Need advice on reporting incident with relative

[kbclary4]

I have just started nursing school and only have a vague idea of how thing run in the ICU. I have a question about care my grandfather received there recently, but am not sure if it is reportable (I feel I should) and how to go about reporting it. I am pretty upset and am directing my feelings toward one nurse in particular, but am not sure if I am directing it in the right place.

My grandfather was in ICU on a ventilator. It was against his wishes to be put on it (another story), so they were taking him off. They told my grandmother to call the family because he was not expected to make it long after. The night before, the nurse on-duty told us what to expect the next morning...she said once everyone was there to let the waiting room attendant know and we would all be allowed to go back and visit for a bit. Then my grandmother or dad would be able to be in the room when they took it out if they wanted while the rest of us waited in a separate room. She asked what time everyone would be there the next day. My grandmother told her 9 am. The next morning we had all arrived and my grandmother was stuck in traffic. At 8:30 a nurse called to the waiting room and asked if the family was there. I told her no, my grandmother was not and we were not due to be there until 9...she says 'well, you didn't tell me that' and hangs up the phone. A few minutes before 9 my grandmother is pulling into the hospital finally and about the same time the nurse calls out again and says she needs the wife and one other relative in back there. My dad and uncle went since my GM was parking car and such. THEY HAD ALREADY TAKEN IT OUT!!! Did not tell us, they were going to do it or anything. Just called out after they had.

I cannot fathom why they would not wait for the wife to get there to do this or why they would not call out and say 'we are going to go ahead and do it now anyway, the rest of the family can come back and visit once more.' Fortunately he pulled through, but what if he had not.

I am really furious about this and don't know who to direct it at. Can anyone give me some insight as to what might have gone on there?

Thanks,

KB

[ktwlpn, LPN]

As far as I know, in most places that I have worked, the extubation is done by RT/MD/resident. At very least they generally must be present. An MD usually is nearby to sign the death certificate......

As such, the nurse can argue till the cows come home. Beyond throwing his/her body over the patient...which result in a firing of said nurse, very little will delay the procedure. Nurses get metaphorically beaten up over enough situations beyond their control. It is why there is shortage, and burnout.

Does anyone really believe that we enjoy terminal extubations and would deliberately or neglectfully maltreat the family during such a situation? Laying this all at the nurse's doorstep is not appropriate.

Belle-

You know what? I did not even look at the situation from that angle.It's just too,too easy for many of us the accept the blame when it is not ours.....You are SO right....

[rjflyn, ASN, RN]

Im glad caroladybelle chimed in when she did. Everyone was blaming the nurse for something that may not have been in her control. Having worked at hospitals from 50 beds to over 1000 beds certain things occur when the doctor wants them to.

Anyway to cover another issue brough up fabnurse. Being an ER nurse and a paramedic more importantly guess what you may get intubated or other care you may not want. Take your living will for example- did you read the fine print. Most living wills have a clause in them reference determination of a termimal conditon by 2 physicans. Just for FYI sudden caridac arrest often times doesnt fall under this clause.

Also guess what if the hospital doesnt have a copy when you are there its not going to be followed. I lost count a long time ago on how may people claim to have living wills and powers of attorney for heathcare and 1) dont have it with them, 2) have never provided the hospital/their doctors with a copy. 3) Have never told any other family member of said documents other than their spouse- husbands and wifes do get in serious motor vehicle accidents together.

Rj

[fergus51]

Sounds like no harm no foul. Maybe you could just write a letter saying you wish things were more clearly communicated. All in all if that's the worst thing that happened, I wouldn't make a huge deal of it, but that's just me. I would also be reluctant to blame the nurse when she may have had nothing to do with it. I've actually had a doc extubate a patient while I was in the bathroom (not to die, but to trial on cpap, I got back just in time to see the co2 get to 110).

[apaisRN, RN, CRNA]

The docs extubated one of my patients while I was tied up with the other, who was hypotensive and requiring extensive attention. I checked on the first pt to find he wasn't doing so well off the vent, and I'd had no idea! Very frustrating.