Would you have said something?

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My MIL is in a SNF over an hour away- she had a ruptured cerebral aneurysm before DH and I ever met. I don't know her that well, nor do we often speak to that side of his family (no ill feelings, DH is just bad at keeping in touch). When she was placed in the facility, DH (who was only in his early 20's) couldn't really handle being her HCP and making decisions anymore, so another family member has power of attorney now. So honestly, I feel I have no right interfering in her care, but... she had a PEG placed less than a month ago, and when we went to visit her Christmas Eve, the nurse came in to start her feeding, and asked us to step out for a minute. When we went back in, she was lying completely flat in bed, with a tube feed running at 80ml/hr. I simply raised the HOB out of instinct, and on the way home, hubby asked why. I matter of factly said that it's best to elevate the head with tube feeds running. He was a little upset I hadn't said anything to the nurse. Would you have?

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ugh.....I would have just told the nurse that "hey, I noticed she was on a tube feed and raised the head of her bed". Makes you wonder what else they are not doing??? GRRRR.

That is a tough situation you guys are in, but it makes no matter if you visit her once a year or every day....that is basic, basic standard of practice.

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absolutely it is your right...

and responsibility.

whenever someone has knowledge and doesn't share the repercussions of doing something erroneously, that person could be found just as negligent as the person performing the action.

always speak up.

you were correct in elevating the hob, but i would have sought out a supervisor as well.

leslie

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Specializes in ICU.

YES I would have said something. And I would have said it loudly enough for the DON to hear. Because guess what!!?? They're doing that all the time when you're gone. I can guarantee it!!!

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Specializes in MSP, Informatics.

Yea, I think I would have said something. Possible the nurse just forgot, got busy... but also possible that she didn't know. better speak up than have to visit MIL with aspiration pneumonia and have that guilty feeling!

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Specializes in LTC, assisted living, med-surg, psych.

Yes, I would have raised the HOB and then raised some you-know-what with the DON and the resident care manager.

I work in LTC, and when I come on shift I almost always find one or more of my tube feeders lying flat in bed after the aides have turned and changed them. No matter how many times I talk to the staff or how big the over-bed signs are, this basic rule is often forgotten in the rush-rush of routine care. I can understand this happening occasionally, but when it happens on a daily or almost-daily basis, I'll talk with the DON because ultimately it's her responsibility to make sure the residents receive proper care, and education and reminders are necessary to keep staff in compliance. (I've been a DON myself, so you'll have to pardon the legalistic tone here.)

I don't know anything about your MIL's facility in particular, but I speak from the experience of many years in LTC and know that a lot of "minor" details get missed because there is so much to do and so little time to do it.

Good luck to you.

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Specializes in ENT, Neurology, Pediatrics, LTC, Skilled.

I would have said something even though I truly wasn't envolved in her healthcare. It is just that I would have said something about it if I noted it on any other patient. It is so scary to see what is the possibly the trend of care there. As Nurses we are pt advocates all times and everywhere.

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Specializes in Family Nurse Practitioner.
ugh.....I would have just told the nurse that "hey, I noticed she was on a tube feed and raised the head of her bed".

I like this approach. It is definitely possible that she was just in a hurry to get out so you could continue your visit and forgot to raise the hob. Maybe its just me but I wouldn't think screaming for the DON is necessary at this point.

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Specializes in MSP, Informatics.

well, I looked back at my responce, that said I would have said something...but then I think of a time I went to visit my dog who was in the overnight ICU at the Vets. (I used to be an animal health tech before I went into nursing....) when I got there, the dogs IV was bone dry. The tech who let us in to see her noticed, grabbed a bag and hung it ..... on the tubing that was also bone dry. no filter, no pump. and about 5 feet of air in the tubing. She left, I didn't say a thing, unhooked the tube, purged the line, and hooked it back up to the dog.

I know it takes a heck of a lot of air to make an air emboli... but you don't hang an IV on dry tubing. But I didn't say a thing.

as a nurse, I know when I first started, that I would get intiminated by other nurses in the room when I did anything. Or if I had to do a procedure on another nurse/Dr/or someone in the healt care field. Maybe this nurse knew you were a nurse, and that is what made her forget to put the HOB up. You never know.

I have gotten over that by now. Now when I go into the vet clinic, I am my dogs advocate. Just like in the hospital I am my patients advocate...or if it is me or my family as a patient, I am there advocate. I do know that at my vet clinic now, there are little red stars on my charts. ;-) I asked someone once if that means I am a bad or problem client! She stammerd....oh, no..... but I knew! I am the problem client!

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Specializes in Family Nurse Practitioner.
My MIL is in a SNF over an hour away- she had a ruptured cerebral aneurysm before DH and I ever met. I don't know her that well, nor do we often speak to that side of his family (no ill feelings, DH is just bad at keeping in touch). When she was placed in the facility, DH (who was only in his early 20's) couldn't really handle being her HCP and making decisions anymore, so another family member has power of attorney now. So honestly, I feel I have no right interfering in her care, but... she had a PEG placed less than a month ago, and when we went to visit her Christmas Eve, the nurse came in to start her feeding, and asked us to step out for a minute. When we went back in, she was lying completely flat in bed, with a tube feed running at 80ml/hr. I simply raised the HOB out of instinct, and on the way home, hubby asked why. I matter of factly said that it's best to elevate the head with tube feeds running. He was a little upset I hadn't said anything to the nurse. Would you have?

what is a Mil ? SNF ? DH ? I know what a HCP and peg tube is ...

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what is a Mil ? SNF ? DH ? I know what a HCP and peg tube is ...

mil = mother in law

snf = skilled nursing facility

dh = dear husband (if you're on good terms with him:))

leslie

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Specializes in CTICU.

Leslie beat me to it.

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