supportive treatment....poor- LONG!!

[ilmbg]

I just returned from 4 days in the hospital. I think I am still in shock....not due to the dx, but due to the treatment by nurses. Now, don't think that any of them were 'witchy', or in bad moods. I am horrified to find out that patients are being treated this way! I will try to explain without giving info that should not be shared at this point. I went to the ER with chest pain. At several times during my stay, I did not make eye to eye contact with any person for 1/2 to 1 hour. When I put my call bell on, I finally went to the desk after 12 minutes to let them know my chest pain had increased. At one point, I was given the correct procedure for chest pain, but instead of checking back with me to see if the pain scale had changed, the RN didn't come back for 35 minutes. Didn't ask if there was any improvement, either. The doctor was good- at least as far as I could assertain, being in a room by myself. Prior to surgery, I did not go through a pre-op check list with my RN. Good thing I remembered to take out my earrings and remove my underwear in the pre-op. After surgery, when taken to my room, an RN did not follow dr orders...the dr came in and asked why not. Dr says "I want this done with all my pts- orders are written. Dr. leaves, and RN puts item on partially. Says "You don't need it". What the H.. is an RN doing blatently defying dr orders??!! This was an important task. For my health, thank you.

Next, I had a med that I am on routinely. I missed 3 doses, and asked why I had not had it. RN says "It isn't ordered", as goes through med sheet. "Oops- it IS ordered". The med came up about 15 minutes later. It is a med that must be given a particular way. The med was not given correctly. During the next 8 hours, after I had just returned from surgery, there was a hat in the toilet. I used it several times. After it was full, I dumped it. The RN shift finished, went home, never came back into the room to ask if I voided. I was awake, up, alert- but was never asked if I would like to 'clean-up', brush teeth, get clean gown. Not on any day that I was there.

Only 2 RN's brought me fresh water the whole time I was there. OH! Excuse me- I was wrong! I was given a nice fresh pitcher of ice water about 3 hours before surgery.... RN didn't realize I was NPO. RN didn't look at incisions after initial move to room, either. (Four incisions).

Next shift RN comes on, asks if I had written it down anywhere, because prior RN did not chart output.

At one point, I went to the desk to ask for something- I asked the person who was loudly laughing with another employee at the desk. About 30 minutes later, I returned to the desk to ask why it had not been delivered yet, as everyone was sitting there. "OH!- nobody brought you a popscicle yet?" was brought one then.

My IV sites were not labeled/dated on my arm. (2). The IV sites were of poor quality- the anesthesiologist commented on how bad they were, and restarted them for me.

There are more, that I cannot state publicly now. Yep- I am just a tad shocked. Disgusted with the majority of nurses. There were 2 nurses that were great- I will remember to comment on them to the DON.

I will be asking for a meeting with the DON. I will also be contacting the BON in my state.

If you can think of anybody else, I am all ears.

As you can tell, I am just disgusted- these nurses were not swamped- I was ambulating, counting the patients. The RN(s) had enough time to be loud, laughing at the desk for several hours.

Why was the RN staff like this? They were NOT swamped-as a nurse myself, I looked and listened. Is it because the hospital treats the staff poorly? Is it because nurses have become lazy? There are not enough words to express my disgust! I now see why nurses are looked at as no better than a motel maid. (No offense to any motel maids). If this is the way nursing has become, then nurses deserve to be treated poorly. How to separate the good from the bad would be a difficult task- I know I was a GOOD, HARD worker, who now knows the other side of the coin.

[rizzle]

I just returned from 4 days in the hospital. I think I am still in shock....not due to the dx, but due to the treatment by nurses. Now, don't think that any of them were 'witchy', or in bad moods. I am horrified to find out that patients are being treated this way! I will try to explain without giving info that should not be shared at this point. I went to the ER with chest pain. At several times during my stay, I did not make eye to eye contact with any person for 1/2 to 1 hour. When I put my call bell on, I finally went to the desk after 12 minutes to let them know my chest pain had increased. At one point, I was given the correct procedure for chest pain, but instead of checking back with me to see if the pain scale had changed, the RN didn't come back for 35 minutes. Didn't ask if there was any improvement, either. The doctor was good- at least as far as I could assertain, being in a room by myself. Prior to surgery, I did not go through a pre-op check list with my RN. Good thing I remembered to take out my earrings and remove my underwear in the pre-op. After surgery, when taken to my room, an RN did not follow dr orders...the dr came in and asked why not. Dr says "I want this done with all my pts- orders are written. Dr. leaves, and RN puts item on partially. Says "You don't need it". What the H.. is an RN doing blatently defying dr orders??!! This was an important task. For my health, thank you.

Next, I had a med that I am on routinely. I missed 3 doses, and asked why I had not had it. RN says "It isn't ordered", as goes through med sheet. "Oops- it IS ordered". The med came up about 15 minutes later. It is a med that must be given a particular way. The med was not given correctly. During the next 8 hours, after I had just returned from surgery, there was a hat in the toilet. I used it several times. After it was full, I dumped it. The RN shift finished, went home, never came back into the room to ask if I voided. I was awake, up, alert- but was never asked if I would like to 'clean-up', brush teeth, get clean gown. Not on any day that I was there.

Only 2 RN's brought me fresh water the whole time I was there. OH! Excuse me- I was wrong! I was given a nice fresh pitcher of ice water about 3 hours before surgery.... RN didn't realize I was NPO. RN didn't look at incisions after initial move to room, either. (Four incisions).

Next shift RN comes on, asks if I had written it down anywhere, because prior RN did not chart output.

At one point, I went to the desk to ask for something- I asked the person who was loudly laughing with another employee at the desk. About 30 minutes later, I returned to the desk to ask why it had not been delivered yet, as everyone was sitting there. "OH!- nobody brought you a popscicle yet?" was brought one then.

My IV sites were not labeled/dated on my arm. (2). The IV sites were of poor quality- the anesthesiologist commented on how bad they were, and restarted them for me.

There are more, that I cannot state publicly now. Yep- I am just a tad shocked. Disgusted with the majority of nurses. There were 2 nurses that were great- I will remember to comment on them to the DON.

I will be asking for a meeting with the DON. I will also be contacting the BON in my state.

If you can think of anybody else, I am all ears.

As you can tell, I am just disgusted- these nurses were not swamped- I was ambulating, counting the patients. The RN(s) had enough time to be loud, laughing at the desk for several hours.

Why was the RN staff like this? They were NOT swamped-as a nurse myself, I looked and listened. Is it because the hospital treats the staff poorly? Is it because nurses have become lazy? There are not enough words to express my disgust! I now see why nurses are looked at as no better than a motel maid. (No offense to any motel maids). If this is the way nursing has become, then nurses deserve to be treated poorly. How to separate the good from the bad would be a difficult task- I know I was a GOOD, HARD worker, who now knows the other side of the coin.

You didn't give enough information in some of your other complaints. I have a hard time understanding exactly what made you so upset. re: the medication given wrong etc.

I'm not sure what your expectations were, but to expect the staff to physically come into your room and ask if you are okay every 30-60 minutes is a bit unrealistic. If your biggest complaint during your hospital stay is that you didn't have ice water, than I don't know what else I can say. It sounds like you had no problems making your concerns/needs known and could done more things for yourself.

I don't understand why you are so upset your nurse was at the nurses station talking with her coworkers. Everyone needs a break!

How do you know your nurse didn't complete a pre-op checklist? Just because my patients don't know when I'm filling one out doesn't mean I didn't do it!

I am so irritated at this poster likening nurses to hotel maids. I can't afford to waste any more energy on this.

Your post made me wonder if you truly are a nurse and what type of setting you work in.

[ohmeowzer RN, RN]

You didn't give enough information in some of your other complaints. I have a hard time understanding exactly what made you so upset. re: the medication given wrong etc.

I'm not sure what your expectations were, but to expect the staff to physically come into your room and ask if you are okay every 30-60 minutes is a bit unrealistic. If your biggest complaint during your hospital stay is that you didn't have ice water, than I don't know what else I can say. It sounds like you had no problems making your concerns/needs known and could done more things for yourself.

I don't understand why you are so upset your nurse was at the nurses station talking with her coworkers. Everyone needs a break!

How do you know your nurse didn't complete a pre-op checklist? Just because my patients don't know when I'm filling one out doesn't mean I didn't do it!

I am so irritated at this poster likening nurses to hotel maids. I can't afford to waste any more energy on this.

Your post made me wonder if you truly are a nurse and what type of setting you work in.

i agree with you.. most nurses are far from lazy.. i just can't pin point what exactly the writers compliant was... there were lots of little things... i wonder what kind of nurse the writer is myself....

[rn/writer, RN]

you didn't give enough information in some of your other complaints. i have a hard time understanding exactly what made you so upset.

i saw plenty of information that should raise at least a few eyebrows.

i'm not sure what your expectations were, but to expect the staff to physically come into your room and ask if you are okay every 30-60 minutes is a bit unrealistic.

a couple of years ago, i went with someone to the er when she was complaining of chest pain. she was in a rapid triage room within five minutes, had plavix and morphine immediately, had ivs started and ekg hooked up, and was being prepped for the cath lab in under thirty minutes. at no time was she left alone and she had many assessments during that 30 minutes.

how do you know your nurse didn't complete a pre-op checklist? just because my patients don't know when i'm filling one out doesn't mean i didn't do it!

um, there are items on a pre-op check list that require the patient's input. and the fact that the earrings and underwear were not removed suggest that if one was done, it wasn't done well.

if your biggest complaint during your hospital stay is that you didn't have ice water, than i don't know what else i can say.

ice water figured kind of low on the list of priorities after the following:

after surgery, when taken to my room, an rn did not follow dr orders...the dr came in and asked why not. dr says "i want this done with all my pts- orders are written. dr. leaves, and rn puts item on partially. says "you don't need it". what the h.. is an rn doing blatently defying dr orders??!! this was an important task. for my health, thank you.

next, i had a med that i am on routinely. i missed 3 doses, and asked why i had not had it. rn says "it isn't ordered", as goes through med sheet. "oops- it is ordered". the med came up about 15 minutes later. it is a med that must be given a particular way. the med was not given correctly. during the next 8 hours, after i had just returned from surgery, there was a hat in the toilet. i used it several times. after it was full, i dumped it. the rn shift finished, went home, never came back into the room to ask if i voided. i was awake, up, alert- but was never asked if i would like to 'clean-up', brush teeth, get clean gown. not on any day that i was there.

dr.'s orders not followed? med repeatedly missed and then administered the wrong way? i&o hat not emptied during an entire shift and i&o data not recorded or reported. no hygiene assistance offered post-op? poorly inserted ivs?

any one of these would be a problem. collectively, they suggest a pattern of substandard care.

it sounds like you had no problems making your concerns/needs known and could done more things for yourself.

she didn't have problems making her needs known. she had problems getting them met even after they were known. a pre-op cardiac patient shouldn't have to do her own checklist or remind the nurse she is npo. a fresh post-op cardiac patient should not have to follow up on her own meds and orders, keep track of her own i&o and gather everything else she needs by herself. these are things that her nurses should have been taking care of, some of them without the patient having to make a request.

to the op:

i'm so sorry you went through such an unsatisfying experience. talking to the don (and maybe the ceo of the facility) is a good idea. they need that kind of feedback to be able to change things for the better.

i wonder if the fact that you're a nurse led to the all-too-common error of thinking that you didn't need to be treated the same as regular patients. that's totally wrong, but it would offer the slim hope that they might not do this to everyone. when i have medical folks as patients, i tell them that i will gladly respond to any extra concerns they might have because of their background and training, but my first priority is to see them as a patient. in fact, i encourage them to set aside their medical perspective and just be a regular person as much as possible. i have never had anyone complain about that approach, and most are grateful to be able to relax and just be the patient.

in addition to putting an unfair burden on your shoulders, i'm sure this "care" took away from your sense of security that your needs were being properly assessed and would be seen to without great effort on your part.

again, the powers that be need to know what it's like to be on the receiving end of this kind of treatment. your doc should also be informed that his orders were not followed.

even if nothing is done (and i hope that is not the case), you will feel better because you will have made it clear that you matter.

i am so glad you came through all of this and are recovering.

[ChristyMNOP]

I think more information is needed. I agree that the output not being emptied is troubling, but is it possible that it was noted and just not recorded? As in, you the patient are having output so kidneys are functioning fine, no need to do outputs. I disagree with this but hardly think it means substandard care, just needs a little unit reeducation.

The med given the wrong way, what way was it given? Was it a rectal med meant to be P.O.? Not offered with food? What was the deal?

Also, what was the order that was ignored? Again, troubling but without knowing specifics its hard to ascertain what really went on. And finally the pre-op checklist. Often times I complete the checklist unbeknownst to the patient. And then when its time to go to surgery, I get the pt up to void, remove all the stuff needed and address it at that time. Its not like the stuff on the list that needs to be done with the patient takes more than 5 minutes.

Guess I'm just wondering and curious for more specifics. I'm a new nurse and always learn from these types of posts from the other side of the coin, kwim?

[XB9S, BSN, MSN, EdD, RN, APN]

It sounds like you have had a horrible experience, as a nurse we know what should be done but as a patient we are at the mercy of our care providers. Having just been on the other side I can empathise completely with you, and I was not there for any emergency but as an elective patient and my expereince has been very different.

I can only imagine the worry and distress knowing that things that should be happening were not. I was a very demanding patient and because of who I am (a nurse) I had lots of questions and needed lots of reassurance, I was very lucky because the nurses who cared for me were outstanding and at no time did I have any concerns about the care.

Although the wards in the UK I think are a bit different to yours I saw a nurse reguarly thoughout my stay, both pre and post op, I never had the opportunity to ask for pain relief as I was asked reguarly and the staff made sure that I was comfortable, and that the pain relief was adequate. My call light was answered within seconds of me pressing . The pre-op check list couldn't have been done without me knowing as RNwriter has said there are many things on there that need the pateint input and cannot be known without asking me.

My only complaint about the care I recieved was that on my day of discharge a nurse asked me "oh are you still here", I know now she meant it in a friendly and joke because I was going home a day early but i took it to mean that I was malingering. I guess the analgesics were making me a little crazy.

Actions that we take and things that we say as nurses affect our patients in ways that we cannot begin to imagine, and as patients we are vunerable and rely on our nurses to advocate for us and provide us with the care we need.

There are so many things about the original post that I find concerning when compared to my recent experience. It does nothing to help patients heal if there is no confidence in the care that is given.

I only hope you don't lose faith completely in your fellow nurses, I have had a very positive experience and been cared for by some wonderful nurses.

I was a little dismayed by the judgments made by previous posters, poor nursing care is poor nursing care and although I understand the desire to defend our profession if we cannot acknowledge when things are not right how can we begin to improve the care we give. The way we as nurses are viewed by our patients and how they feel about the care they recieve should help us to develop our nursing care and improve what we do for our patients.

[XB9S, BSN, MSN, EdD, RN, APN]

And finally the pre-op checklist. Often times I complete the checklist unbeknownst to the patient. And then when its time to go to surgery, I get the pt up to void, remove all the stuff needed and address it at that time. Its not like the stuff on the list that needs to be done with the patient takes more than 5 minutes.

Guess I'm just wondering and curious for more specifics. I'm a new nurse and always learn from these types of posts from the other side of the coin, kwim?

So do you guess if the pateint is wearing contact lenses, site is marked and consent is signed correctly. This is all something that we check in the UK as part of the pre-op check. I was asked specifically is this your signature and is this the correct side and limb for surgery. Can I see the mark that the doctor has done. Do you have any loose teeth, caps or crowns, even though these are done elsewhere during the admission they are all double checked before theatre and marked off the pre-op check list,

My patients all know that they are having a pre-op checklist done when I do it

[ChristyMNOP]

OP it might also be helpful to know what type of floor you were on. You never stated that it was an actual cardiac surgery so I'm thinking you were possibly on a regular floor, in which case policies for assessments may have been different.

PP, on our floor onsent is signed well before the surgery, usually the day before or if on my shift I already obtained it. Also, we don't usually mark the site on our floor, this is done in pre-op holding. The rest of the questions can still be asked in the 5 minute time span. Dentures and contacts can be removed, glasses removed, etc.

And I'm not trying to defend poor care. I definitely see some deficiencies but I just wonder about more details. Why is it so easy to assume that it was all the nurses' fault? I could easily see one or even 2 nurses providing very substandard care, but most over a stay? That's why I asked for specifics. I'm just trying to learn here. :nuke:

[XB9S, BSN, MSN, EdD, RN, APN]

Our consent is signed in pre-op clinic weeks before and then checked on admission, by anaesthetics and by the nurses on the floor. Just to double, triple and quadruple check

Our pre-op checks are very obvious and not something that you would miss happening

[cardiacRN2006, ADN, RN]

Um, there are items on a pre-op check list that require the patient's input. .

No part of my pre-op checklist requires pt imput. I can see if earrings are removed, the pt does NOT sign the checklist, and missing undies is such a low, low, low mistake to make on the priority list that it's barely worth mentioning.

When I'm charge, I usually do the pre-op checklist for other pts/nurses while they do other tasks.

I agree with the PP who say that everything is a little vague about the complaints. I mean, going to the BON because of ice water and popsicles??? Seriously?

And I laugh loudly sometimes while I am extremely behind in charting (I can laugh, chart and eat gum at the same time!). Laughing doesn't make me or anybody else a bad nurse.

[Spidey's mom, ADN, BSN, RN]

Miranda - excellent post.

Ice water and popsicles are not the main points.

I read many specific complaints.

I&O's are very important after surgery. An anesthesiologist said the IV sites needed changing and did it. Being disrespectful to a physician and not following orders - in front of the patient? If you have a problem, talk to the doc in private.

But most important is the lack of observation during the pt's chest pain episodes . . . I've worked in ER and that just sounds completely unprofessional.

(This sounds like an ER with private rooms - which our local ER is going to do - and I have a big problem with that . . .I want to be able to see my patients . . . . ).

steph

[rn/writer, RN]

I agree that the output not being emptied is troubling, but is it possible that it was noted and just not recorded? As in, you the patient are having output so kidneys are functioning fine, no need to do outputs. I disagree with this but hardly think it means substandard care, just needs a little unit reeducation.

You know the old saying--"If it wasn't documented, it wasn't done."

Next shift RN comes on, asks if I had written it down anywhere, because prior RN did not chart output.

If the oncoming nurse has to ask the patient if she has kept track of her own I&O because the previous nurse didn't record it, something is wrong.

Re: the pre-op checklist, ours is similar to Sharrie's with questions that the patient needs to answer. Perhaps it is not that way in the facility that the OP was in (though I don't know how you can tell if underwear has been removed without asking).

Viewed in isolation, some of these things may seem small, maybe even petty. But when you add them together and you are talking about an ER cardiac patient being left alone for lengthy periods, med doses being skipped, incisions not being assessed, and I&O being ignored, these are serious lapses. Add to that the general lack of consideration shown to this patient, and you have a situation that requires more than just being blown off and told you are a complainer. The accumulation of problems eventually becomes greater than the sum of its parts because it can lead a patient to question her safety.

The important issue is not just the care but the perception of the care. The message that pervades the original post is that the OP felt that some of the people taking care of her either were not aware of things they should have known about or didn't follow through with some aspects of her care, and that left her feeling frustrated and uneasy. This is not conducive to a relaxed recovery.