So here I am sitting with my grandmother who is in the hospital with UTI, sepsis, ARF, and dehydration. I've only seen the nurse twice and I've been here since 6am. No one has assessed her, looked at her skin, or brought her fresh ice. No hourly rounds? They are obviously not on any computer systems but they don't even bring a paper MAR into the room when giving meds. I always assess my patients and at least try to round every other hour. What is the deal? Glad I'm here to look after her.
Last night my g-ma had a small seizure. Only lasted 10 seconds, no ictal period, but she had some disorientation afterwards. When we told the nurse she just said... "I'm sure she didn't have a seizure." Um... you know a seizure when you see one. Thankfully I was here this morning to tell the doctor about it. He thinks it was related to everything going on with her.
I just don't feel safe leaving her here but I can't stay 24/7. Also I have to back to work Thursday. Please say a prayer.
Hmmmm, dont sit there as your Gran deteriorates question, question and question again....DEMAND action and state your concerns-then and there.
Maybe he/she figures if your a nurse they can relax a bit knowing you will do the caring and such. I know this can happen. It is so dissapointing-and not acceptable- when you dont get the care thats deserved and i hope your Gran feels better soon, she sounds like a feisty little lady lol.....
This sounds like one horror story of an admission, and you wonder why people never want to go to the hospital. So the very first thing that would be on my lift of people to contact would be the Nurse Manager for the floor. The NM would be the one to get things turned around in your nursing care quickly.
I would also think about contacting the Patient Advocate from the hospital-all you should have to do is call the hospital operator and ask for the patient advocate. They not only bring attention to the situation, but hopefully are able to resolve it peacefully.
Lastly, if you are at the hospital and witness something that has not been addressed by the floor nurse-Speak Up! I know there have been nights when I don't get to all of my patient's before their family leaves for the night (I work 7p to 7a). But if I have a family say something to me, know very well, myself or one of my colleagues will make every effort to be in that room before they leave.
Those are just a few suggestions as to how I would go about this situation. I hope your grandmother gets well soon!
So sorry to hear about the carelessness of your grandmother's care Tiger. So unfortunate! Had I been you - it would have been clearly communicating to every nurse that "cared", or received compensation, for "assessing" your grandmother that HI I AM A NURSE....and this is what I have assessed, do you agree with me, could you look at these legs, or feel for this pulse, or hear any crackles in her lungs..like I do..or can I borrow your steth-I believe I hear something rumbling in her lungs??...and my grandmother needs a bath please!! (so many folks leave within 2 days CSA's get careless) I would want to hear from my patients family - WE HAVE A PROBLEM! - also...this is what we are experiencing today, right now!! So many families wait :)and don't complain:o...because the nurses don't talk to the families.??.. :down:and then I will, assess the patient, and family, and catch myself walking into a beehive:uhoh3:..that passive nice visitors crap doesn't help when you have crappy nurses. Nurses are overwhelmed these days. Unfortunately, we have two patients, per night, that seem to get most of our attention, with med frequencies, or being alone in a room and having troubles. We have a 5-6 patient load, CSA's round on odd hours, Nurses round on even hourly numbers just eyeballing and questioning the 3 P's..pain, position and potty..and add "do you need anything else..I have the time, we want to take good care of you"..even though it doesn't always come out exactly like that. We also have to sign a time sheet in the patient's room as we leave. (those dry eraser boards are coming!!!!) If I have a family member, of the patient, who is also a nurse, I let them know how pleased I am to have another set of eyes watching patients under my care...and clearly inform them that if there is something that I need to know or get let me know...do not hesitate to call me. I'm never perfect. Had I been your nurse..I would have assessed...and pulled information out of you, esp. if I wasn't familiar with her.(so many family members just sit and stare..I get them all involved!!)...I hear from patients that most nurses are robotic, don't say much, just get in and get out as soon as they can...and are always in a big hurry. Our floor has everyone on SCD's if they aren't ambulating around. Sorry, so long, so sorry about grandmaws DVT's..shame, shame, shamey!! SIC EM BULLDOG!!..and isn't that a shame..so many squeeking wheels "get oiled"...and the nice ones get ignored.....squeeky wheels..is sorta like having good insurance.....(sorrrry, ohh noo..I'm a pothole...that's another subject)
Have you ever thought the nursing staff knows your a nurse and with the patient? And/Or your grandmother is the least acute of the patients that she has...and she might be having one of those days? I know I have been there. I one time only had the opportunity to check on my patient 3 times during the shift, but knew the were ok because I asked my tech to do more of the watching because of the more critical condition of my patient. I felt bad about it but at the same time when others are going bad and you know that you have an off duty nurse at the bedside with one of your patients-although you don't know her compentancy, you feel a bit better about the situation then having no one there. As I have found in most cases, the patients who have family members who are nurses freak out the most so any little change gets relayed to me. Please don't tell me that you have never had a day when you couldn't check up on your patients as much as you should have. And please don't tell me a patients family hasn't ever thought something didn't get done but it did without them knowing...because I won't believe it. I have seen the best nurses out there accused of not checking on someone before just because the patients family member went out for a smoke, etc. while she was in there. So I feel bad that your grandmother is in the hospital, and there are some nurses out there that don't check on the patients, etc...but I have a feeling you could leave your grandmas bedside and realize that the nurse the next shift is a completely different person. Just because something happened on the shift at one time does not mean it is the norm. I hope you understand this and if not I wonder where on earth it is that you work that you can check on each patient hourly every single day you work. If that is the truth, I want to work there becuase obviously the acuity and ratios are different from my job and I'd say at least half of those that post on these boards.
You should talk to the charge nurse and her doctor and anyone else you can. Pester them until you are blue in the face because YOU know what needs to be done. Tell them you are a nurse and she is your family and you WILL NOT stand for this.
I'm really sorry to hear about your Grandma. & I wanted to let you know that you aren't alone in your concerns or your experiences.
My Grandma 87 years old with end stage COPD & incredible Type II Respiratory failure (her PaCo2 baseline was between 85-90 and could climb into the 100s while she was still A & O, not acutely symptomatic - the respiratory team said they never seen anything like it.) She was also bed bound, incontinent and unable to feed herself. Her final admission was for palliative care - she was on BiPAP 22 hours a day prior to withdrawal of care.
We experienced things much similar to you:
- My grandma was rarely changed or even had her pad checked (upward of 6 hours in a soaked, dirty pad) to the point where I was personally checking and changing it. This occurred continuously for over a month and didn't improve.
- I had to feed her at each meal. She was unable to use the buzzer to call for a nurse so unless I was by her side constantly she wouldn't have been able to ask for or receive drinks (which she needed often due to the very drying effect of the BiPAP.) There was no documentation that there was a risk for dehydration or discomfort because she couldn't use the buzzer (probably related to her mild dementia.)
- The very worst thing that happened on a constant basis? The management of her BiPAP (which was crucial to her a) comfort and b) survival, to put it bluntly.) On several occasions I found the oxygen tap turned off, the oxygen tubing not connected to the tap or the tubing between the machine and the mask disconnected. All whilst she was wearing the mask. Imagine that, wearing a BiPAP mask (total seal over the nose & mouth) with no air or oxygen at all. If there hadn't been a family member with her to notice this and rectify the situation, this could have been the case for several hours until a nurse noticed (I don't know how likely this would have been, they rarely checked on her and only came to the bedside when they needed to give meds/take obs etc.)
I'm really sorry that your Grandma has had to go through this. I stayed with my grandma constantly, slept on the floor of the hospital when I could and provided almost all her care for her (including giving meds, managing the BiPAP, feeding her, changing her etc) because it became increasingly clear with each day that the nurses were not doing these vital things. To me, it seemed like they were doing the things that needed to be documented (like giving meds) and only coming to the bedside if I buzzed for their assistance.
I think we and the OP knows how busy nurses can be BUT No assessments??? Hecks, If I don't get to see or really assess a pt I will let the next nurse know that "Mrs X seems fine and I didn't have the time to give her a good head to toe so can you check her out?" Granted I work LTC and assessments are different, but I'm just as busy as the next nurse.
Gma was probably the "good" patient..no real complaints and family in the room so she was skipped because she "seemed okay"
I'd ask to speak to the nurse manager. I think the key is to stay calm and polite because no matter how outraged you (rightfully) are, if you go ballistic, you'll set up a you-versus-them situation. Squeaky wheels do get the grease, but if you're too squeaky, you'll be viewed as a PIA, no matter how legitimate your complaints.
I think the NM is the person to see because she's the one who's responsible for staffing, and clearly this unit is understaffed. Perhaps the NM needs to see the light and make some changes before other patients get harmed (and you can bet other patients are being harmed). If you get nowhere with her, go on up the chain of command.
I've been on the receiving end of bad nursing care, myself. I was hospitalized with severe dehydration from a bad C. diff infection. (My husband remarked, "I can see your skull through your face".) Despite the liters of fluids they were pouring into me, I was desperately thirsty. I used my call light exactly once: to beg for a cup, so I could drink water out of the sink. The nurses refused to bring me a cup, so I stuck my head under the faucet and drank from the tap. I pretty much went from sink to potty to sink, dragging my IV pole with me. I'd have given a hundred dollars for a freaking cup.
Also I was not put on contact precautions. The nurse didn't even wear gloves or wash her hands after touching me, and I was only looked at by a nurse (not assessed, just looked at) once in two days. They didn't do an I&O on me, even though I was pouring out gallons. I told the nurse that the fluid was flying out of me just as fast as it went in, but she didn't seem to think this was a problem. So I did my own I&O on the form taped to the bathroom door, but I think the nurse just threw it in the trash. (This nurse was in my class in nursing school, BTW.)
My potassium was 2.5, but they didn't check a tele strip to see if maybe I had an arrhythmia. My heart rate was 150. My BP was 65/30 (which made the trips to the sink and bathroom a dizzying and ardurous experience) but that was only checked twice.
This was at the hospital WHERE I WORKED. I did not complain because I was afraid of retaliation. Also, at that point I felt like dying would be the best option because I was so miserable.
I'm personally ashamed whenever I hear of patients getting substandard care. There is no excuse. If the nurses caring for your grandma are too busy to actually care for her, something's gotta change.
Sorry to hear about your experience. Did you tactifully speak to the nurse about your concerns? As you know there are more and more demands made on nurses and we are often looked at by families as "the enemy". I work on a critical care unit where nurses are the sole care providers (no techs, na's etc.). The way your nurse responded to the seizure was unacceptable, but rather than posting this message it may have been more effective to address your concern directly. As nurses we work really hard. Maybe this nurse needed mentoring rather than criticism. (?) Don't mean to be insensitive, hope you understand my point.
Well my grandmother was discharged today. I didn't really want to say anything about the care until she was out of the hospital. I was afraid things would get worse. As you know she ended up developing a DVT which extended her hospital stay by 6 days. The last 6 days were much better than the first 6 days. She said she was happy with the care the last week. I wasn't able to go back down to her hospital due to work. My mother went down a few times and said things seemed to be going okay.
I do plan to let the nurse manager know about no one doing assessments. I am a floor nurse and I know how busy it can be. I know how family member can be PIAs. We were very well behaved while she was in the hospital.
I'm just glad she is going home and that she didn't develop any other complications from her hospital stay.
Specializes in Alzheimer's, Geriatrics, Chem. Dep..
Well my grandmother was discharged today. I didn't really want to say anything about the care until she was out of the hospital. I was afraid things would get worse. As you know she ended up developing a DVT which extended her hospital stay by 6 days. The last 6 days were much better than the first 6 days. She said she was happy with the care the last week. I wasn't able to go back down to her hospital due to work. My mother went down a few times and said things seemed to be going okay.
I do plan to let the nurse manager know about no one doing assessments. I am a floor nurse and I know how busy it can be. I know how family member can be PIAs. We were very well behaved while she was in the hospital.
I'm just glad she is going home and that she didn't develop any other complications from her hospital stay.
Specializes in PERIOPERATIVE,GERIATRICS -COMMUNITY NURS.
I hope your grandmother is feeling better. Unfortunately, the workload that nurses must take on, will have a direct impact on the type of nursing care that is given. I have gone through a similar experience with my mother. I am not making excuses for bad nursing. However, I have found that heavy workloads forces good nurses to set priorities according to the severely of the patient's condition. Many years ago, nurses got to know their patients. Today, It is a very different scenario. We have become task oriented nurses, because we are now given so much more responsibility, and we must constantly keep our focus in order to avoid errors at all cost. Sadly, we are not always able to be as nurturing as we should be.:redpinkhe
So sorry to hear about the carelessness of your grandmother's care Tiger. So unfortunate! Had I been you - it would have been clearly communicating to every nurse that "cared", or received compensation, for "assessing" your grandmother that HI I AM A NURSE....and this is what I have assessed, do you agree with me, could you look at these legs, or feel for this pulse, or hear any crackles in her lungs..like I do..or can I borrow your steth-I believe I hear something rumbling in her lungs??...and my grandmother needs a bath please!! (so many folks leave within 2 days CSA's get careless) I would want to hear from my patients family - WE HAVE A PROBLEM! - also...this is what we are experiencing today, right now!! So many families wait :)and don't complain:o...because the nurses don't talk to the families.??.. :down:and then I will, assess the patient, and family, and catch myself walking into a beehive:uhoh3:..that passive nice visitors crap doesn't help when you have crappy nurses. Nurses are overwhelmed these days. Unfortunately, we have two patients, per night, that seem to get most of our attention, with med frequencies, or being alone in a room and having troubles. We have a 5-6 patient load, CSA's round on odd hours, Nurses round on even hourly numbers just eyeballing and questioning the 3 P's..pain, position and potty..and add "do you need anything else..I have the time, we want to take good care of you"..even though it doesn't always come out exactly like that. We also have to sign a time sheet in the patient's room as we leave. (those dry eraser boards are coming!!!!) If I have a family member, of the patient, who is also a nurse, I let them know how pleased I am to have another set of eyes watching patients under my care...and clearly inform them that if there is something that I need to know or get let me know...do not hesitate to call me. I'm never perfect. Had I been your nurse..I would have assessed...and pulled information out of you, esp. if I wasn't familiar with her.(so many family members just sit and stare..I get them all involved!!)...I hear from patients that most nurses are robotic, don't say much, just get in and get out as soon as they can...and are always in a big hurry. Our floor has everyone on SCD's if they aren't ambulating around. Sorry, so long, so sorry about grandmaws DVT's..shame, shame, shamey!! 
SIC EM BULLDOG!!..and isn't that a shame..so many squeeking wheels "get oiled"...and the nice ones get ignored...
col3
19 Posts
Hmmmm, dont sit there as your Gran deteriorates question, question and question again....DEMAND action and state your concerns-then and there.
Maybe he/she figures if your a nurse they can relax a bit knowing you will do the caring and such. I know this can happen. It is so dissapointing-and not acceptable- when you dont get the care thats deserved and i hope your Gran feels better soon, she sounds like a feisty little lady lol.....