Reader's Digest article on nursing

Published

http://www.rd.com/content/night-shift-nightmare/

What do y'all think about this? Makes a good point I guess, but this article made me angry when I read it.

Specializes in ORTHOPAEDICS-CERTIFIED SINCE 89.

This happened in my state. There is now a statute directed to it.

http://www.scdhec.net/health/licen/LewisBlackmanAct.pdf

And no I didn't read the article yet. All I know is that the child should not have died.

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Specializes in ER/Trauma.
Melinda says that the night shift staffers at UCLA were kind and caring but appeared to be overwhelmed by patients needing attention. "I could hear other patients crying out for help that didn't seem to come," she recalls. "It was horrible listening to them."
Now why does that sound familiar? :uhoh3:
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Specializes in Trauma ICU, MICU/SICU.

I also read the article. The article slams night shift. Yet this poor boy was tachy by shift change in a.m. and everyone still did NOTHING until they were unable to obtain a BP @ 1200. Are you kidding me??? I don't care if he was on oncology, surgery, renal, GI. That is just plain bad nursing care. Where was the attending? Did anyone call his service? Did anyone call a nursing supervisor? Did they have a rapid response team? Call someone in ICU 'cause you're in over your head? Call another nurse and ask her what to do? It just sounds like this child was surrounded by idiots. I'm sorry to sound so mean, but I was 3 lines into the article and I'm like, "he's bleeding into his belly." Come on, I think a GN, first day orientation could have seen this coming and coming and coming for 30 hours!!! Geez! I hope heads roll over this.

Note to administration, computer staffing program can NOT fix this. Staff education on basic patient assessment and WHEN TO CALL THE ATTENDING would be a lot more helpful.

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Specializes in Med/Surg; Psych; Tele.
The guy who wrote the article doesn't get it. He attributes what happened to this young man was because of night shift staffing. That's silly and his article doesn't support it. The article also discounts the value of experienced and knowledgeable nursing care as the fault of the nurses seems to be solely that they did not call a more experienced doctor. After the Toradol, the first thing that went wrong was that this young man was admitted to an oncology floor instead of surgery. I believe that this was probably the most significant mistake leading to this young man's death. I think that an experienced surgical nurse would have caught on to what was happening with this young man sooner, both by assessment and by questioning the lack of post-op CBC and the poor pain control. This is not to question the skills of oncology nurses but a nurse is a nurse is a nurse -not true. A nurse who was experienced with this type of postop patient may have saved this young man's life but the writer of the article as well as the parents of the patient do not know that.

I politely must disagree. Tachy, diaphoretic, unrelenting abdominal pain, pallor...I don't need to know much more because I'm calling someone, be it MD, rapid response, or someone. I don't mean to sound harsh, but this nurse and this resident failed miserably in their assessment skills. The way this kid was looking alone should have have warranted further action...let alone you also throw in the distended abdomen, low temp, and inability to obtain a BP?!!...especially in an otherwise healthy 15 year old?!!?! Neither gas nor an ileus is going to yield this type of clinical picture.

I'm not some kind of master nurse, but if one of my patients appears to be in some kind of distress, even if I am not sure why, I'm calling someone of a higher rank.

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Specializes in Junior Year of BSN.
The sad thing is, it is not just night shift. How about weekends and holidays? Apparently, patients don't need the same care on weekends and holidays either. And that includes day shift.

The article discussed weekends and nightshift.

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Specializes in nursery, L and D.

This article should have addressed poor nursing and medical care, instead of bashing night shift.......it would have taken 1 good nurse with good assessment skills and 1 good doc with good assessment skills and some lab work to find out what was going on. Be it day shift or night shift.

That being said, my gramp died of a duodenal ulcer bleed, in the hospital, 4 days after admission. With everything that could have been done, being done. Sometimes you just can't stop them from bleeding. This could have been one of those cases, but kids usually respond better than 69 year old men, and NOTHING was done for this poor kid. I feel so sorry for him and his parents, wish I had been taking care of him. At least I would have gotten a doc in there and done everything I could to help him, and not just said, "oh its just gas". So sad.

Oh and BTW, nurses have known for years and years that we need better staff to patient ratios, maybe the whole world will know soon and push for this. A computer program is NOT going to fix this, more nurses might.

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As a a former RN whose husband died from medical neglect (see my first post) I see several parallels... remember to treat the pt instead of the machine--maybe take a manual BP and believe it when a pulse is high..don't hesitate to call an MD even if it's in the middle of the night, and listen to the family that's being labeled as a pain in the %#@ when they say their loved one doesn't look right...and remember you are an advocate for the pt.--you may not make friends that way but you may save someones life...it is also good to see such errors made public..let's not sweep them under the rug and hide them. My sympathy to the family...but I also feel for the nurses/staff that know now they screwed up...

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Specializes in ER.

It truly sounds like a nursing issue to me. Givn the patient's appearance, pain, and his mother saying there was something very wrong the doc should have been called, and if the doc refused to come in the charge nurse could assess and call again, and again, and again.

The new law that requires staff to wear identification...wasn't that in place before for everyone in every hospital?

Calling the doc every time a patient asks...great, but if they had great nursing assessment and communication skills to begin with it wouldn't be necessary. Plus- how many times do you think the patient will be coherent enough to express their issues, or insistent enough to actually get helpful action? This law will not solve the problem. Nurses are supposed to be advocates for their patients, and we need to insist on education and staffing to do our job.

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Wait a minute. The boy bled for 30 hours and it's the night shift's fault? Last I checked, there were only 8 to 12 hours in night shifts. Anyone want to explain why the other shifts aren't implicated?

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Sad story. Have seen any number of sad stories lately. This article makes it seem like it was night shifts fault but the boy was in trouble for many shifts and everybody who assessed him failed. That being said, there is much truth addressed in the article. There are always a few night shift nurses with much experience but a good many have little if any experience. I've seen Clinical Resource Nurses with little experience. What good is that? Those people should have years of experience instead of being the only nurse management can persuade to work the position.

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Specializes in Med-Surg Nursing.

I read the article and didn't like how night shift was being bashed. I work straight night shift and have for most of my 10 yr career. I am an experienced critical care CCRN certified RN. Sounds to me like a LOT of people dropped the ball on this one and not just night shifters. Did anyone ever to an Abd CT scan? Guess not.

Where I work, there is ALWAYS a house officer in the building--first yr intern, in addition to the ER doc. The House officers know that if they are unsure about anything that they can bounce stuff off the ER doc and if all else fails, they can call one of the attendings, it's been done. And most of the docs where I work now, don't ever get upset at being called in the middle of the night. This boy did not have to die. My sympathies to his family

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Specializes in Community, OB, Nursery.

I work nights and some of the best nurses I know work nights too. Like someone else pointed out, the kid had been going downhill for quite some time NOT just on nightshift.

I read the article with mixed emotions. I feel horribly sorry for this child's death; can't imagine the family's agony. Shouldn't have happened. But please don't blame night shift.

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