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.
I agree that there were some problems with your care. A nurse not monitoring I&O on a patient, espec. post-surg patient is a problem for me. I would also like more info on what was meant by "poor quality" of the IV sites. Were they infiltrated? Also, many eyes overlooked a med that was ordered for three doses to be missed. And a post-op should have incisions checked regularly. How else can a nurse know if an incision is bleeding or infected? While I agree with the above, a few things really bothered me about your post:
Only 2 RN's brought me fresh water the whole time I was there.
While I do try to make it a point to refill water pitchers periodically during the day, the fact is that it is a low priority compared to assessment and meds, and many other things that occur throughout the day. If you wanted water, perhaps you could have simply asked?
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.
Okay, lets give them a break. #1, they deserve to laugh. And for all you know, you asked the cleaning lady. They never bother to tell us when you request something. For whatever reason, they forgot you wanted a popscicle. Same as with water, I am sorry- It just isn't high on priority list. They propably felt bad about having forgot it, just as you do when you forgot a patient request (and if you deal with patients, I am sure you do)
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.
Some of the worst days I have had was with 3 or 4 patients, and some of the best have been with 7. The number of patients mean nothing. And unless you were at the desk the entire 12 hour day, you really don't know how long they "laughed" at the nurses station. My husband (PT) was ambulating my patient in the hall last week. He commented that it must be nice that his nurse can sit at the nurses station instead of providing patient care and "was sure I could find something to do". It was 5pm and I was at the time opening my first note of the day. Point being, you don'tknow what their day was like unless you have followed them around. They may have sit down 2 minutes before you saw them "laughing" after spending the whole day running.
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.
Perhaps your nurses know they are a good, hard worker. Perhaps some of your patients have felt the same about your care that you provided. It is hard to judge when you don't see all that goes on.
And I am no maid.-If you went in with that type of attitude towards your nurses, that may expain sometimes you say you experienced.
Wow, that sounds terrible. You have every right to address your complaints with the DON, I don't know about the BON. Without knowing the full picture, I would be hesitant to try to ruin someone's livelihood. I also wouldn't say that all nurses deserve to be treated badly based on this one episode; that's harsh. I am extremely grateful that I am not working at the bedside anymore. I hope you feel better.
I have been home a week now- maybe I can convey my thoughts a litlle better without being so scattered. I have also been a bit vague, because some of the very nurses that I am talking about may be some of the people that are on this forum.
raykel... I am talking about 30-60 minutes IN THE EMERGENCY ROOM WITH AN MI IN EARLY STAGES!! I received a Nitro tab sl, morphine IV, and then the RN did not come back in to assess for 35 minutes. This is very bad. I am NOT talking about when I was on the unit.
Raykel- I think it is stated clearly that I was not complaining that I didn't have ice water- I WAS NPO! Regarding not being loud behavior at the desk- it is not professional to be loud. It is also not easy to rest at 3am when this is going on. Regarding not given a popscicle- it is not the idea of not getting a simple item that I could do without- it is the idea that a staff member (who was standing next to an RN, but I asked the person that was already standing, it is the idea that a request was not followed through- remember, this was my first clear liquid- it is an important step after surgery.
Regarding a pre-op checklist, you can't very well do part of one if I still had earrings on and underwear on. Also the IV was infiltrated at this time. Would you send your pt to surgery with jewelry, underwear and an infiltrated IV?
And yes, I am an RN. I have been since 1985. Went to Oakland Community College, in Union Lake, Michigan, and Oakland U. in Rochester, Michigan. I have worked High Risk L/D, ICU, Open Heart Recovery, and ER. I am not currently working due to a neck/back injury. Hopefully I will be able to work part-time in another year or so.
Kittykat.. same answer to you about what kind of nursing I do.
rn/writer...I see that I did make sense, as you were able to understand the whole picture.
To a couple of you who are critisizing me because I did not get ice water- you should have been more careful in your reading. I have stated that I was NPO! I am upset because she GAVE me water. Read carefully before you jump the gun.
Christy- you should also read more carefully- I stated that the next shift RN came into my room and asked me if I had written it down-or knew my I&O, BECAUSE THE PREVIOUS NURSE HAD NOT RECORDED IT! I&O is a very important part of nursing- it can show oncoming problems. Christy- I am not sure what you are asking about the DR orders part?? I am stating that the RN did not follow written orders, and then did not follow them when the dr saw that the anti-embolic machine was not on. The RN put the leg-wraps on, then purposfully did not hook them up to the machine, stating, 'there- they are on now', meaning they were 'on' my legs, but not attached and running.
Cardiacrn2006- Being loud at any time is not appropriate, especially when it is 3am. Of course I do not think poorly of someone who is sitting at a desk- my gripe is that they were loud, it was night, and as stated above, I was asking for my first clear liquid, which I was told they would bring, and did not. And to a point it is very low on the totem pole....except that it was the first oral intake.
Rn/writer- yes, you are correct.
Jessie/rn- Yes, both IV's were infiltrated when I went to surgery. I can not use one of my arms for any IV- I already had several sites that had to be taken out due to infiltration- potassium is so hard on peripheral iv sites that my other arm was pretty well used up. When the anesthesiologist restarted my iv, he looked/felt for about 5 or more minutes before deciding where he would try. He was thinking about using a foot, but I would be ambulating, which is hard to do with an iv.
Sharon- I certainly would not want to damage a persons livlihood- but I do think that the hospital/charge nurse/DON should know what is going on with some of their people. I would want to know.
Yes, it is the whole picture that I am taking in. When a pt is hospitalized, (me), I do expect to get-
1. Correct care in the ER- cardiac is nothing to slack off on. I expect to be re-evaluated when given Nitro/morphine for cardiac pain. I do expect (and is the standards) to be observed/evaluated in person as per standards.(30-60 minutes is not standard in an ER).
2. I expect to be given the meds that were ordered for me in the correct manner (no spacer), and the correct times (missed three doses).I have VERY bad asthma with COPD- I am on Xolair also. You don't skip these type of meds.
3. I expect to be evaluated at each shift correctly and each system evaluated. That includes looking at the incision, listening to lung sounds properly, as in upper right lobe, upper left lobe, middle right lobe, middle left lobe, lower right lobe, lower left lobe. Not going from all lobes on right side to all lobes on left side. I expect IV's to be assessed, cheked by flushing when INT.
4. I expect post-op orders to be followed.
5. I expect to get my meds as ordered. (I have found out since, that I missed several Heparin shots. They were ordered every 8 hours around the clock, sliding scale. (yes, I have the chart now).
6. I expect correct procedures to be followed when I am going to surgery. (those were expensive diamond earrings I had on, as I certainly was not thinking to take them off when I was taken to the ER).
7. I want to know that my I&O are in the norms. I wouldn't want to find out that there were no I&O and find out that my heart was retaining fluid, my kidneys were not fully functioning.
As I mentioned in my first post- there were areas where the nursing care was outstanding. The holding area. The Recovery Room-at least what I can remember of it. The Cardiac Lab knew her job to the hilt.
There were some nurses on the Cardiac Floor that were great.
My thinking is this- I am a nurse and know what is supposed to be done. What about the people who come into a hospital and don't have a clue??? These people are depending on good care throughout their stay. They expect that nurses will be giving the meds that were ordered. They expect whatever is wrong with them to be taken care of. The RN is the lifeline. If the RN is not doing the best job possible and communicating this (correct) info to a doc, then the care is lost.
This is what I was talking about when comparing a nurse to a maid. If the job is not done correctly and thoroughly,utilizing a great amount of knowledge, it might as well be a maid that is caring for a pt. If a nurse does not want to do the whole job- the little items that are important in the long run, then he/she shouldn't be a nurse. There are areas where you can just 'skim' by, I guess as a nurse. Too bad.
To those of you who read what I wrote thoroughly and commented, thank you. To those of you who did not read so well and think I am griping because I did not get ice water- I would not wish to have you be the nurse who cared for me, my family or friends.If you cannot read/understand that I was not griping about NOT getting water , how can you understand dr's orders?? You showed that you cannot read/comprehend the problems that was stated. You showed how thorough you are NOT, by those comments.
Again, as I stated in the first post, I was vague for reasons in some areas.
Some of you understood perfectly- some unfortunately did not read well.
Thank you.I will get a new aortic valve in the future (probably mitral also, but that is not as important). No longer have a gallbladder.
I forgot to mention that I have talked to a neighbor- she is also an RN. I asked about the attitude of the nurses. She said because San Antonio is so very, very short of nurses, that they feel (some of course, not all), that they can do what they please because they know that the hospitals are so short- there will be no repercussion because the hospital can't afford to fire/lose a nurse. One nurse said that if she got fired she could always get a job anywhere else because the shortage is so severe. Very professional, eh? Very sad. If this is the way it is, I won't want to return to hospital work.
Well thank you for a more thorough reply. As I stated previously, I really learn a lot from these types of threads. I think I have a more accurate picture of what went on. Thank you for clearing up the I&O problem and the pre-op checklist question. BTW, before you get angry at everyone for saying you were mad about not getting water, perhaps you should read your original post. You did state "Only 2 RN's brought me fresh water during my stay", implying that this was substandard care, and then followed up with a sarcastic, oh I take that back, one did but not at an appropriate time. I'm just saying, maybe you are still on pain meds and forgot what you said originally. I know these kind of things can get confusing.
I hope you are recovering well from your heart attack and/or gall bladder surgery ( ). I bet it was very frightening. I'm also sorry to hear about your chronic condition. I know many of my COPD patients are very particular about their medication administration r/t the severity of this chronic disease. I try to always be understanding of their demands even if they are unreasonable at times because I can only imagine what it must be like to experience chronic shortness of breath.
Oh, and if you could just answer one more question for me. What is the "heparin sliding scale shot"? I have not seen this before. We have Heparin A or B protocol orders (cardiac or neuro) but these are I.V. infusions at a set rate based on the most recent APTT results. Any actual Heparin shots we give are not on a sliding scale, they are SQ shots of a set dose ordered by the physician. Please explain, maybe this is different in other areas?
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.
I don't think, or have I observed, that nurses are looked at as no better than a hotel maid. Some patients are disrespectful and far too demanding. Hope you are feeling better.
I was coming off a hypertensive crisis when one LPN repeatedly charted my BP 40 pts lower than I could feel the systolic starting, spinning that knob down as fast as it would go. I insisted on an automated cuff for "consistency between different personnel." Another time an RN covering for my nurse charted 125/82. "Looking good," my own nurse told me - except the covering RN never took my BP at all; he took another patient's by mistake. Going from the ICU to the floor I thought I was going to die of benign neglect - they just assumed I was all better and going home tomorrow - had to stay five days.
One nurse did not clean my intermittent access before giving an IV push. Got a big infiltration at the hands of another nurse - she didn't stop when I said it hurt.
After another hospitilization and surgery I was on IV fluids for 24 hours - no I/O done after the Foley was removed. I could see my hands and face swelling and told the surgeon but still no I/O. Started keeping my own I/O chart. I was 10 lbs. heavier when I went home - took me four days to pee it off. Surgeon also bears responsibility there for not insisting on I/O, or d/c'ing fluids.
Also during that stay I called for help at 0400 getting to the bathroom - no one came so got myself up after 15 minutes and went - almost passed out on the john and pushed the button - after 10 minutes no one came so got back to bed on my own - put the automated cuff back on. Next reading 80/42 - so decided I had better not use PCA morphine any more - you think?
3. I expect to be evaluated at each shift correctly and each system evaluated. That includes looking at the incision, listening to lung sounds properly, as in upper right lobe, upper left lobe, middle right lobe, middle left lobe, lower right lobe, lower left lobe. Not going from all lobes on right side to all lobes on left side.
). I bet it was very frightening. I'm also sorry to hear about your chronic condition. I know many of my COPD patients are very particular about their medication administration r/t the severity of this chronic disease. I try to always be understanding of their demands even if they are unreasonable at times because I can only imagine what it must be like to experience chronic shortness of breath.
jessiern, BSN, RN
611 Posts
I agree that there were some problems with your care. A nurse not monitoring I&O on a patient, espec. post-surg patient is a problem for me. I would also like more info on what was meant by "poor quality" of the IV sites. Were they infiltrated? Also, many eyes overlooked a med that was ordered for three doses to be missed. And a post-op should have incisions checked regularly. How else can a nurse know if an incision is bleeding or infected? While I agree with the above, a few things really bothered me about your post:
While I do try to make it a point to refill water pitchers periodically during the day, the fact is that it is a low priority compared to assessment and meds, and many other things that occur throughout the day. If you wanted water, perhaps you could have simply asked?
Okay, lets give them a break. #1, they deserve to laugh. And for all you know, you asked the cleaning lady. They never bother to tell us when you request something. For whatever reason, they forgot you wanted a popscicle. Same as with water, I am sorry- It just isn't high on priority list. They propably felt bad about having forgot it, just as you do when you forgot a patient request (and if you deal with patients, I am sure you do)
Some of the worst days I have had was with 3 or 4 patients, and some of the best have been with 7. The number of patients mean nothing. And unless you were at the desk the entire 12 hour day, you really don't know how long they "laughed" at the nurses station. My husband (PT) was ambulating my patient in the hall last week. He commented that it must be nice that his nurse can sit at the nurses station instead of providing patient care and "was sure I could find something to do". It was 5pm and I was at the time opening my first note of the day. Point being, you don'tknow what their day was like unless you have followed them around. They may have sit down 2 minutes before you saw them "laughing" after spending the whole day running.
Perhaps your nurses know they are a good, hard worker. Perhaps some of your patients have felt the same about your care that you provided. It is hard to judge when you don't see all that goes on.
And I am no maid.-If you went in with that type of attitude towards your nurses, that may expain sometimes you say you experienced.