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.
The discussion with the physician will involve the whole picture. Her assessment is what she has found IF SIGNIFICICANT (she is a nurse) and her concernes will be as a caring daughter who, is also an RN, and has the knowledge to be able to speak in like-tongue to her dad's physician, with all due respect. He will understand that, as he would do the very same if his family friends were inpatient. It is a given. It is understood.
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.
Check to see if it was prn or scheduled. If it was prn, and the nurse doesn't witness much coughing, or the patient downplays it, he won't get it. Ask the doc if he can make it scheduled for now. And keep in mind, he might have been given it, but didn't recognize the name of it when the nurse gave him his other meds, or if the nurse didn't explain what it was for.
This is an issue that we have a lot, though, where the doc will say he's writing for something for cough, only he writes for it prn, the patient doesn't know to ask for it, and the nurse doesn't give it because the patient doesn't complain about the cough.
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.
Calling and yelling at the nurse IS rocking the boat in my opinion. I've had families come to me and request and staff change when the patient was alert and oriented.
If she is not providing good care, the phone call is not helping the situation nor will it change her practice. I would speak with the charge nurse.
The discussion with the physician will involve the whole picture. Her assessment is what she has found IF SIGNIFICICANT (she is a nurse) and her concernes will be as a caring daughter who, is also an RN, and has the knowledge to be able to speak in like-tongue to her dad's physician, with all due respect. He will understand that, as he would do the very same if his family friends were inpatient. It is a given. It is understood.
I guess we'll have to agree to disagree regarding methodology.
ACE coughs result from an excess of bradykinin and don't respond to DM or codeine derivatives. Complaining about not getting useless meds is well, useless. ;-) If the provider feels the cough is really d/t ACE, the only options are to tolerate the cough or d/c the drug. ARB can be satisfactory replacements, but presently might be cost prohibitive for your Dad. Valsartan is supposed to go generic this year, but I don't know when, and I don't think it will pop up on the $4 list for a while and may still be quite costly.
4 visits in 12 hours is once q3h, which seems reasonable for anyone not in critical care. Call lights or intermittent complaints need to be addressed as they come up, however. Ask your father to document calls that go unanswered or specific complaints that are not addressed and take those to the nurse manager.
And I agree, you owe the nurse an apology for conduct unbecoming. Only then will you be able to have a dialogue with someone who, like it or not, has an integral role in your father's well being at this time.
I come from a different place. I don't fuss with protocol, as a nurse, I know what it is and I don't like the chain of command, it has no meaning to me when I am not at/confined by work rules. I always, as I have stated will go to the top first if the problems are serious, and have not been remedied with the first notification to staff. I don't like any kind of delay or redo. I am a results person -- would do it for you too, friend.
Agree, and just wait all of you who have not had such experiences with your own care, or your friends care, or your family's care. Never really known/understood what case management is? Well, you better get some knowledge. It's gonna be a huge loss of innocence. I will promise that to you. About insurance status -- your hospitalist knows it, your ED doc knows it, your ortho consult (that never happened) knows it. Your insurance status drives your inpatient care to a large (unspoken extent).
I do think people underestimate how much payer status impacts plans and delivery b/c as nurses, it doesn't impact us directly. Staff get paid $X/h, either way. So I personally doubt the RN villainess in this scenario is doing or not doing whatever she is b/c of the OP's father's lack of insurance. However, it is true that under the system of health care this country has chosen, generally you don't get what you cannot pay for. If you don't like that system, I encourage you to contact your government representatives.
no flipping idea which patients have insurance or not. Doesn't affect my care one whit. From a ICU nurse viewpoint. Not saying it doesn't affect others.
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:
Let's see: we want 100% awesome care for our loved ones. We want nurses that care for them as they would their own loved ones.
We also want them to be perfect. No smoking, drinking, cursing, off duty. No chubbies need apply to cardiac floor. No uglies, scars on surgery, no mothers that have to get off on time or diabetics that might have to actually eat a lunch at a reasonable time. We expect our nurses to either not take breaks or merely spend them reading professional magazines or in contemplative silence ready to drop everything at the drop of a call light.....
And we want them to take all the abuse that we can dish out when we are worried about our loved ones and/ or feeling guilty that we cannot do more to get them to care for themselves better and keep themselves out of the hospital as it may also reflect our skills.
And we wonder good sensitive nurses leave the profession in droves.
To the OP. Several questions
Have you tried to get your father transferred to your facility or one near you that you trust?
Have you approached the unit director regarding this issues?
As a healthcare worker, do you know what the nurse to pt ratio is on the unit? And are the nurses assignments close together or scattered far away, and is your father near the nurse station?
Your father is not a vulnerable child or elderly individual. He is perfectly capable of speaking for himself, presumably of using the call bell or even if ambulatory, of walking down the hall. Has he asked for cough medicine or for emergent issues and been completely ignored. Did your sister call for him and when not getting a response, spoken to the unit director? On those days that he was only seen 4 times in 12 hours, did his condition require more attention for care?
Why is this facility allowing staff to work seven 12 hr shifts in a row something that screams unsafe. It also requires OT, which tells me that staffing safely is not a priority to the facility. If staffing is poor, the staff may be running their butts off with the severely ill ( like your father when he first came in 50 lbs up), and see your father less now that he is more stable.
And I also suspect that You may feel a bit guilty.....your father comes in with 50 lbs up of fluid. I have a mother that weighs over 350 lbs, and when she gets admitted for DM or back issues., I get the "eye roll - she's a nurse why can't she get Mom to diet, exercise, etc- from staff. My mother like the OP's father are their own people and bear some responsibility for their illness, yet sometimes it feels bad that we cannot get them stay in good health like we are at fault.
To the OP, try to maintain your composure and speak to the UD. But don't accuse a nurse of lying when you have nomproof- you do owe her an apology for that.
She is entitled to smoke if Permitted on her break - and don't use the "cardiac nurse who smokes is a red flag" story . NONE of us are perfect models of health. She may not have heard the coughing if busy in other rooms. But if you have concerns, go to UD.
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To those that think that we care about insurance..... I never bother to look. Most nurses have too
little time to worry about that. We will get sued regardless of that status, if anything goes wrong.
Specializes in LTC,Hospice/palliative care,acute care.
" It's past ten. My daughter is in pain. I don't understand why she has to have this pain. All she has to do is hold out until ten, and IT'S PAST TEN! My daughter is in pain, can't you understand that! GIVE MY DAUGHTER THE SHOT! " Anyone remember Shirley MClain as Aurora in that that scene from 'Terms of Endearment"?
Have WE ALL forgotten the stages of grief? Of course the OP is angry-she is angry at the CHF and can't do a thing about it so she is responding in exactly the way that many many of our patient's families do. Just being a nurse will not exempt her from her emotions. None of us were at her dad's bedside so we don't know what has happened. Obviously she got a vibe from a particular nurse that made her uncomfortable. I have lost count of the number of threads on here about smoking nurses and how they ALWAYS manage to take their frequent breaks. Most of you have worked with such a nurse..
Reminding her that our elders don't always report symptoms accurately is a good place to start but suppose she is correct in her assessment of her father's care? What then? That's what this thread should be about-not slamming her. We all know exactly what is going to happen to her dad -she knows it too. He is ONLY 51....Where is your compassion?
OP- I hope you can get him to move closer to you -you are in for a rough road. Good Luck
Her assessment is what she has found IF SIGNIFICICANT (she is a nurse) and her concernes will be as a caring daughter who, is also an RN, and has the knowledge to be able to speak in like-tongue to her dad's physician, with all due respect. He will understand that, as he would do the very same if his family friends were inpatient. It is a given. It is understood.
:confused:
netglow, ASN, RN
4,412 Posts
The discussion with the physician will involve the whole picture.
Her assessment is what she has found IF SIGNIFICICANT (she is a nurse) and her concernes will be as a caring daughter who, is also an RN, and has the knowledge to be able to speak in like-tongue to her dad's physician, with all due respect. He will understand that, as he would do the very same if his family friends were inpatient. It is a given. It is understood.