macleod340

Thanks for all the replies, so many good points and a good all-around discussion. We are also having issues similar to that TurtlesRcool explains and there is nothing quite like trying to log into your rooms on Vocera with an N95 or PAPR or CAPR on. "Did you mean Mechanical Plant Boiler #3???" Just glad I passed my fit test and and don't have to deal with wearing a helmet anymore. I think now more than ever, it's important to address problems in a logical manner and not give into frustration, alarm fatigue, burnout and the chaos of being a Nurse in a pandemic. I see so many of our nurses that are overwhelmed, fatigued and doing thinks like not logging into their rooms on Vocera or a phone system, so that they aren't able to receive notifications about their patient's wonky pleth wave or V lead that has lifted off a hairy man's chest again. Unfortunately, in one of our sentinel events, the alarms were blaring, fatigue and burnout was present, no one could get a hold of the nurse and the patient with a "bad Pleth wave" or a sensor off was decompensating and died without anyone knowing. This is the very, very, unfortunate reality of a global pandemic and my heart hurts for that patient and their family members. As Nurses we should always respect that Airway is always first, Alarms are there for a reason and not to be ignored, no matter how fatigued we are, we have a responsibility to at least lay eyes on our patients. I will post our recommendations included in our practice alert and let you know how it goes with the equipment reps.

Thank you everyone for your comments and suggestions, that really helps a lot!! I have a meeting with our equipment reps and I am so lucky to work at a hospital that has leadership that is supportive and listens to their Nurses. COVID has led us into a state of harried impulsivity and I think a lot of our med/surg units that have been forced to change into COVID units are experiencing frustration, burnout, and an overall, loss of control. We are all being forced to work outside of our comfort zone and are not always able to stay focused, grounded, and mindful of what we are doing. I am so thankful that I work in an area where I still have someone to handoff my patients to at the end of a 12hr shift and have been fully vaccinated. I'm sure we will address our problems shortly, I just hope we don't have another event in the meantime. Thank you for your suggestions, I will definitely include them in our Practice Alert.

Thank you MunoRN, Being a respiratory RN I am pretty aware of the issues with getting a good pleth that is consistent, reliable and the best thing is to have eyes on your patient. We used to have pagers that Nurses would carry and this placed the ability to silence alarms directly at the bedside and in the hands of someone who has eyes on the patient. I'm guessing we are just experiencing issues due to the rapid influx we have had of our COVID population and with our Nurses that are not as keen at troubleshooting issues in an efficient way. Also with our move to centralized monitoring, we took the ability to interpret an alarm away from Nurses at the bedside and placed it in the hands of our monitor techs (who do an amazing job). I will definitely push for the alarms for our COIVD patients to be set at a lower threshold. Thanks a lot for you response

We have a centralized monitoring system with at least two dedicated monitor techs present at all times and they are completely overwhelmed. Our new system has 4 connections that nurses are trying to troubleshoot and just mess around with them until they work for another 15 minutes until the patient batts an eyelash. I've timed it and sometimes I've spent over an hour troubleshooting our systems. It seems like a very bad design and is making my job harder. But, you gotta love those Philips touch screens that make the boxes run through 3 AA batteries ever 6 hrs.

Yup alarms are set. It's more that we get so many sensor malfunctions, poor pleth waves and false alarms due to poor signal quality. I have had setups where I've had to put over six new pulse ox probes on one patient over a 12hr shift. I think our adapter cords are faulty and we are so short of supplies, the faulty ones stay in service because we don't have extra. We upgraded our system 2 years ago and we have just accepted the fact that its not at all reliable. We ran a report and are getting over 1000 alarms for a 500 bed hospital with less than 100 pts on monitors in a 4hr period. The only thing I can think of is to use opaque tape over the probe to stop outside light sources from interfering. Our alarm fatigue has directly led to patient deaths that I can't accept.

I think it's so funny when I see meds blasted up on our ceilings from clogged NG tubes. Gotta love the liquid tylenol in it's bright red glory!

Hello Allnurses, I am attempting to troubleshoot some issues we have been having at our hospital that have resulted in patient harm while monitoring patients on continuous pulse oximetry. I work in ICU stepdown and we have seen a dramatic increase in the number of patients being monitored for continuous pulse oximetry with COVID. Understanding that that loose connections, a sweaty finger or patient conditions like afib/PVD/DM impact circulation and ability to monitor pulse oximetry, what type of system do you use and how to rate it's reliability? We have had more than one patient die while supposedly being monitored on continuous pulse oximetry without anyone even knowing and this seems completely unacceptable to me. Any comments or suggestions appreciated.

Just wanted to say thanks to CiaMia and JustBeachyNurse. My hold resolved about an hour ago and I unofficially PASSED. Thanks for your support and for sharing your knowledge. I've been pulling my hair out this past week waiting for results, but now I'm so pleased to be over the NCLEX hurdle. Now on to landing my first nursing job...

Thanks for the advice CiaMia, I called them and again was not given any reason for the hold, just told to wait. To be honest I am getting quite tired of waiting. Thanks JustBeachyNurse, My credit card has never been charged for an extra exam fee of $200. I just find it frustrating when I paid the regular exam fee and was told my scores would be ready to view in 48 hours and have been sitting here waiting since. I have job opportunities, school loans, bills to pay and need to get working ASAP. I followed all the instructions, didn't touch my whiteboard thingy during the Tutorial, raised my hand every time I needed something and didn't take my cellphone or any study material into the test center. I just wanted to share my frustrations with this process so that others can know that the PVT doesn't work for everybody and not to get discouraged. My test results are still on hold and although I find it frustrating, there is nothing that I can do about it. Hope y'all have a good NCLEX

Bonjourno everyone, I took my NCLEX on February 11th and still have my results on hold. I've done the PVT trick so many times that if it actually charged my credit card, it would probably be maxed out by now. It just keeps saying "The candidate currently has test results that are on hold. A new registration cannot be made at this time." My state participates in quick results and those have never been available. I would gladly give Pearson another $7.99 to know that I passed... I contacted Pearson using the online chat thingy twice to ask why my results were on hold. One person told me to wait another 24 hours and recheck... its been over two days now...nothing Another guy told me to contact my BON. So I contacted my BON and got a response of "DO NOT CONTACT THE BON REGARDING NCLEX RESULTS." Trying to stay positive, but I am beginning to wonder why I paid $200 to take a test if no one can tell me if I passed or not. Frustrated... Any advice???