Why Do I Keep Seeing This?

[oblivionenigma]

Please do not see this as inflammatory; within this rant is an actual concern!

Recently, family members have been hospitalized for a variety of reasons. I keep seeing this very disturbing trend. Nurses are constantly sitting at the nurse's station while patients are in pain, showing signs of problems, etc., and no one leaves the station to help or to hunt down the patient's nurse. What are these nurses doing at the station that is so important at all hours of the day?

Case in point, a relative was hospitalized post appendectomy. She had excruciating pain to the point of screaming, and began projectile vomiting constantly. As she was doing that, there were approximately 5 nurses sitting in the nurses station seemingly doing nothing (maybe something on the computer, but still?). When family came out to get help, they said "We're not her nurse. Sorry," and left it at that. It took nearly a week with every nurse just claiming she was being "melodramatic" while inserting nasogastric tubes, giving morphine, etc to discover that her colon had herniated somehow as a complication of surgery and required emergency surgery. Literally, it was discovered because our family literally screamed at the doctors and nurses, threatening everything from lawsuits to personal injury before they agreed to do a scan. This was not isolated, either. They wouldn't walk with this family member in spite of her weakness. They would not do anything with her. This family member is very hard of hearing, but instead of ensuring that she understood procedures, they would tell her what to do or just do it without talking to her at all. When they did interact with her, they treated her as they she were stupid or retarded, instead of hearing impaired. Across the hall a patient kept screaming for help and no one was EVER observed entering the room to check on him. CNAs did what they could and did an admirable job, but their reports to nurses did not seem to change things.

Second was my mother, actually, who wound up in another hospital with sepsis--first from a previously undiscovered UTI and second from staph acquired at that above-mentioned hospital (her IV came out, and instead of starting a new one they just stuck the old one back into her arm and taped it up better). Due to many pain conditions as well as pain from her illness, she was in agony to the point of where she could not walk and reported pain 10/10. She was literally screaming, crying, arching her back, writhing in agony, etc. Yet again, family went to the nurse's station and asked them to do something. Yet again, at this separate hospital, a good half-dozing nurses were sitting there. No one would get up. They each outright refused to check on her, hunt down her nurse, etc. Her nurse refused to do anything, suggesting that my mother was either melodramatic, an addict, or that had already had pain meds recently. She refused to call the doctor for pain regimen changes, and ultimately turned around and walked away from the discussion.

Interestingly, a CNA came on, took one look at my mother, found the nurse, took her outside the hall and literally shouted at her until she finally agreed to provide pain medication to my mother. The nurse since then treated my mother with contempt, but at least she kept giving pain meds (apparently this CNA has worked there for YEARS and therefore he has a little clout that many do not have normally). This was not an isolated incident, however. No matter what we needed, what time it was, we could NOT get assistance, and the 6+ nurses at the station would refuse to assist. This was at a MAGNET hospital!

I witnessed the same thing with a terminally ill family member who died recently. No one wanted to help him, medicate him, etc. This was at the first mentioned hospital. My questions were treated with annoyance and answers given as though I were stupid. When I started using their terminology, I actually observed several turn pale, and suddenly their care and behavior improved dramatically while I was there. I did hear a comment at the nurse's station when I was passing by before they knew of my presence to the effect of "Watch out, we have a wannabe RN in that room." "Oh god. One of those." The only thing that made his care acceptable in the end was actually a very caring DOCTOR who advocated for him and ensured he got taken care of, and CNA staff who were attentive to the needs they could provide for.

So my concerning is this.. Why is it I keep seeing all these blatant needs, and yet I keep seeing so many nurses in one location seemingly not doing anything to satisfy these needs? SIMPLE needs, too. In the case of the first example, she had a life-threatening condition that they just could not be bothered with (because, you know, projectile vomiting is part of "melodrama" all the time!) What is at the nurse's station that is more important than answering someone screaming in pain or projectile vomiting and sobbing?

I haven't been in med/surg for quite a while, so maybe things have changed. Am I missing something? If another nurse cannot do anything for a patient who is another nurse's patient, can they not at least check on the patient, get them water or something simple and let them know that they'll be getting their nurse asap? I cannot fathom any explanation to this other than these being HORRIBLE nurses. And if that's the case, how on earth can there be a whole staff of horrible nurses at all times I have observed? Is the environment so caustic that literally every nurse is burned out?

[classicdame, MSN, EdD]

I have never worked in a facility like that. My response is that bad nursing is a result of bad administration. Corporate culture begins at the top. So sorry your family had this experience. Go to www.hospitalcompapre.hhs.gov and complain.

[BunnySan27]

I agree i haven't worked at places like that either...and if all those things really happened like you say, then you should have talked to the nurse manager, or administration if necessary, i mean really.....

[tokmom, BSN, RN]

Never would fly at my facility!! In fact, I have never worked at a hospital like that. Well, my last one has nearly turned into the above, minus the yelling, and I left.

[Miss Kitty00]

Did you speak to the nurse managers of this floor (or floors)?

[Freedom42]

Just curious: When an IV comes out, how do you just "put it back in" without starting a new one? And if you truly saw that happen, why wouldn't you report that to a manager?

[oblivionenigma]

A number of you mention speaking to the nurse manager. I only tried a couple times during which there was no manager visible, we got stonewalled, etc. Other times, my family refused to let me pursue it, saying they didn't want to make a fuss. (In his work, my father has had thousands of dollars ripped off in the past due to non-payment because he wouldn't pursue legal action). Invariably, my family is one that won't speak up, but then after looking back, sometimes wish they had.

The first hospital at times is horribly understaffed and I'm not sure there even IS a nurse manager. The other day, I tried to give a report to the ER, and they couldn't take it because there was only one nurse on the entire unit (at least according to this nurse over the phone).

As far as administration goes, I personally came in to the hospital at off hours due to my own schedule. I had no idea how to pursue him/her, and quite frankly it did not occur to me at the time.

Just curious: When an IV comes out, how do you just "put it back in" without starting a new one? And if you truly saw that happen, why wouldn't you report that to a manager?

I did not see it happen per se. She came back from a CT with her IV site covered in blood. I asked what happened, and they told me that it had come out and they put it back in. I asked how that was done, and they said "Oh, the tip was still in. We just fed it back in." Again, who the manager was was unclear as this was late at night, and there were two nurses in the ED.

Finally, I notice a lot of skepticism and a lot of "Why didn't you...?" Simple. In the one case, my mother was one moment seemingly fine from what I knew, and then suddenly unresponsive making weird groaning noises, combative, and breathing weird. Yes, maybe I "should have" hunted down a solution. Quite frankly, all I could think of was "Oh god, I'm going to lose my mom" and didn't process much else.

In the case of my aunt, what I knew was she was miserable and no one was appearing to do anything about it. Much of what was really going on was not known to me until after the fact. Case in point, I didn't realize just how bad things truly were with her physically until she went to a SNF for SEVERAL WEEKS post appendectomy.

Also, I came from a mindset of a distraught family member, not a nurse, who had a trust that the ED "must know what they're doing." It is naive to think a hospital won't make mistakes, but when I'm in crisis I've tended to trust that the right people will take care of me and my loved ones. On the plus side of these circumstances, I have learned to better advocate for my family and have healthy cynicism even during crisis.

[BunnySan27]

I'm sorry if my responses came off as skeptic, but I just find something about your story unusual. Like when you say the hospital didn't appear to have a manager, where I work there's a managers, for the whole unit, and there's 2 unit coordinaters being as though we have a large unit. Plus a charge nurse, we have several.case managers, and we have a house wide rapid response team, in addition to that there is a line for patients to call of they have any concerns they fill aren't being addressed on the unit.

Having said that...If this hospital is truly a magnet hospital as you stated in your previous post, then there would have been a number of people to talk to regarding your concerns, For a hospital to have that magnet status they have to go through a very rigorous process, Im not doubting the concerns for your family members but to say no one was around no one cared? I'm mean what was the hospital closed or something....I definitely wouldn't have taken no for an answer if it was my mom.

If something like that went on, I would make it my point that somebody knew about it.

[tokmom, BSN, RN]

I have seen hospitals with no managers. We couldn't keep them longer than a year, so that is possible. I have seen it. Anyway, if it is a magnet, you would think there would be someone.

OP, complain now. It's never too late.

[oblivionenigma]

I have seen hospitals with no managers. We couldn't keep them longer than a year, so that is possible. I have seen it. Anyway, if it is a magnet, you would think there would be someone.

OP, complain now. It's never too late.

I guess it's not. I had been under the impression that, for my aunt at least, her children were taking care of that. I guess I'm just frustrated as I saw the whole "sitting at the station saying 'That's not my patient'" at two separate hospitals; and I continually see it.

Sorry for the confusion, as there were two hospitals in that story. The IV, ignoring signs of abdominal complications, and no signs of a leadership role anywhere (not saying there wasn't; it's just not clear) is a non-magnet hospital with a generally negative reputation, periodically in the news for fatal complications of med errors, massive layoffs, strikes, etc. The magnet hospital is known for being competent but rather cold/uncaring. They simply ignored pain, made assumptions about pain, etc. As I said in my original post, a CNA actually stepped up and advocated beautifully. To be fair to the magnet hospital, it is 2 hours away, and I saw it at specific times. Maybe I was seeing the exception. I cannot find any such excuse for the other place.