Seriously Ill Patient vs A New RN Who Clearly Did Not Know How To Work in That Area

[FranEMTnurse]

This happened to me about a year ago. I have several serious life threatening conditions that affect my heart and my lungs.

This particular time I was hospitalized is serious condition after waking up around 04:30 AM gurgurling on my own blood, and was desperately gasping for breath.

The Medics gave me 15 litres of oxygen via non-rebreather mask, and rushed me to the ER. My heart was tachy, and it felt like it was going to jump out of my chest.

As the X-ray tech came to take X-rays, I vomited about 2 1/2 quarts of blood. After I was stabilized, I was placed in a room on 6 litres of oxygen.

This happened about a week before Memorial Day weekend, and it was very hot and humid at the time, but was too early for the hospital to turn on the AC.

I was alright laying flat, and on the 6 litres of oxygen, but when my Pulmonologist entered my room a few days later, he turned down the oxygen to 2 litres, and placed me in the high fowlers position. Everything turned black, and I felt like I was going to pass out, and my heart began to race again. When my Physician and my Pulmonologist saw what happened, I was immediately placed in the TCU, with a monitor placed on me.

Then when Memorial Day arrived, my kidneys began to fail. How do I know? Because what small amount of urine I was putting out was black.

I was so uncomfortable, I eventually asked my nurse, (a GN who clearly did know which end she was supposed to think with,) to please place a cold washcloth on my feet to cool me down. She placed a sopping wet one on my feet, and it made me even more uncomfortable.

A short while later, an 8yo was wheeled in after being ejected from a van in serious condition following a head-on crash with a motorcycle. He died a short while later. How do I know? Because the charge nurse, who had a very loud voice, said; "He's gone."

Needless to say, I did not need to hear that, nor did I want my door wide open without my curtain drawn, and the hall light blaring in my eyes.

I rang my callbell, and asked her if she would turn off the hall light. She said she couldn't do that. So I asked her to pull the curtain so the light wouldn't blare in my eyes.

Her response; "I can't do that, because I need to watch you." My immediate thought was; " Wonder where you went to school, and how much homework did you do, or are you brand new, and not yet trained?

That was the worst experience I had in that hospital. When I mentioned about the boy dying, she asked me if I saw it on TV, or read it in the paper, I told her neither, but I just had a clear show-and-tell experience about it.

After I got discharged, I asked my doctor to please put me on hospice. I did not want to ever even see the inside of that hospital again.

Well, a few months later, I was back in there, but in a much more comfortable room. In fact it was private. But when they came to transfer me into the accute care area, I asked them if they hire brand new graduates and place them in the TCU for training. I said they did not belong in there until they learn something first, because they are placing peoples' lives in jeopardy.

After they got me into the Accute care area, the one nurse whispered in the reveiving nurse's ear about treating me with TLC, because I was onto them.

Is this standard practice in other hospitals, or is this dumbbell experience I had just an isolated incident?

[widi96]

Our ER and ICU leave curtains open - if you are truly that sick - they need to be able to see you. I understand you were sick, but it sounds like you are being very judgemental. This new grad didn't screw up your meds, didn't miss something on your assessments. She gave you a washrag you asked for a little wetter than you preferred - therefor she's incompetent? I don't think so. Besides, even if she were new, everyone has to learn at some point. If there weren't people who were new at this at some point or another and were given the opportunity to learn, there would be no one there to take care of you now.

As for complaining about the 8y.o. - the staff was probably busting their asses to save him and he lost his life - but lets all be concerned about YOU.

[goats'r'us, ASN, RN]

i'm sorry you were so unwell and uncomfortable, but really, i think you're being a bit hard.

like other people have said, i don't think the nurse in question's actions really deserve her label as a new RN who clearly did not know how to work in that area. an overly wet washcloth, though i do understand that you were very ill, stinking hot, and probably felt like crap, is not really such a bad thing.

similarly, it's a sad fact that curtains are not walls. they don't block out snoring or bedpan noises, and sadly, also can't block out the noises of people trying to save a life. i expect that having to code an 8 year old is tough, emotionally taxing, and noisy. if i was the charge nurse, i'd probably be very upset at the loss of life, and would probably lose my volume controller a bit. once again, bad that it happened, bad that you had to lay there listening, but overall, not really the mark of incompetence.

and, like others have said, leaving the curtains open and light on sucks, is disturbing to your rest, makes you feel worse, etc, but, well, you're really sick and if you need watching, you need watching.

IMO, one of two things has happened here.

either the nurses really were incompetent, wrong, whatever, and you just haven't really painted an accurate picture for us, or

the nurse's actions were not how you'd act in the same situation, and coupled with your being unwell, hot, uncomfortable etc, little things that you didn't like became really big things.

whichever way, glad you're on the mend now, i never like to hear of one of my kind having to be on the recieveing end.

[Smackdown]

In the ICU I work in - we do not close the curtains except during procedures, etc.. I understand that a patient may feel more comfortable with the curtain closed, but their comfort comes second to me being able to monitor them. It is my understanding that this is standard in all the ICUs in my hospital.

[BBFRN, BSN, PhD]

Fran- were you in the ICU or ER?

It was my understanding that you were in TCU?

[oramar]

Yes hospitals do use inexperienced nurses in critical care areas. They do it because that is all they can get. Which means you had two choices, inexperienced nurse or none at all.

[bagladyrn, RN]

(((Fran)))!

That sounds like a really awful experience for you! I think sometimes it is harder on us because we see all the things that we would handle differently, and are extremely aware of the reality of what is going on around us in these situations. That had to be emotionally wrenching to witness when you were so critically ill yourself.

I know that sometimes ( more and more frequently) a newer nurse with minimal training in an area will be pushed into working that area by admins who se "a nurse is a nurse". An uncomfortable situation at best for the nurse as well as the patient who is able to recognize her discomfort. I can't say this was what happened to you, but if you have concerns after this long it would probably do you good to write a letter to the hospital about this, then decide whether or not to mail it.

Hope we see more of you around again - I always enjoy reading your posts.

[RosesrReder, BSN, MSN, RN]

Fran, I am so sorry about your health. Please take lots of care, get well and be back posting some more jokes..........I miss them

[FranEMTnurse, CNA, LPN, EMT-I]

I know from reading here at allnurses.com that you've had a long & difficult health history that gives you great insight into patients' experiences. We can all learn from this.

Your specific complaints about your GN were 1) the curtain not being pulled and 2) the washcloth being wetter than you would have liked. I wasn't there, but I don't know that those 2 items would cause me to label a GN, or anyone, incompetent.

BTW, we don't pull curtains or close doors of the rooms of our ER patients either except when it is obviously appropriate (patient dressing/undressing, being examined, procedure being performed which exposes the patient, or talking/teaching about a difficult subject) or a staff member is in the room. All kinds of things can happen behind closed doors/curtains -- falls, pulling out lines, etc. I can't monitor what I can't see. It is a shame that the curtain wasn't pulled around the boy who was the trauma patient.

I wish you well.

Issue 1. The curtain not being pulled; I was located right by where the telemetry machine and the nurses desk were located. Just one room up, same side. The overhead light in the hall was shining in my eyes. When I was an EMT, we (at least in New York state) had to learn the rhythms before being certified in defibrillation. Not AED either; the old fashioned, 12 lead way, plus I was a CPR instructor.) Now that is why I, but (maybe not true for other states) assumed RNs would be taught 12 lead rhythms, and how to read them without checking on the patient. I have been in that unit many times, and the RNs always closed my door so I could get some rest.

Issue 2. The AC wasn't yet functional. It is turned on by an automatic set time of year. It was a week in the 90s, a very unusually hot week, and I was seriously ill. I was even unable to raise my head without passing out, and my heart being tachy.

I was extremely uncomfortable, and was why I asked for a cold, wet, washcloth to be placed on my then very hot feet. In retrospect, I believe I should have clarified slightly damp only. If anyone has ever awakened from a dead sleep with a sopping wet that person would understand what I was talking about.

Admittedly, it wasn't the worst thing to have happened to me that night.

The worst thing was having been subjected to the 8yo's death. I didn't see him by the way, I heard the nurse loudly pronounce; "he's gone." Then when they brought the transport gurney by my door with him on it, I did see the outline of his small body.

And finally, the ER is not PCU.

When I was in training, we were told not to discuss medical issues or patient experiences in the elevator, because we didn't know who was listening; nowhere else.

[FranEMTnurse, CNA, LPN, EMT-I]

Fran- were you in the ICU or ER?

It was my understanding that you were in TCU?

That's correct.

[Altra, BSN, RN]

When I discuss "monitoring" my patients, I am referring to more than their cardiac rhythm.

I wish you well.

[FranEMTnurse, CNA, LPN, EMT-I]

i never like to hear of one of my kind having to be on the recieveing end.

I understand that. I went to school and became a nurse too and most of my friends are nurses. In fact, if you read some of my earlier posts, you will see that I back nurses up all the way. I believe they are the soldiers on the frontline of hard work, keeping doctors happy by clearly following their orders, sometimes even saving the license of an MD because he ordered the wrong medication or was about to perform the wrong procedure on the wrong patient. Too bad you didn't read my earlier footnote. I love nurses, I love nursing, and I loved being a nurse. In fact, this is my favorite website. I have been in healthcare myself as either a nurses aide (before certification was required) but even helped with foley cath insertion, and giving out meds. after that I was an EMT for 18 years, taught CPR and Basic First Aid for several years, and even helped with clinical instruction in the EMT classes.[/i']

[reesern63, RN]

This happened to me about a year ago. I have several serious life threatening conditions that affect my heart and my lungs.

This particular time I was hospitalized is serious condition after waking up around 04:30 AM gurgurling on my own blood, and was desperately gasping for breath.

The Medics gave me 15 litres of oxygen via non-rebreather mask, and rushed me to the ER. My heart was tachy, and it felt like it was going to jump out of my chest.

As the X-ray tech came to take X-rays, I vomited about 2 1/2 quarts of blood. After I was stabilized, I was placed in a room on 6 litres of oxygen.

This happened about a week before Memorial Day weekend, and it was very hot and humid at the time, but was too early for the hospital to turn on the AC.

I was alright laying flat, and on the 6 litres of oxygen, but when my Pulmonologist entered my room a few days later, he turned down the oxygen to 2 litres, and placed me in the high fowlers position. Everything turned black, and I felt like I was going to pass out, and my heart began to race again. When my Physician and my Pulmonologist saw what happened, I was immediately placed in the TCU, with a monitor placed on me.

Then when Memorial Day arrived, my kidneys began to fail. How do I know? Because what small amount of urine I was putting out was black.

I was so uncomfortable, I eventually asked my nurse, (a GN who clearly did know which end she was supposed to think with,) to please place a cold washcloth on my feet to cool me down. She placed a sopping wet one on my feet, and it made me even more uncomfortable.

A short while later, an 8yo was wheeled in after being ejected from a van in serious condition following a head-on crash with a motorcycle. He died a short while later. How do I know? Because the charge nurse, who had a very loud voice, said; "He's gone."

Needless to say, I did not need to hear that, nor did I want my door wide open without my curtain drawn, and the hall light blaring in my eyes.

I rang my callbell, and asked her if she would turn off the hall light. She said she couldn't do that. So I asked her to pull the curtain so the light wouldn't blare in my eyes.

Her response; "I can't do that, because I need to watch you." My immediate thought was; " Wonder where you went to school, and how much homework did you do, or are you brand new, and not yet trained?

That was the worst experience I had in that hospital. When I mentioned about the boy dying, she asked me if I saw it on TV, or read it in the paper, I told her neither, but I just had a clear show-and-tell experience about it.

After I got discharged, I asked my doctor to please put me on hospice. I did not want to ever even see the inside of that hospital again.

Well, a few months later, I was back in there, but in a much more comfortable room. In fact it was private. But when they came to transfer me into the accute care area, I asked them if they hire brand new graduates and place them in the TCU for training. I said they did not belong in there until they learn something first, because they are placing peoples' lives in jeopardy.

After they got me into the Accute care area, the one nurse whispered in the reveiving nurse's ear about treating me with TLC, because I was onto them.

Is this standard practice in other hospitals, or is this dumbbell experience I had just an isolated incident?

Without meaning to be insensitive, my question would be why you are bringing this up a year after it happened? While what that new nurse did wasn't exactly the greatest, I wouldn't exactly call it incompetence.

Is there something else going on here?