other side of the coin. again.

[mmc51264, BSN, MSN, RN]

I wish I was a gifted writer to write a profound article about being on the receiving end of care.

My son was hospitalized for the second time this year for dka. This was a very mild case and really wanted to come home. His anion gap was just high enough that they wanted him to stay. So I agreed.

He got there at 1600. I was working so my husband brought him in-I met them in the ED. They don't mess around with dka so we went back to a room in less than 5 minutes. They got vs, BG, labs, IV started etc. First red flag was the float nurse rambling on about what a crappy place it was to work (I have my badge on, too-plus I am dealing with a sick child). I almost had to tell him to SHUT UP. I let it go.

revolving door of residents and the finally endo comes in. This was about 1800. Still ok. tells us of the plan, very nice man. Tells us one more CBC/BNP to make sure heading in the right direction. Child is NPO at this time. Last meal was lunch.

2100, they tell up we are not going home, get the "don't worry your pretty little head about it" from the resident. Starting to get upset that this "doctor" will not be straight with me. Did not dawn on her that as a nurse AND the parent of two Type 1s that I know the drill as far as anion gaps, bicarb levels, pH, etc. Send hubby and son #2 home.

Sick child is hungry. Has not eaten in 9-10 hours. they have no food for him. I have to outside to go back into the main hosp to get subway-only thing available at this time.

Every time child needs to void, I have to ask for a urinal. Found the used ones under the sink in the room (wth?)

0300 "Admitting team" comes in to complete the admission. Point out to them that child has not had ordered fluids running for about 3 hours. "Oh!" I guess we need to fix that. duh,

Then we have a random 4 unit dose of insulin and no one can tell me the rationale as to why child is getting it. it is not a mealtime or SS dose. Do you give meds that you do not know why? I do not.

By 0530 cont glucose monitor is alarming for low BG (67) call for food They bring him an appropriate snack to bring it up, but I wanted breakfast for him. I get a menu, call dietary and get a lecture that ED pts don't get fed no matter how long they are there. I explain that my child has been admitted, there just were no beds available. They tell me the nurse has to place the order.

Now it is 0645. SHIFT CHANGE! call HUC for help and get yelled at again that he can't order a tray, they just send whatever up. I explain that is not what I was told-continue to get fussed at. Asked to speak to Charge so I could get food for little boy who has eaten very little, slept very little and been stuck a bunch of times. 0830. no one has shown up.

I call ped endo on call as the last time I was there was a HUGE fiasco and they asked me to call them if I had issues. get the same nice gentleman Dr. from the night before, at this time I am crying. I am crippled from trying sleep on a stretcher. I wish someone had taken a picture of the two of us curled up on this stretcher using his hoodie for a pillow and the cloth chucks pad as a cover (no blanket or pillow offered).

Doctor tells me he is going to get me out of there. Child eats stale turkey sandwich that they rustled up for him at 2100

Now I ask about insulin coverage for the food he did eat. They only have SS ordered.called endo again

Straw that broke the camel's back this time-day nurse does not understand that child has eaten, gave her the carbs, mind you doctor's orders are in. Finally she understands that he is getting 5 units. Went to give it. IM. just started to cry again. and asked fro d/c papers.

Charge nurse comes in and I tell her it is not worth it to speak with her. The problems are so systemic no where to begin. She saw the urinals on the floor, I told her about the food issue.

My issue is this: how do nurses and providers treat patients and families this way? I cannot believe that I am the exception to the rule. Not only was my child offered anything to drink, as a courtesy, not one person asked me how I was doing. I was visibly upset. What kind of nurses are being turned out these days?

I have been a nurse for only 5 years, but I am older. I have compassion for pts and family. I felt totally abandoned.

I just wonder for those of you that have been on the opposite side of nursing, have you had good experiences? This is the second time in 3 months and the first time was worse than this one. there has been one or two nurses that were great, but the majority acted like they couldn't care less that my child hadn't eaten in 9 hours, that he needed breakfast, how to give a SQ insulin shot.

Sorry this is so long, but I feel so defeated that the place that I work at, treats patients so poorly. And of course there is nothing to be done. Hollow apologies. I hope that someday, those that had little concern for my child, do not have to go through what I have to go through and get let down by one's own colleagues.

I am supposed to have surgery there later in the summer and now I am worried.

If you lasted this long, thank you. Please remember that that mom, or child, or grandma, or brother, is a person. They are scared. They are uncomfortable. Please help someone like me next time.

[amoLucia]

My deepest sympathies that such an ordeal happened to you & your family. It is an embarrassment to many of us that such sub-par care was rendered.

No need to wish you were a 'gifted' writer. This post makes your point very succinctly and eloquently. I suggest that you provide the hosp Administration and all the involved depts (incl Customer Relations) a copy also. They really do need to address your care issues BIG TIME and FAST.

I would also be specific with the post-hosp survey. I'd be curious what their overall ratings have been.

Since you are an employee there also, I would tread gently. They need to consider this as an opp'ty for QI improvement. One can only HOPE they do.

(((Good luck.)))

[Libby1987]

I'm sorry for all of it. Hope your boy is doing better.

[RNperdiem, RN]

I am the mother of a chronically ill child and am familiar with the insides of all the emergency rooms and pediatric departments in the area, so am familiar with the stress of dealing with kids and their health issues.

The care has always been excellent. A couple of things that have helped me:

Periodically, get outside and take a break. Seriously. Get your friend, husband, parent or someone else to sit with the child while you go get a cup of tea and sit outside or watch the fish in the lobby fish tank. Things that seemed trivial just get magnified if you never leave the bedside.

This one sounds a little strange, but have a mental plan of what to bring to the emergency room. In my case it is a phone charger, a couple of grab-and-go snacks, and an easy to read/skim book. Some cafeterias close early, so vending machine money is a good idea.

I learned how to politely make needs known and ask for what I want. "Excuse me, my son needs to use the bathroom, could you please bring a urinal?" Staff can get distracted, and what is obvious to you sometimes needs are not obvious to them.

Lastly, are there other emergency rooms/hospitals in your area he could go? Is there one that is specifically a pediatric emergency department?

[OrganizedChaos, LVN]

I know the ER in the hospital in my town is known to be horrible. The staff is rude & judgemental. But the other departments (OR, L&D, ICU & med surg) have really great staff.

[klone, MSN, RN]

This is a systemic problem. EDs everywhere are incredibly understaffed, both nurses and providers. It's a national issue that has reached crisis levels.

[mmc51264, BSN, MSN, RN]

I talked to the charge nurse about issues but I am not going further with this. The last hospitalization was way worse, but they saved his life. I spoke with patient relations. They do nothing but send you a letter about how sorry they are.

Nothing is going to change. this is a large, very good teaching hospital with some of the best doctors ever. It is one of two hosp that have spec ped ED, which we could go to in another type of emergency, but our physician, who is wonderful, is here.

Just have to put up with it. I guess. 24 hours after being home, I feel like I have been hit by a truck.

As the thought that ALL ED's are short-staffed. I work short staffed but we manage to get things done. I think the systemic issue that new grads want ED or L&D. There are an abundance of newer nurses and I think they just don't know what to do in a non-urgent setting. The fact that the nurse was going to give SQ insulin IM is a little scary to me. that is a fundamental.

I recently had a different experience in my life where I was reminded of the phrase "Expect nothing for you shall never be disappointed" This was yet another reminder of that.

Thank you all for your support. Bottom line is that my child is alive. the rest is fluff.

[SaltySarcasticSally, LPN, RN]

I am so sorry this happened, how awful

I haven't had this experience with my child but with myself. I have Crohn's that went undiagnosed for a long time. I would get flares, which I didn't understand that's what it was at the time, and I would end up in the ER ever so often due to dehydration, pain, and passing out from low BP. I can't tell you the amount of times I was treated as if I were a drug seeker or overreacting. It was pretty upsetting to not be believed but it taught me a really great lesson as a nurse. That the most important thing I will ever do for a patient is for them to know I am on their side, whether I think they are "overreacting" or not. So that's what I do, even if they are only in my care for 10 minutes, I am "their person", and I will do whatever I can do for them in that time to comfort them and advocate for them. Of course it's not always easy but when it isn't I remind myself of my own experiences and how isolating it felt to be treated like I was making up my symptoms for drugs when I have zero past history of substance abuse.

Not trying to generalize but I have noticed that teaching hospital ERs can be a rough experience if not there for a major trauma. Our local mantra for the University hospital is "Take me if there I am shot or dying but anything else take me to the private hospital down the road!". I am glad your son is better, hugs to you both!

[canoehead, BSN, RN]

I don't think the care you got was acceptable. Individual issues I thought, well such and such might have happened, but it should have been communicated! My particular hospital, if you try to order from dietary and they aren't in a breakfast mood, you aren't getting it. You'll get what they send you, when they feel like it. But we have snacks in the ER. Not good stuff, but enough.

I think the idea to bring a bag was wonderful. Snacks, and darn it, your own insulin/syringes! You don't ever have to use them, but you'll know they are there. Make a list right now, and put a copy where a friend could find it and bring stuff to you. Sounds like you need to bring your own pillows and blankets too.

I suspect you had a new nurse. A seasoned one would have been able to cover you on a lot of your needs, or at least recognized that you could use an extra blanket and pillow. And giving insulin, but not knowing why...really? That screams new grad just following orders to me. I'm glad you spoke up, and even happier that you are home safe.

Just wanted to add- ASK for blankets and pillows, and follow the nurse so you can help yourself next time. Sneaky, but much easier on you.

[mmc51264, BSN, MSN, RN]

Actually, they offered to bring the pillows and blanket. They just never brought it. normally I would have known where stuff is, but the ED is set up very different than the floor units.

At the point where it was 0300 and no one seemed to give a crap, it was principal of the matter at this point. The night nurse was good. I liked her, she just forgot about the non-important stuff. I was a little annoyed that she couldn't come and order him breakfast, it was 20 min before shift change. It would have taken a minute. Then I knew that it would after shift change. the day nurse, who I think was new, didn't show up until after 0800. They didn't round on us or do bedside report-both are required. Oh well.

[TriciaJ, RN]

Giving insulin IM? How many other people has she done that to? I don't care if she is new; that is just basic. What else doesn't she know how to do? Very scary. If you got her name, you should contact the BON. Seems mean, but that person needs remediation before she kills someone.

[DeeAngel]

This letter should be signed and send to the head of the hospital.