I am a new manager in an LTACH facility. We have critical care/acute care patients here for about 3 weeks. It's a for profit facility where it is very kiss-butt customer service oriented, but I believe it is beginning to compromise patient care. There is one patient who's daughter is an LPN in a nursing home. She is nasty and mean and thinks she can actually make orders. Well, the Dr. got sick of her, every time she "orders" something he writes it. I have dealt with this woman on numerous occasions. Many disagreements, but our CEO want sus to kiss these peoples butts. This time, I got angry. She went out of our facility for a same day wound debridement. Then she gets back and the daughter insists on her getting a PICC line and start her on an anticoagulant. Tuseday was the debridement, wednesday the anticoagulant was begun, thursday was the picc(where she started with me because i wouldn't let the wound vac leave the hospital, we are not supposed to, I eventually gave in only beacuse there was a code and the procedure was being held up over this) then friday I walk in to work and she bleeding big time from her sacral wound!!!! I am assisting the house md in stiching it (yes, I am nurse manager who gets active, bot just sits on my lazy butt despite all the work I have to do) I tell him she is on arixtra. he is shocked ot hear this. I was ****** it was started. but the Dr ordered it because the daughter said to, fresh post a major debridement! And she was oozing at the PICC site too:)
The another family member keeps complaining about the care of his father. His father is vented, nothing really upstairs. The patient spikes a fever, and is compensating against it and he is freaking out that the nruse didn't stay at his beside while the fever was breaking. *****? The nurse did everything right. Checked the temp, say the spike, gave tylenol and drew BC as ordered, called the ID and even called the house DR bc the patient was in mild resp distress while the RT was at the bedside. he is timing everything... the nurse waited by the phone whens he paged the house dr so she can explain the situtation. The RT was there. Well, the son flipped about everything. Well, in my eyes, everything that was done was done correctly. The nurse is a seasoned nurse who knows what she is doing. The son doesn't understand the process of a fever breaking. The sweat is normal. She HR being high at the beginning of the fever is normal, the way to take it down is to take the fever down. All this was explained. And then he is convinced his father is being fed too much. He thinks his stomach is too disteneded. Feeding only at 30cc/hr. Belly soft, positive BS, having BM's, no residual. feel we should stop the feeding. WHy? So his wounds don't heal? me and the director fo quality insurance handled him. She wasnted ot apologize for everything. I did not. I felt everything done was appropriate. If we apologize to make him happy,t hen it makes it look like we are doing something wrong. I explained the natural process to him, everything in laymans turns and said sorry if you don't feel like this situation waS handled correctly, but it was.
Sorry for the long vent. I believe in family members being involved in the care, but not dictating it. We are the medical professionals. The dr's have to stop encouraging this. And customer service is customer service, but not when it compromises care. Anyone agree?
