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.
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.
:confused::confused::confused:
I totally understand your concern. My grandpa is 74, has CHF, has COPD, has had a MI with stents placed and I love him to death!
He has been hospitalized more times that I can count for all his health problems, we almost lost him a few years ago.
Yes, emotions get involved because it's your family member. I understand that. But you have to try to control those emotions when dealing with the nursing staff. It makes better for all those involved.
When my grandpa was in the ICU, I was the contact person for the family. I didnt tell the staff I was a RN, I sat back and observed. I cried a couple of times, and my emotions got the best of me. If it wasnt for the nurse he had, I probably would have lost it. She was awesome and even gave me a hug. In return, I was trying my best to be the easiest family member to work with, all the while keeping my own huge family in check from going off on the staff.
It's hard to do sometimes, but you have to take emotions out and try to see things objectively.
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.
How does this pose a impass for you? This is part of the discussion. Why wouldn't it be?! IDK, I've never had a problem with any MD -- even surgeons. It's all in the way you present yourself, RN or layperson. Wow. Hope you will use your knowledge to advocate for, well, somebody. FYI don't be afraid of MDs. If you present with data and concerns to discuss you will do fine. It's called being a PROFESSIONAL REGISTERED NURSE.
sorry that your dad is sick. i read through the thread but might have missed it, but is there any way you can have your dad transferred to a hospital in your area or your hospital (if you work at one)? i can't even imagine but becoming combative with the nurse will not help the situation.
Only read the OP, I may have missed something. The nurse is entitled to take a break, I'm glad for her that she got it. I think a little professional respect would go a long way; ask her how she thinks your father is doing, then share in a non-accusatory manner what he reported to you. She called you back (after a demand I find out of line), and she deserves the benefit of the doubt. If you came off as hostile on the phone as you do in the OP, she was probably right to hang up. Unreasonable people cannot be reasoned with, kwim? I hope your Dad gets better. In the mean time, take a step back and try to be more objective. Good luck.
OP, you have the right to try and get the best for your Dad. Screw it, you know, just that. Pull it together and calmly get it done. I've care managed for friends, and for family. IT IS NEEDED. OP, :hug: it takes so much out of me too, but you and I, have to, and WILL do it very professionally, but firmly. I have paged a surgeon in his car and had staff removed from care. I will always be there and absolutely rule with all I got for family and friends. Each and every time. I swear to all those I love.
How does this pose a impass for you? This is part of the discussion. Why wouldn't it be?! IDK, I've never had a problem with any MD -- even surgeons. It's all in the way you present yourself, RN or layperson. Wow. Hope you will use your knowledge to advocate for, well, somebody. FYI don't be afraid of MDs. If you present with data and concerns to discuss you will do fine. It's called being a PROFESSIONAL REGISTERED NURSE.
My point is, if the DAUGHTER goes in, does an assessment without having any knowledge of lab or radiology results, without having read the physicians' and nurses' previous and current assessments, without knowing his current MAR, i/o, VS, tele rhythm, how exactly is her isolated assessment going to help in any way? And why would the physician care at all, particularly if she can't tell him anything new (not that she would know that, because she doesn't know what any of the previous assessments have been). I can see how that conversation could go: "He has crackles in the bases and 2+ edema." "Well, thank you for that observation. Since his pro-BNP has improved dramatically, his edema was 3+, he's lost 50 pounds of fluid, we've weaned him down on the O2, and his CXR shows improvement, what exactly is your point?"
Better to request to discuss his situation with the nurse and charge nurse, and, since she's so far away, with the physician by phone after he/she's made rounds. An isolated assessment with no other or minimal knowledge of the entire picture isn't going to be helpful in the least, and could make her look absolutely stupid which will further harm her relationship with the staff. My comment had nothing to do with not advocating for a patient or with being afraid of MDs, and everything about being able to have a relevant, intelligent, reasonable conversation about her father's care.
If you didn't like the nursing care on the FIRST DAY, you should have had him reassigned to a different nurse. Don't watch for 3 days and then complain when you aren't there anymore.
I encourage patients/family if you have an issue address it sooner than later, do not let it fester and get out of control.
Do you know if your father has specifically asked for something to relieve the cough? Were you ever able to be present when the MD made rounds to be updated on his condition?
Bluegrass, your discussion will involve meds/labs/tests. This is what is discussed. The MD will look into and advise on what he has ordered... and so the discussion goes.
If you didn't like the nursing care on the FIRST DAY, you should have had him reassigned to a different nurse. Don't watch for 3 days and then complain when you aren't there anymore.
I encourage patients/family if you have an issue address it sooner than later, do not let it fester and get out of control.
Do you know if your father has specifically asked for something to relieve the cough? Were you ever able to be present when the MD made rounds to be updated on his condition?
I asked the doctor for cough medication yesterday when he was in on his rounds. He said he would prescribe it and when I asked he said he has not been given any.
My father asked me not to rock the boat in asking for a new nurse. He is already overwhelmed that this visit is going to cost him an arm and a leg and he is afraid to draw attention to himself. Because he is the patient and still has full control over his wishes and what he wants there is nothing I can do to keep the nurse out.
I guess I don't understand what you were saying, then. I thought you were advising her to bypass the nursing staff, go do an assessment of her father and then page the physician with her assessment if she notices "anything of significance". That seems completely nonsensical to me. How can she possibly know what is significant if she doesn't know the whole picture? I'm not arguing against a discussion of her father's plan of care with the physician, I was simply disagreeing with your recommended method.
Specializes in Plastics. General Surgery. ITU. Oncology.
Leave the lass be! I'm lucky enough to be English where all healthcare is free. I can only imagine how bloody awful it must be to be sick and having to pay to be sick.
While I think you definitely overreacted emotionally in the moment and your actions may have actually made the situation worse, I am not as quick to jump on the bandwagon that your father was lying and that the nurse was providing attentive, wonderful care. Yes, some patients do not remember accurately what happened but I would never write off a patient's (aka your father's) concerns as invalid just because he is a patient.
The reality is there are some lazy, incompetent nurses out there. Read all the threads of people complaining about their colleagues! Maybe she didn't check on your dad and had no idea he had been coughing, or maybe she did. We really don't know. My grandmother was hospitalized a few years back and the nursing care she received was absolutely appalling. I was shocked and horrified at the manner in which 2 of the nurses in particular treated my grandmother. Not every nurse is honest or competent or caring. I think it is really dangerous to dismiss a patient's concerns and complaints if what they say conflicts with what the nurse says.
I do think thought that it would actually help your father more to address your concerns through more official channels so that they are documented. I understand your emotion in the moment - it is incredibly hard to see someone you love suffering and feeling as though more could be done. You can't take back how you acted on those emotions but seeing the conflict it caused, hopefully in future efforts to get your dad's needs met, you can work with the team.
All the best to your dad and to you in the days and weeks ahead.
shoegalRN, RN
1,338 Posts
I totally understand your concern. My grandpa is 74, has CHF, has COPD, has had a MI with stents placed and I love him to death!
He has been hospitalized more times that I can count for all his health problems, we almost lost him a few years ago.
Yes, emotions get involved because it's your family member. I understand that. But you have to try to control those emotions when dealing with the nursing staff. It makes better for all those involved.
When my grandpa was in the ICU, I was the contact person for the family. I didnt tell the staff I was a RN, I sat back and observed. I cried a couple of times, and my emotions got the best of me. If it wasnt for the nurse he had, I probably would have lost it. She was awesome and even gave me a hug. In return, I was trying my best to be the easiest family member to work with, all the while keeping my own huge family in check from going off on the staff.
It's hard to do sometimes, but you have to take emotions out and try to see things objectively.