My father was hospitalized last Wednesday with CHF. And it was bad too. He has since lost 50 lbs of fluid, and he is still coughing uncontrollably.
So I had to finally go back to work today and I called him. He says that he has been coughing terribly all night and all day, and no one has been in to see him, and he can't get any rest.
I just called up to the floor to find out what was going on. His nurse was on break, but the fill in for her said that her notes said there were no problems and he is resting peacefully.
I nearly lost my damn mind. I got very nasty and said I want his nurse to call me back immediately, and when she did, she told ME that I needed to calm down and that they were doing everything they could for him. I fired back to find out what in the world she was falsifying his medical record sating he has no problems and is resting peacefully when he is anything but and she hung up no me!!!
I am so angry right now. I want to go and pull him out of there.
Sorry. This is very hard for me to watch. My father has not been in good health for years, and this was finally the straw that broke the monkey's back with the CHF. He is miserable, and doesn't have health insurance, and that I can't be with him 24/7 is driving me bonkers.
Sweettart, I do agree with those who have pointed out that it is difficult for you to be entirely objective, given your strong emotions and fear for your dad. I cannot blame you for that, and I sympathize with you, but if you want to achieve something positive, accusing his nurse without proof is not the way to go about it. Unfortunately, you've probably now earned the reputation of being a "difficult visitor", and I don't see any way of resolving that unless you do apologize.
I think you should call and speak to the charge nurse; explain to her your concerns, but also ask her to convey your apology to the nurse in question. Hopefully, that will serve two ends; to "rehabilitate" yourself in the eyes of the staff, and give the charge nurse a heads up to keep an eye on things. Other than that, there's little else you can do; the persistent cough may indeed be a side effect of the medication, but the doctor is the one you need to speak about regarding that.
My sincere good wishes to you, and hopes that your father makes a speedy recovery.
Sorry, just read some subsequent posts; you also need to assess whether your professional opinion is tinged with personal dislike; in other words, that you are not prejudiced against her, for whatever reason. If you can document specific incidents where she obviously gave sub standard care, then you have grounds to approach the Hospital authorities. You can't do that on feelings or personal dislikes, so you need to be very sure of your facts.
Daughter or not, that don't give you a right to accuse a RN of falysifying medical records!
And what is it that you have against this RN? If you feel she is not giving your father good care, you could have asked to have his nurse changed.
And what kind of RN are you (as in specialty)? Do you work a floor or do inpatient nursing? Because I can tell you if your father has CHF, he is probably on a tele floor. Which means he is being monitored and his vital signs should be taken q 4 hours and two head to toe assesments a shift. That's in addition to passing any meds and answering call lights for bathroom requests etc. And if this nurse has 3-4 pts that are ALL on tele, getting the same treatment as your father, then how much do you expect her to be in that room?
To say he is resting comfortably when you can hear him coughing down the hall is a false statement last time I checked.
I just spoke with my sister who has been there most of the day. She says he has been "coughing like crazy" and she has seen the nurse twice.
But, I am the one in the wrong, on this of course.
I strongly disagree with owing the nurse an apology, but I will concede to the possibility of him being started on lisinopril could be contributing to the cough, but he has had this cough for weeks now. (The buildup of the fluid, and the CHF.) If he states he is coughing, and is unable to rest, yet she states he is resting "comfortably" and is documenting this, how can the attending physician possibly be getting the correct information on treating this dry hacking cough, and if so, couldn't that potentially cause more damage? That is what I more worried about. Since I have observed her "care" for a few days now, I am not certain that she is accurately reporting information the way that she should be. I felt that she hung up on me because she got caught not doing her job, not because I was "out of line."
Say what you want, but I feel you were still out of line. End of story.
And do you KNOW if he used his call light to call out for not being able to rest? And if a pt is coughing that I know is on an ACE-I, I will offer guafensin as ordered, or call the doctor and request is to be ordered. Were YOU there when he was trying to rest and coughing and nobody attended to him? He could be coughing from the CHF or from the ACE-I, but that matter is, were you there to observe him NOT resting comfortably? My grandpa has CHF and he don't cough 24/7. It comes in spurts. And when he was in the hospital for it, there were times he did not have a coughing spell and was able to rest. Even at home, his coughs comes in spurts.
I seriously think that nurse charted what she observed. And it could have been what SHE observed at THAT time. And if your father don't use the call light and express his restlessness, how would she know he was having a problem resting?
You don't have to give her an apology, but you took it to a whole nother level when you accused her of falysfying medical records. That is what you are WRONG for in my opinion. And I'm not even gonna mention the yelling.
Perhaps, this nurse has just rubbed me the wrong way since she walked into his room. (Reeking of smoke- and maybe that's what turned me off from day one. A nurse on a cardiac floor who smokes- major red flags.)
I just want my dad to be alive for a few more years. Is this too much to ask for?
Don't any of you want only the best for your loved one?
This is all I am asking is for top notch 100% care for my old man. I love him more than anything and to lose him would just about kill me.
OP, :hug: Here's what I'd do (have done) and you might too. Get a shoulder bag. Put in bag: stethoscope, BP cuff, thermometer, penlight, pulse ox. Take bag and go give your Dad a complete physical tonight when you go visit him. Don't announce you are going to do this, CALMLY go in to see him. Don't stop by the nurses station and announce who you are. Go in street clothes. You know what your doing, so do it! If a nurse stops in say you are a nursing student and this is your dad. Just tell dad that it feels better if you check too.
Take your data IF IT IS OF SIGNIFICANCE and call the hospitalist. Don't deal with nursing. Remember, nursing does not write orders. So even though I am a nurse, I am a second degree nurse, and when I see what I don't like (and have knowledge to know), I go over everybody's head like I would/will always do as a corporate chick and get it done ... calmly with data, and present my case, short and sweet. Now, if you don't get the hospitalist, fine. Call the DON and meet with h/her calmly (keep it short of relavance and sweet), skip the smoker nurse comments.
To Allnurses Peeps! It is a FACT that someone inpatient w/o insurance will likely not be watched/given the whole shabang as someone with insurance would in many hospitals. I have advocated with hospitalists and other nurses for folks without.
To say he is resting comfortably when you can hear him coughing down the hall is a false statement last time I checked.
I just spoke with my sister who has been there most of the day. She says he has been "coughing like crazy" and she has seen the nurse twice.
But, I am the one in the wrong, on this of course.
Like I said, I'm quite sure he is taking an ACE-I for the CHF. Coughing is one side affect of this classification of meds. If your sister is there, why havent she asked to speak with the doctor regarding his coughing? Ask if he has been given a cough suppressant.
And again, if you are so displeased with this RN's care, why havent you asked for another nurse for your father? Why havent you spoken with the charge nurse? Why have YOU yourself spoken with the doctor?
And that nurse is probably avoiding that room at all costs based on the conversation you had with her on the phone.......
Specializes in Oncology/Hematology, Infusion, clinical.
Ok, I give up. I have tried to constructively respond to your initial post, as have others, and I don't see anything positive coming from it. I'm not sure what kind of responses you were expecting, but it is obvious that you haven't received them.
I totally understand why you acted as you did, and you feel as you do, but I can't reassure you that you were right in your actions. What can any of us say, short of agreeing with you that your actions were appropriate, will help to make you feel better? If it is support or empathy for you regarding such a difficult event in your life, I'm more than willing to offer such to you. Please let us know.
To Allnurses Peeps! It is a FACT that someone inpatient w/o insurance will likely not be watched/given the whole shabang as someone with insurance would in many hospitals. I have advocated with hospitalists and other nurses for folks without.
BS. I don't even know my pts' insurance status, unless they tell it to me.
How is the daughter supposed to know about what meds the pt is on, what assessments the nurses and physicians have been performing, tele readings, the vitals, lab and radiology results...and how is she supposed to contact the physician with her assessment? Are you kidding me? The doc would just roll his eyes if she somehow gets his number and calls to say that he has moist crackles in the bases and 2+ pitting edema and what exactly is he going to do about it stat? Do you honestly think a nursing head to toe assessment is going to somehow change her father's plan of care, and that that particular action is somehow warranted or will be welcomed by the physician? For goodness sake.
OP, I'm glad you're calmer. Of course everyone wants the best care for their loved one. No one has argued about that.
It's within your rights to request another nurse, if you think that's best. Why not talk to the charge nurse? Tell her what you've seen, and what your father says.
I want to throw out there, though, depending upon their staffing matrix, the nurse may not see the patient hourly. If there is an aide assigned to that pt, it may be entirely normal for that floor for the nurse to primarily do assessments and med passes, with the aide performing most hygiene, vitals, and rounds, particularly if your father is stable.
You are going to be way more effective if you go in there, ask to speak to the charge nurse, and calmly and factually detail your concerns. If you lose your temper, jump to conclusions, and put everyone on the defensive, quite frankly, your concerns will most likely be disregarded, whether they are justified or not. If you remain calm while discussing your concerns, you are more likely to see positive results, or at least be able to have a reasonable discussion of unit routines and expectations.
To Allnurses Peeps! It is a FACT that someone inpatient w/o insurance will likely not be watched/given the whole shabang as someone with insurance would in many hospitals. I have advocated with hospitalists and other nurses for folks without.
I honestly don't know, nor do I check to see who has insurance and who does not. If it's not glaringly obvious, I don't usually even know the insurance status of my patients.
Yes, I know there are different outcomes for patients who have insurance vs those that don't (based on trends, preventative care, socioeconomic status, etc.), but you are insinuating that this patient is getting different treatment BY THE NURSE because he does not have insurance. If you were to say this to me, I would be completely insulted.
AND I WOULD NOT advocate going past the nursing staff if I had a concern about my father's care. Go up the chain of command - in the appropriate manner, but do not completely bypass the nursing staff. It undermines the nurse's role here.
:confused:
SweettartRN
661 Posts
Why is everyone missing out on the fact that I have observed this woman for at least 3 days of providing sub par care to my father already?
Good grief Charlie Brown.