My gram is in the hospital d/t a small stroke and has been in there about 2.5 weeks. I try to be there and do a lot myself to give staff one less pt to have to hover over constantly. I am pretty tolerant of nurses and aides but this one reall irked me like you would not believe! I had to do all I could not to tell her to get out and then some!
The LNA came in to do vitals on grammy while I was there. Auto BP cuff goes on left arm and is activated. Next instant, LNA is putting the pulse ox on the LEFT middle finger!! I corrected her politely and explained she would not get an accurate reading while circulation was cut off from BP machine. She gave me a blank stare and I explained the whole oxygen/blood thing to her in a quick way. Well she thought for a sec and STILL put the darned thing on anyways!!
I also explained she had a pacemaker and last I knew the right arm should always be used for BP according to cardiologist. Didn't stop her. Hmmmm no wonder her O2 was only 94.....
ON a TELE Unit no less!!
I bit my cheek HARD to not speak. I did not report her, rather I spoke to a nurse on floor who is a good friend and she said she would watch her and correct/teach her if necessary. I will be working there soon so I did not want to make an adversary before I even started and thought this was the best way to handle without making a big fuss.
Did I do the right thing in correcting her? In not reporting her? In stating that left arm should not be used d/t pacemaker leads?
If you're going to get that upset over which hand the O2 sat is on, I can only imagine how angry you will get over things that are actually important.
As everyone has stated prior, it's okay to put the censor on the same hand. You stated that you "corrected her", but in reality you were wrong. Maybe she was the one belong polite by not correcting you. And from my experience and knowledge, its okay to take a pacemaker client's bp in their right arm (as long as they are not in the post-op/weeks after time frame).
You should apologize to her the next time you visit your grandmother.
And I take offense to the comment about her having an attitude being r/t her being young. As nurses, we need to step away from generalizations.
Um I think you are missing the point. I am not apologizing, she should have been written up! She should not have even taken the BP on that arm per doc orders that were posted in room rather priminently. Would YOU continue even after this was pointed out to you and risk injuring your patient further? Why is that not important to you or something that really matters? She had a hemorrage from the insertion, then the leads dislodged and another bleed. She has issues also d/t no lymph nodes on that side. Not to mention said left middle finger is missing the tip and disfigured due to crush accident years ago. She is not to have BP taken there nor is she to be lifted by that arm.
I guess maybe I should not have shortened the incident when posting initially. There were many other probs as well such as the aide automatically assuming since I was there I would do her job for her and that she had one less pt. I had been called in three nights in row to sit 1:1 with her awake (unpaid of course) because they couldnt handle her alone and did not have the staff and I was going on almost no sleep. Very stressful time for me being her only caregiver. Several other things as well. It all led up to me being upset about things.
The comment about her being young was not a generalization nor a dig at all, just an observation. It is a known fact that young teenagers are generally not as mature and that life experiences, education, etc. change us as we grow older. That she is young is not a slam, just an obsevation that this young lady still has much to experience in her life. I deal with the same attitudes and behaviors at home with my teens and hey it is just life- they grow out of it. Science has recently shown that there are differences in teens brains such as immature frontal lobe (impulse regulation), etc. This is not to say that all teens act like this at all, as I have seen many teens that are wise beyond their years (unfortunately none of mine are so afflicted!).
At least I hope it was due to inexperience and young age that made her so obtuse and reckless..... I honestly can't see someone with more experience clicking their tongue and rolling eyes at a pt family member in response.
I have to say if a family member pointed out something like that to me I would be tripping over myself apologizing and making sure to appease them as well as certain not to do that again. I would examine WHY I made such an error and want to make darn certain I NEVER did it with any other patient and I would be more than thankful for someone pointing it out to me for sure.
She should not have even taken the BP on that arm per doc orders that were posted in room rather priminently. ....She had a hemorrage from the insertion, then the leads dislodged and another bleed. She has issues also d/t no lymph nodes on that side. Not to mention said left middle finger is missing the tip and disfigured due to crush accident years ago. She is not to have BP taken there nor is she to be lifted by that arm.
Had you included all of this pertinent information in your original post, I think you would have received a different response.
I thougt I had said enough when I said her cardiologist did not want that arm being used in my original post.
She lost the tip of her middle finger in a factory accident many many years ago. Not mangled by any means, just shorter and bone was lost.
This was over a week ago and really seems so insignifigant to me now. She is still in the hospital begging for chicken balls (KFC popcorn chicken) and very depressed, confused and weak. She was living with me until this stroke and now I am unsure if I can still care for her which is hard for me. It is hard to see a woman who used to walk a few miles each day not be able to get herself up from a chair or remember where she is. She has become child like and it is loving and beautiful in some ways, but so hard to see this strong independent old scottish lassie so dependent on others.
Did this event upset me then? yes. Did it harm her? Thankfully not. Did I overreact? I really don't know. Am I protective of her? Fiercely- my mom died 16 years ago (her only child) and she is like a mom to me and are very close indeed. She is all I have left!
She is thankfully no longer on that floor and the floor she is on is absolutely amazing because of the people working there make it that way.
She lost the tip of her middle finger in a factory accident many many years ago. Not mangled by any means, just shorter and bone was lost.
Doesn't mean a pulse ox can't be used on it. We have some that clip on the earlobe and nose. I've done it on a toe. Just because the finger doesn't have a tip doesn't mean anything.
The aide probably didn't deserve a write up, even with a posted sign. Maybe re-education, not a write up.
PsychNurseWannaBe, BSN, RN
747 Posts
So very true! Thank you.