for discharge)

[diva rn, BSN, RN]

It's actually quite common in many facilities.

In my years of agency/travel, I would say that it was more often permitted than not at most facilities.

Yowza,

OMG, I am so sorry to hear that. I have not yet had that experience (in my 18 years) of working in a facility where it was permitted to allow aides to dc IVs and I hope I never do.

However you can be assured that I will be dc'ing all of my patients IVs where I can asses the end of the cannula and the site as well as the entire limb for any signs if infltration or phlebits or thombus. Or aides supposed to be able to know these things as well? and then to initiate the appropriate intervention?

I can only say...WOW...I had NO idea...what is this profession coming to?

sorry, if I have offended any aides, but I really stand by what I have posted...unless you are a phlebotomy tech-then, maybe ok, but I am really uncomfortable with this.

diva

[Nccity2002, MSN, RN]

Nurse techs..not CNAs were allowed to remove IVs and foleys and give a soap suds enema with extra training at my last hospital.

I would definitely complain directly to the nurse manager/unit director.

I agree with Lil'mama. Call the unit directly and ask to speak (or the number) of the nurse manager... and have a little chat with her. As someone mentioned before, stick with the facts. As a manager, I would appreciate the call (d/c surveys go around for a while before result get to the appropriate manager). Sorry for your experience.

[bjaeram]

I don't see the big deal with aids taking out iv's. ours do and it's certainly not rocket science.

Bed rest 4 hours after dilaudid???? That is crazy too! I work in the ER and we give it and send people home all the time. We don't let them drive but they are quite capable of walking.

As far as your pain meds in the hospital that is awful and the fact they were talkinga bout you is even worse, especially where you cold hear them. I would complain to the floor manager, on the survey, and often hospitals have patient advocates. Just call the operator and ask! That is horrible.

[Altra, BSN, RN]

Bed rest 4 hours after dilaudid???? That is crazy too! I work in the ER and we give it and send people home all the time. We don't let them drive but they are quite capable of walking.

There was a time when this was common in my ER too ... but no more, for a few years now. Some sentinel events r/t Dilaudid in my region.

[nopainNurse]

Wow 4 hour bed rest after dilaudid IV? Is it only dilaudid or all opioids? And is it only IV? WHat about SC or PO? What is the rationale behind such a practice?

[Carebear77]

Why did you wait for an hour? Maybe they were testing you and since you didn't call back for that long they assumed you really weren't in pain? Stranger things have happened.

Now is the time 'that annoying family member' would have been useful!

[Edited to add] - That aide is on some kind of power trip. She is commenting on something that is beyond her scope. She needs to be dealt with becasue she might have been feeding the nurse false info. It's the nurse's fault too - but don't forget about the aide's contribution. What a piece of work!

I waited cause I don't like to constantly ask and ask.

Why would they test me? I had surgery. I have 4 incisions. I think it's pretty obvious I was in pain. Every time I moved I would be in tears. The meds they sent me home in are not even working. But I am scared to even call and say to anyone cause I dont want to be treated like a druggy.

I might call though cause my navel incision is burning red and hot. I think I have an infection. It is the worse pain I've ever had and I have 2 kids.

[madwife2002, BSN, RN]

Everywhere I have worked in the last 22 years, IV's have been removed by CNA's, Techs, Aides and I have only ever worked in Hospitals. I have removed a lot myself too but I have no issue with IV's being removed by any of the above-Why would anybody worry?

[Tait, MSN, RN]

Our PCT's (Patient Care Technicians) are allowed to remove IV's. They have around 8 months of training and only recently were restricted from placing/removing foleys as well as a history of placing even NG tubes!

That aside, you need to call and talk to the nurse manager. If she does not seem supportive I would just write a letter to the CNO or CEO. There is no reason for them to be calling you a "drug seeker" at all, let alone two steps outside of your door.

I am sorry this happened to you.

[Altra, BSN, RN]

Wow 4 hour bed rest after dilaudid IV? Is it only dilaudid or all opioids? And is it only IV? WHat about SC or PO? What is the rationale behind such a practice?

Only IV. The rationale is ... q 30 minute VS and continuous pulse ox monitoring. The chole patient, as in the OP's example, would never have had IV Dilaudid as an order option where I work unless for some reason they were in the unit.

Yes, really.

As I said ... once upon a time in the ER I routinely gave 2mg Dilaudid IV and sometimes even 4mg. But after sentinel events ... everything changes.

[netglow, ASN, RN]

OP, I take it you are home. I hope your pain is manageable, PO medicated now?

So, I am understanding that you didn't get a chance to go PO prior to d/c? What if you got in the car and by the time you got home, were in so much pain that you had to get taken back in through the ER? There is a crappy readmit ding for them!

I would not deal with nursing staff. I would just call my surgeon. That is the way I roll. I called my mom's surgeon in his car to notify him of some really crappy nursing (long story that you just wouldn't believe). He was @!*^ as well, and that was that. I just don't care that I am a nurse. I just don't care for chain of command because SUPER crappy nurses = SUPER crappy nurse management. The corporate girl comes out and I get it the heck DONE!

[Altra, BSN, RN]

Everywhere I have worked in the last 22 years, IV's have been removed by CNA's, Techs, Aides and I have only ever worked in Hospitals. I have removed a lot myself too but I have no issue with IV's being removed by any of the above-Why would anybody worry?

Agree. The site should have been assessed by a nurse during a part of overall assessment. Simple removal of a lock is a task that can be delegated.