Dang, here goes another health care bent....
I have been with my mom this week as she underwent a total knee replacement. Of course, they didn't do it at my preferred hospital, Children's Mercy, since she's, you know, an adult. It was an eye opening experience and it reminded me of a few things.
I take care of post op patients regularly. Sometimes they are post a fracture reduction, post feeding tube placement, post kidney transplant, post spinal fusion. Ideally, I see the patient several times in the first couple of hours, check their comfort, check their pain control, check their wound. But that's me and that's my hospital. It's kind of an expectation, you know, to look in on your patient after they have had a surgical intervention. Sometimes things go wrong after surgery, like bleeding, puking, pain. But again, that's just me and my overprotective nature. When I get to the hospital after Mom's surgery, about 2 hours after coming out of the OR, Mom says, "No, the nurse hasn't been in here since I got to the room." WHAT?!?!? You haven't seen your nurse, I ask. Nope, nada, negatory.... Great. Of course I can't help myself from looking at her dressing, looking at her iv fluids, the PCA, etc. Somebody needs to. Guess who's feeling a bit bitchy about now? Yep, I'm a little ticked and guess where the nurse is?? Lunch. Do you want to hear the cherry on top of this little shit cake? Her IV pump was beeping and continued to beep infusion complete for, I kid you not, 30 minutes. Her roommate...her IV was beeping as well, for 20 plus minutes. So that's at least an hour of that incessant beeping!! GRRRRRRRRRRRRRrrrr!!!!!!!!!
NOTES TO SELF: Continue to be the attentive nurse post op. Continue to answer my alarming pumps promptly and continue to keep the high level of care that is expected of me at CMH. Note I said continue. I never want my patients or families to be as annoyed as I was over something as simple as checking in with my patient and answering alarms. And the pisser of it all, any time I went to the nurses desk, her nurse and the others were at the desk talking and surfing their phones.
I've been a nurse for a bit, 15 bits, er, years, as a matter of fact. Most of my coworkers know this, but I don't routinely tell my families this. Sometimes it'll come up in conversation and sometimes, I will tell a family in a lame attempt at reiterating that I know what I'm doing and I can handle the placement of an IV or something. It's usually that family that is having some control issues that I find the need to bring it up. This week, my mom had a nurse who had this compulsion to tell us how long he'd been a nurse. It was funny how the story went from being a nurse for 18 years to being an Army nurse for 13 years to being a nurse here at OPRMC since 2004. Basically, I had his resume memorized by the end of my visit. Really??! Is it necessary to impart this useless information?? Do you think I think you're a better nurse because you report you've been a nurse for 18 years? Do you need to pin these comments onto the end of your excuses for not having placed the compression stocking on my mom's affected leg as ORDERED BY THE PHYSICIAN??? Really?!?!?!
NOTE TO SELF: The number of years isn't as important as the direct care that I provide. No one is impressed by the nurse with 20 years of experience but can't get anything done.
I've been on the night time side of pain medication administration to a sleeping individual. On my part, I kind of don't like giving pain medications to patients who are sleeping. We've all heard the complaint: "They woke me up to give me a sleeping pill (or pain medicine)!" But, a reality check this week unfortunately at the expense of my mom's comfort. She texted me at 0521, "Had terribe nite dohg xr.bxw...". Course, I didn't see this text until 0730 when I got up. Crap!! I was worried. When I talked to her, she said she had a lot of pain in the night and is still hurting. She couldn't tell me when she got her pain med in the night and she didn't know what it was. This is about 16 hours since her PCA was stopped. "Did they give you something in your IV?" I asked. "I don't know, I just hurt!" she said. My fears: they didn't give her pain meds "scheduled" and her pain got out of control. When I finally made it to the hospital, I had an opportunity to talk to the nurse. He looked up the pain med in the eMAR to see what times meds were given. She had received her every 4 hour medication after 5 plus hours and this was after crying out, then got her next dose in 3 hours 15 minutes. In conjunction with decreased movement from sleeping for 5 hours and the 5 hour time span, her pain got out of control. What was the nurse thinking? "Ah, she's sleeping, I won't disturb her" or "I don't want to give her too much medication, she could get addicted to the pain pills." Who knows what the murse was thinking and unfortunately, I've seen myself having the same internal dialog. Ultimately, though, I am a family member in this scenario and I was pissed that my mom was so uncomfortable. Why did she have to be suffering and "waiting" for her pain medication after literally getting her knee amputated then rebuilt? Why didn't that nurse anticipate the pain as an ortho nurse on an ortho floor??
NOTE TO SELF: Administer pain medication as a rule not as an exception. Why wait until my patients are in pain to get pain medication. Duh.
I think it's important to stop and take a second look at what I'm doing day in and day out and make sure that it meets the standard of my personal expectations and values. I can't let myself get lax and complacent. I have to remember that every one of my patients deserve the level of care that I expect for my own family. A message that I plan to remember in the coming days of my scheduled shifts.
I have been with my mom this week as she underwent a total knee replacement. Of course, they didn't do it at my preferred hospital, Children's Mercy, since she's, you know, an adult. It was an eye opening experience and it reminded me of a few things.
I take care of post op patients regularly. Sometimes they are post a fracture reduction, post feeding tube placement, post kidney transplant, post spinal fusion. Ideally, I see the patient several times in the first couple of hours, check their comfort, check their pain control, check their wound. But that's me and that's my hospital. It's kind of an expectation, you know, to look in on your patient after they have had a surgical intervention. Sometimes things go wrong after surgery, like bleeding, puking, pain. But again, that's just me and my overprotective nature. When I get to the hospital after Mom's surgery, about 2 hours after coming out of the OR, Mom says, "No, the nurse hasn't been in here since I got to the room." WHAT?!?!? You haven't seen your nurse, I ask. Nope, nada, negatory.... Great. Of course I can't help myself from looking at her dressing, looking at her iv fluids, the PCA, etc. Somebody needs to. Guess who's feeling a bit bitchy about now? Yep, I'm a little ticked and guess where the nurse is?? Lunch. Do you want to hear the cherry on top of this little shit cake? Her IV pump was beeping and continued to beep infusion complete for, I kid you not, 30 minutes. Her roommate...her IV was beeping as well, for 20 plus minutes. So that's at least an hour of that incessant beeping!! GRRRRRRRRRRRRRrrrr!!!!!!!!!
NOTES TO SELF: Continue to be the attentive nurse post op. Continue to answer my alarming pumps promptly and continue to keep the high level of care that is expected of me at CMH. Note I said continue. I never want my patients or families to be as annoyed as I was over something as simple as checking in with my patient and answering alarms. And the pisser of it all, any time I went to the nurses desk, her nurse and the others were at the desk talking and surfing their phones.
I've been a nurse for a bit, 15 bits, er, years, as a matter of fact. Most of my coworkers know this, but I don't routinely tell my families this. Sometimes it'll come up in conversation and sometimes, I will tell a family in a lame attempt at reiterating that I know what I'm doing and I can handle the placement of an IV or something. It's usually that family that is having some control issues that I find the need to bring it up. This week, my mom had a nurse who had this compulsion to tell us how long he'd been a nurse. It was funny how the story went from being a nurse for 18 years to being an Army nurse for 13 years to being a nurse here at OPRMC since 2004. Basically, I had his resume memorized by the end of my visit. Really??! Is it necessary to impart this useless information?? Do you think I think you're a better nurse because you report you've been a nurse for 18 years? Do you need to pin these comments onto the end of your excuses for not having placed the compression stocking on my mom's affected leg as ORDERED BY THE PHYSICIAN??? Really?!?!?!
NOTE TO SELF: The number of years isn't as important as the direct care that I provide. No one is impressed by the nurse with 20 years of experience but can't get anything done.
I've been on the night time side of pain medication administration to a sleeping individual. On my part, I kind of don't like giving pain medications to patients who are sleeping. We've all heard the complaint: "They woke me up to give me a sleeping pill (or pain medicine)!" But, a reality check this week unfortunately at the expense of my mom's comfort. She texted me at 0521, "Had terribe nite dohg xr.bxw...". Course, I didn't see this text until 0730 when I got up. Crap!! I was worried. When I talked to her, she said she had a lot of pain in the night and is still hurting. She couldn't tell me when she got her pain med in the night and she didn't know what it was. This is about 16 hours since her PCA was stopped. "Did they give you something in your IV?" I asked. "I don't know, I just hurt!" she said. My fears: they didn't give her pain meds "scheduled" and her pain got out of control. When I finally made it to the hospital, I had an opportunity to talk to the nurse. He looked up the pain med in the eMAR to see what times meds were given. She had received her every 4 hour medication after 5 plus hours and this was after crying out, then got her next dose in 3 hours 15 minutes. In conjunction with decreased movement from sleeping for 5 hours and the 5 hour time span, her pain got out of control. What was the nurse thinking? "Ah, she's sleeping, I won't disturb her" or "I don't want to give her too much medication, she could get addicted to the pain pills." Who knows what the murse was thinking and unfortunately, I've seen myself having the same internal dialog. Ultimately, though, I am a family member in this scenario and I was pissed that my mom was so uncomfortable. Why did she have to be suffering and "waiting" for her pain medication after literally getting her knee amputated then rebuilt? Why didn't that nurse anticipate the pain as an ortho nurse on an ortho floor??
NOTE TO SELF: Administer pain medication as a rule not as an exception. Why wait until my patients are in pain to get pain medication. Duh.
I think it's important to stop and take a second look at what I'm doing day in and day out and make sure that it meets the standard of my personal expectations and values. I can't let myself get lax and complacent. I have to remember that every one of my patients deserve the level of care that I expect for my own family. A message that I plan to remember in the coming days of my scheduled shifts.
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