Nurses General Nursing
Published Jun 3, 2007
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.
k3immigrant
56 Posts
i was teary eyed after reading the story of lewis.it made me angry because i felt the nursing profession failed this bright boy. as i was reading through the article, there were lots of signals, like when the boy was complaining of abdominal pain, auscultate & palpate the tummy would be the first things to assess & due to persistence of pain, somebody could have suggested a KUB to a resident, or when the heart rate was going up & pt appearing pale, a CBC. also, the fact that toradol is an NSAID, a daily or frequent CBC/hemogram should have been done & monitored.
i don't want to judge the people that took care of this boy, i just hope this will be an opportunity for us all to learn to listen to patients & not be judgemental, as i always tell my patients to be proactive with their care as nobody knows their body than themselves.
CarVsTree
1,078 Posts
Here's the response I submitted to Reader's Digest. Hope I sound somewhat intelligent, the whole thing makes me spitting mad!
I am commenting on your article in the June 2007 edition titled, Nightshift Nightmare. As a night shift Registered Nurse, I was appalled that you would use a case that was a case of 30 hours of neglect of a patient and state that it was the fault of night shift. This child was failed by every nurse and doctor that laid eyes on him. His problems started long before night shift and were ignored at least 5 hours into dayshift when he coded at noon. You are correct that there are more inexperienced staff at night, but these are the resources available to nurses at night. If I have a patient that the resident fails to treat properly, I can call his senior resident, the attending physician, nursing supervisor, clinical nurse resource specialist, rapid response team, draw his morning labs early (to see his plummeting blood count) etc. 5/5 pain is unacceptable and toradol is an NSAID known for its risk to cause bleeding. This child died of negligence, not the time of day where his crisis peaked (which was noon by the way, not 3 a.m. Day shift also ignored his problems both before and after night shift was over. The hospital's solution of crisis education is irrelevant for this case, since had it been handled properly, he would not have been in a crisis. A crisis in your patient's condition is often way past the opportunity to save them. I feel so sad for the child and his family, but I to say it was night shift that caused this is irresponsible writing. It was bad nursing and bad medical management. They should have gotten a LOT more than $950,000.
Here's the thread on allnurses.com if you're interested in other nurses' opinions regarding this tragic case. https://allnurses.com/forums/f8/readers-digest-article-nursing-228131-2.html
BTW, I am paid at a premium to be a dedicated weekend night shift nurse. This is to add more experienced nurses on the weekends.
Sincerely,
Susan Zorn, RN
Weekend Night Shift Nurse
blueheaven
832 Posts
My friend had her daughter at a large children's hospital for a vaginoplasty. She was born with many problems with her GI/GU tract and has had many surgeries. Nancy is an ICU nurse and the problems that she had with the care there was unreal. She had to constantly watch that she wasn't getting the wrong meds etc. Nursing staff were not knowledgeable about the meds. Amphoterrible was ordered and while nancy was getting something to eat, the nurse hung it and infused it too fast and J had a reaction. They sent the child home with an ileus (mom had told them she had no bowel sounds and had not passed stool through her colostomy and she talked to the attending). After a 2 hour ride home, they had to turn right around and take her back after vomiting 1500cc. SHEESH!
TigerGalLE, BSN, RN
713 Posts
Your letter to reader's digest sounds good. It really is absurd that "night shift" got the blame. I'm glad I wasn't the only one who was angered by this article.
classicdame, MSN, EdD
7,255 Posts
ACTUALLY, all the things cited in this article could certainly happen during the day. I do recommend a patient advocate when possible. No one is immune to bad care.
icuwant2rn
110 Posts
:angryfire :angryfire This article really angered me. How dare they try to place the blame for some poor childs death on night shift? His death had nothing to do with the time of day (btw he died at NOON) and everything to do with incompetency. It really flames me that they are pushing this off on the nurses, especially when they called a resident doc. Why didn't he/she have an attending come in to see this child, or at least run labs, a CT, ANYTHING?!?
Of course, s*#t rolls down hill, so it's always blamed on the nursing staff.
Susan9608
205 Posts
I've never seen toradol ordered as the only post-op pain reliever. I think that was part of the problem as well. After sugery in my hospital, physicians are required to order some kind of narcotic pain reliever for at least the first 24 hours.
I'm very sad to see that not a single resident could determine what was happening, not even the Chief resident, the one closest to becoming the "veteran" doctor. What does that say about their medical schooling and qualifications? It's not just the nurses who failed this boy.
smk1, LPN
2,195 Posts
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.
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.
As a nursing student this is a classic scenario that we are presented signifying hypovolemic shock from blood loss. I immediately thought he was bleeding as well. This is sad, still though I don't see that it was night shift at fault, a lot of things in the article don't seem right, (11 doctors mentioned coding the patient? Aren't there usually nurses, RT RPH on the code team?) Also there are a lot of patients with dementia and mental issues that groan and yell help all night for no apparent reason. I personally have been in the room "helping" a patient who continued to yell "help me lord" and thrash and did so the entire shift (apparently this is somewhat normal for her). So it can seem as though the staff isn't helping someone when they really are.