Oral Airways on Telemetry floor

Home Health Columnist / Guide · Jun 13, 2012

I sure hope a nursing staff member accompanied this patient to procedure room!

Yes, I've cared for 6-8 patients on telemetry with a client having airway taped. Better believe I checked on them frequently.

CHECK FACILTY poicy is best bet.

TravelJinx · Jun 13, 2012

Of course not. CNA brings pt down and leaves pt in hall until they're ready for them in procedure room. Patients are left with the head of bed facing the OR desk in hallway. SO unless somebody walks out of an OR room nobody can see the patient's face - never have a monitor on patient while waiting in the hall. Never transfer patients on monitors for that matter.

Then they wanted me to accept this patient and the one I'd just finally got comfortable across the room. When I said this patient has an oral airway and is a 1:1 in PACU. GI RN stated 'Yeah I know'. When I stated I couldn't take the patient and my old one across the room. I was told GI RN could only look at monitor. Couldn't care for patient. Guess ok for GI RN to do Conscious Sedation but not recover a GI patient. Also beyond her to call and give a head's up that they're a.) coming to PACU b.) what they're bringing PACU.

We just got a new computer system. The hospital went cheap on the program and then went cheap on the WOWs too. Don't have one WOW per patient. Have 1 for PACU and 2 Desktops. The other WOW we had in PACU is one of the 'shared' WOW for Surgical Services.

It's a definite 'fell thru the rabbit hole' existance so wanted to make sure this wasn't as uncool / below standard of practice as it sounded / felt to me. Thanks for replying.

Creamsoda, ASN, RN · Jun 13, 2012

Yeah....dont think that ones a good idea. Obviously the patient was not fully recovered. So no, should not have gone to the floor until able to maintain airway and reasonably awake. ALDRETE scores ect. IF the patient can't maintain an airway wait till they wake up and if not off to ICU they go, perhaps with an ETT:idea:. That whole situation is just scary to me.

Home Health Columnist / Guide · Jun 13, 2012

This situation is a grand TEACHING MOMENT about patient safety. I would have immediately picked up the phone and contacted Telemetry RN to express concern re patient safety for the next time or directly when escorting patient back to unit.

Documentation to clinical manager paramount without the emotion you expressed in post.

Email title. Patient safety concern

Dear Mgr:

On 6/12/12 I found patient ABC with an oral airway taped in place left unacompied in hallway. They were scheduled for XXX procedure. I was told GI RN could only look at monitor. I was already involved in a case across the hall.

Steps I took include:

This situation could be used as safety reminder at our next staff meeting.

***

TravelJinx · Jun 13, 2012

Thanks - unfortunately in case of this hospital there are so very many teachable moments so little time!

My post allowed my frustration to show. I could spend hours listing all the many, many, many ways we are unsafe at this hospital. But I'll just give you one example.

I could tell you that I've seen nurses sit across the room from patients with their back turned to the patient while they chart on desktop computer while a radio plays near the nurse. Patient has face mask on, RN can't see patient signaling they need something - even if it's just they need to be reassured and reoriented after waking from OR - but RN can hear the monitor when it beeps sat has dropped to 88%. This is considered acceptable because on M/S RNs don't closely monitor patients either. RNs in our department used to do the same with paper charting. At least with paper charting they could be sitting across the room facing the patient if they wanted to.

(BY the way our Clinical Manager is aware that patients are left in hallway.)