Opinions Please

[PennyNickelDime_RN]

I am an RN on an oncology floor. I have been practicing less than a year. A situation occurred last night that bothers me and I am seeking opinions as to what others think. Here is the scenario:

A patient was transferred from MRICU to our floor for comfort cares. He came to the ED that morning with cyanosis, SOB and abd pain. He has lung cancer with mets to his liver and pancreas. His abd was full of stool and he was septic. I received report from MRICU that he was on a fentanyl drip and 3L of O2.

Two RN's from MRICU transferred the patient up to our floor. He was not attached to an oxygen canister, his fentanyl bag and saline bags were thrown on top of his bed. He was in both contact isolation and droplet both of which were not mentioned in report I had just received. After transferring the patient to the bed, I ran to get a pump only to have the lines of his meds tangled up in a mess that it took myself and a NA 10 minutes to untangle them in order to get them in the pump. Here is my question. Is it the practice at the hospitals you work at to transfer a patient in this condition without an IV pump or O2? I was so angry not only that the patient was in obvious distress struggling to breath but that he was treated in an undignified manner in my opinion. I would think that MRICU would have brought his pump with him and either we could have switched out the pump or transfer the lines to one of ours. This situation upset me very much and when I explained to my charge nurse she suggested that I write an email to the CNS of MRICU. What do you think?

Thank you!

[sissiesmama, ASN, RN]

I am an RN on an oncology floor. I have been practicing less than a year. A situation occurred last night that bothers me and I am seeking opinions as to what others think. Here is the scenario:

A patient was transferred from MRICU to our floor for comfort cares. He came to the ED that morning with cyanosis, SOB and abd pain. He has lung cancer with mets to his liver and pancreas. His abd was full of stool and he was septic. I received report from MRICU that he was on a fentanyl drip and 3L of O2.

Two RN's from MRICU transferred the patient up to our floor. He was not attached to an oxygen canister, his fentanyl bag and saline bags were thrown on top of his bed. He was in both contact isolation and droplet both of which were not mentioned in report I had just received. After transferring the patient to the bed, I ran to get a pump only to have the lines of his meds tangled up in a mess that it took myself and a NA 10 minutes to untangle them in order to get them in the pump. Here is my question. Is it the practice at the hospitals you work at to transfer a patient in this condition without an IV pump or O2? I was so angry not only that the patient was in obvious distress struggling to breath but that he was treated in an undignified manner in my opinion. I would think that MRICU would have brought his pump with him and either we could have switched out the pump or transfer the lines to one of ours. This situation upset me very much and when I explained to my charge nurse she suggested that I write an email to the CNS of MRICU. What do you think?

Thank you!

Hello - I am sorry the nurses sent that pt to you in that condition. I would have been chapped about the isolation, especially if you had to run around getting things to use just to begin care for them. Just my .02, but sounds like the nurse didn't give your staff or the patient much consideration either, just sending them up off their O2 and placing their Fentanyl gtt in the bed. Even if you are moving someone in the bed, activity like that can wear them out and cause discomfort. Sending them up with o2 and their gtt would have helped.

Sounds like they didn't think much about the patient's dignity - even if I were unnsure if they were coherent or not, I would do everything I could to maintain their comfort and dignity.

I'm like you, I think, I would probably say something too. You had the right idea, all they had to do was switch out pumps, that kind of thing. Good luck to you, you really sound like a caring nurse.

Anne, RNC

[*ac*]

That would be an incident report at my hospital. No way he wouldn't have had portable O2. If they didn't want to give up their IV pump, the bags would have been hung on a pole that comes up out of the head of the bed - and the drips would have been manually adjusted.

Write and incident report to help keep others from going through this.

[sissiesmama, ASN, RN]

That would be an incident report at my hospital. No way he wouldn't have had portable O2. If they didn't want to give up their IV pump, the bags would have been hung on a pole that comes up out of the head of the bed - and the drips would have been manually adjusted.

Write and incident report to help keep others from going through this.

Exactly, ac - it doesn't take that much time or energy to find an ivac to transport if taking one from the ICU is the problem, or like you said, use the pole that fits into beds (or ours, at least). The nurse making the transfer to the OPs floor made some poor choices, or just didn't ...

I agree, OP, I would do whichever your hospital f/u with, incident report or whatever, so maybe they won't make that a habit.

Anne, RNC