Hi all, I am a new RN and am curious about some experienced RN's perspective on this topic. My dad recently had a very debilitating stroke. We have been to 6 facilities in 5 months and I have seen the good, the bad, and the ugly of nursing staff.
Often I find myself having to remind the nurses to float his feet for pressure wounds and turn him every 2 hours. He has been left in soiled diapers for longer then is acceptable among other communication issues.
I draw a line this past weekend when I went and asked to speak to the charge nurse just to get more info since his assigned nurse was an agency nurse and didn't know much about his history or long term care plan. She acted so unprofessionally. If you have a moment to read our dialogue it is below. (It is typed because I intend on sending a complaint to the company.) If you want to skip that part I totally understand.
[[[Nurse entered his room and immediately had an attitude which was demonstrated in her tone of voice and dismissive body language. She stated You asked to see me, what can I do for you?†and I responded by stating my observations of the treatment of the heal. I stated that there were 3 nurses sitting at the nurses station (one of which had their phone out) and she immediately interrupted me by saying I don't have 3 nurses so that's not true.†I responded by saying Well I saw 3 people at the desk none of which offered to assist with my concerns.†She interrupted me by stating What is your point, get to your point.†I stated My point is I came in and his heal was flat on the bed with a soiled bandage and I want to make sure it is off the bed as prescribed. There is available staff that are capable to attend to this task.†She interrupted me by stating I know you're a Registered Nurse so you think you know but I know how to run my floor and we are doing everything we can to assist him.†I asked to then speak to her manager who was currently unavailable. I asked her to please stick to the concern which was the wound as it had a green drainage that could indicate infection. She stated If the patient had an infection he would have a fever.†I responded by saying A fever is not the only systemic change a patient will have with an infection.†She interrupted me and stated I am not going to play this game with you. What else do you need?†I was completely floored at this point and requested she leave the room and please remind her staff to keep his extremities elevated.]]]
None the less, how do you balance being a nurse and having knowledge on how things should be handled versus being a concerned family member and letting things slide because you know how the system works? I am so disappointed in how some nurses have acted and feel sometimes (with any job) when you have been doing it for so long you really probably shouldn't do it anymore if you lost your passion.
Katiemi if you continued to read my post I stated "Both pressure wounds and cdif as most nurses understand are due to not being turned and most of the time poor hand hygiene from room to room." which I meant pressure wounds are from not turning and cdif are from poor hand hygiene. Sorry if that was not clear.
Katiemi if you continued to read my post I stated "Both pressure wounds and cdif as most nurses understand are due to not being turned and most of the time poor hand hygiene from room to room." which I meant pressure wounds are from not turning and cdif are from poor hand hygiene. Sorry if that was not clear.
There we go:
Up to 40% of C. Diff. symptomatic infections are community- acquired
and, as a cherry on the top, there is no good evidence that washing with soap and water, while being superior in removing spores, can actually help to control C.diff outbreaks
In short, good hand hygiene is, well, kinda helpful but, sorry, not defining for anything. Just like everything else, for that matter. Putting stop on treating sepsis by "criteria" and pouring wide-spectrums like tap water is long overdue.
and, as a cherry on the top, there is no good evidence that washing with soap and water, while being superior in removing spores, can actually help to control C.diff outbreaks
In short, good hand hygiene is, well, kinda helpful but, sorry, not defining for anything. Just like everything else, for that matter. Putting stop on treating sepsis by "criteria" and pouring wide-spectrums like tap water is long overdue.
Soooo not the point.
OP, I think you have handled this very well - the good, the bad & the ugly. Thinks for taking the constructive answers gracefully and for ignoring the rest.
Specializes in LTC,Hospice/palliative care,acute care.
No one can ever take care of your loved one in the manner you would,that's a given. Please remember the staff see sad situations all the time,if we 'felt all the feels' we would have nothing left.Parents and spouses die,usually after months of issues.Most of us have been through it ourselves.
Specializes in Psych, Addictions, SOL (Student of Life).
Both pressure wounds and cdif as most nurses understand are due to not being turned and most of the time poor hand hygiene from room to room
Both these statements have elements of truth but show that you do have a lot to learn. There is a whole lot of factors that go into the development of pressure ulcers. One of the biggest is nutrition. If a patient is not eating enough and goes into a state of protein catabolism wounds can form. In fact our wound doc who is top notch says that the best turning program in the world can't stop a wound from forming in a malnourished client. Throw in a couple of chronic diagnoses like diabetes and COPH, HTN etc and you have a recipe for would development. Yes turning is important but is not the first line of defense and is old school. C-diff is another bug completely. If your dad has it he most likely caught it in the acute setting where it is as common as MRSA and mostly the result of aggressive use of ATB therapy in persons who didn't need ATB in the first place. Yes hand hygiene plays a role but if you look at C-diff under an electron microscope it actually has little Velcro gecko feet that stick to just about any surface - shoes, cloths, laundry etc... even when isolated most people do not properly don and doff isolation gowns and equipment and the worst offenders in this area are family members who I constantly have to remind to follow isolation precautions when they wander from a the patient's room with the iso gown and gloves still on. Most of the patients we see with C-diff are colonized by the time they get to LTC and to really get rid of it takes months of treatment by an infectious disease specialist and at least in our facility they still get PT in their rooms and yes even people with foot wounds get PT and can walk with the appropriate dressings applied. I see it every day.
4. Being on phones is a risky behavior because it is all about perception. In my eyes regardless of what profession if you are on your phone you have time to be doing anything else. All I ask is simply peak your head in the door and make sure his feet are propped.
Although I did expect some negative feedback I am curious to know how some nurse's can become so numb to situations. I am brand new and still have a soft heart so to speak and I hope to never lose it. Through this experience I have really encountered some nurse's who I question why they are nurses but I guess that is with every profession.
Thank you everyone for your posts. Opinions are always appreciated.
I just want to address this point. I am an on site liaison at a hospital for a home infusion company. My iPhone (owned by my company) is my only means of communication. If I am on the phone, I am coordinating patient care. I may be speaking to a case manager or the pharmacy. If I am looking at my phone, I am emailing about patients. Being on one's phone does not mean one is not doing work. Sometimes I sit at various floors' nursing stations. I am not a nurse on those floors and will not overstep my bounds and go into a random patient on the floor's room. The charge told you that there couldn't have been 3 nurses sitting at the station on their phones because there weren't three nurses on. Those people could have been anyone.
It is really hard to try and relay an experience that has been going on for months especially in text. When my dad first had his stroke I took a 3 month leave from work to be at the hospital with him and take care of him. In the time I was off the nurses LOVED us. They loved us because we brought donuts every morning and fraps from Starbucks for the floor. They knew they didn't have to worry about the patient because there was always someone there. I did his bed baths and turned him. I provided pretty much all care that didn't require an order and built a relationship with the nurses in a way that they all rooted for me as a Nurse. I did not have to hide the fact that I was a nurse. It was great!
As soon as I went back to work and could not follow him to every facility (again due to insurance coverage) is when we started having problems. 3 bed sores, 3 rounds of Cdif to date, fractured legs, 2 falls, pneumonia. As a family member who has some knowledge of nursing (I agree I am new so not a lot but at least some to get me by) it is extremely hard to watch him deteriorate and not be able to do anything about it. It is even worse that I have to fear saying anything because I am a nurse and have no right to judge the care he is given.
I have experienced lack of empathy and robotic care from nurses and while again I totally understand I am a new nurse and cannot possibly understand yet what it feels like to have 5/6 patients a day it still makes me sad for my dad that the people he sees everyday treat him like a number instead of a person. This is not every nurse as he has had some wonderful nurses. I am so thankful and blessed to have met some of the best nurses to date through this experience. It makes me sad that some nurses have responded on here with such a lack of empathy or remorse for the patient rather just defending why the scenario I described is acceptable and how I was out of line for bringing it up with the charge nurse.
Maybe I am naïve but I became a nurse initially to help but now after this experience I have been more determined then ever to be a nurse so I can hopefully make someone's worst day a little better. I just ask that some of the tenured nurses who have made some pretty harsh comments on here step back and think about the patient for a minute and not the job and try and put yourself in the patient's and their families shoes.
I have learned quite a bit about how I will react moving forward from these great responses and I appreciate those of you who have provided gentle constructive coaching versus those who seemed fairly malicious in nature. I truly appreciate it. I hope I encounter wonderful nurses like y'all in the future!
What the heck?? What a course your dad has been through!
I'm stumped that it's the heel floating that you initially posted about. Your dad's needs far exceed floating his heels will even scratch the surface. And why is he not in heel suspension boots?? Do I need to mail them myself?
Not really, my post is pretty accurate to his current condition. He currently has the cdif and 2 pressure wounds. He had one of the worst strokes the doctor has seen (his words, not mine). We are just trying to take it day by day.
The crazy thing is is that when I walked into his room and saw his feet flat on the bed his heel suspension boots were on the floor! I know I am not perfect and definitely can say I am stressed and emotional but it is hard to not be so frustrated when there are little mistakes like that being made.
I agree with you, especially about the nurses on phone business. I see that a lot at my work and no they are not using calculators, nor using timers. They are texting and playing on FB or Utube. I find it unprofessional and a selfish waste of time. I am just an LPN, but I take my break out side of my unit and notify the staff I am taking my break. When in my unit I tend to my patients needs and those duties required by my facility, i.e., charting. You may be young, but you have good values, that are slowly disappearing in todays youth. God Bless you and your dad. A stroke is one of the most difficult illnesses to deal with IMO.
Mommy_RN1211
236 Posts
Katiemi if you continued to read my post I stated "Both pressure wounds and cdif as most nurses understand are due to not being turned and most of the time poor hand hygiene from room to room." which I meant pressure wounds are from not turning and cdif are from poor hand hygiene. Sorry if that was not clear.