posted on September 9, 2001 10:50:27 PM new
It seems in an attempt to achieve a healthy bottom line, more hospitals are using aides to do the work of RN's. In some instances these aides that are doing IV's, cathaters and such had been in housekeeping the week before. When you are sick enough to be admitted how in the world do you know who is giving you care. They all wear badges, that you can't read. Who is is that is interfacing with the Dr. regarding your reaction to meds etc.
Anyone know someone or have experience with this type of situation?
posted on September 9, 2001 11:34:02 PM new
My personal experiences with hospitals have been very discouraging. I have to be in unbearable pain or unconscious before they are options.
posted on September 10, 2001 04:13:02 AM new
Fortunately my experience w/hospitals has been very limited. But...
I once had to pull a Shirley Maclaine (sp?) from Terms of Endearment to get a nurse to give my mom her scheduled pain meds. After she went in, I asked to speak to her supervisor and told her my mother didn't like that nurse and if possible could she please have another nurse tend to her. She actually did shuffle the nurse around so my mother never had to see the b*tchy one again.
My grandmother had signed a DNR. Well Florida HMO's apparently see seniors as disposable. I was called in the middle of the night by a doctor who was concerned that they were going to let my grandmother die when a simple procedure could prolong her life a bit (I had power of attorney at that point and also power to make some medical decisions). Note: she wasn't unconcious, they were going to let her lungs fill up with fluid and let her drown to death! I thanked the doctor, drove to the hospital, and told the hospital that DNR or not, if they came close to doing that again, they wouldn't have to worry about a lawsuit, because when I was done with them I'd be serving serious time. I was serious as a frikkin' heart attack.
Now for the good news. The experience I had at a hospital in Toledo, OH was so pleasant that it would almost be worth the 2000 mile (now) trip if I ever had to go to a hospital again. My doctor was the best I've ever had, and the nurses were bright and helpful. The food was awful, but it was ok to have pancakes at any meal, so even that was ok. My hat is off to the medical community in Toledo.
posted on September 10, 2001 04:44:51 AM new
I have been in a lot of hospitals and there is as much variation of ability and honesty as there is an auto repair.
There is also the matter of experience.
I would much rather be taken to Pontiac Osteopathic than Crittenden in Rochester if I have a massive injury. Why? The Pontiac hospital has a trauma center that sees massive wounds from high powered pistols and assault rifles every week and they can treat someone who comes in on the gurney looking like they should be wrapped in cellophane and sold as a rump roast. Crittenden gets 4 or 5 like that a year. Practice does matter.
I just saw a show last night about the "Lost Boys of Sudan" These kids walked away from the war in Sudan ended up in Kenya and the United States agreed to take 3,500 of them.
They have been in refugee camps for years and most of them are around 19 or 19 now.
The three they were showing are sponsered by a Catholic charity to come here and they are expected to be self supporting in 4 months. They got them into a 5 week nurses aid auxilery program that trains them to change beds - roll patients over - take their blood pressure etc. Fairly simple things. However they admitted they were very difficult to train because they have to be shown how to open windows - adjust blinds - use the toilet - things we all take for granted another trainee woiuld know. I really worry that for a long period maybe a year their patients will be at risk of them doing something dangerous because they don't know how to live ina technological society. They have never seen cleaning products so for example they may mix toilet bowl cleaner and bleach which makes poisen gas. If there is a fire have they taught them how to get a fire extiguisher and use it? Will they know how to escape a fire themselves in a big building?
I don't think it fair to the patients to risk them before those young guys have had a year here to know the very basics.
posted on September 10, 2001 05:40:08 AM new
From what I've witnessed in the last couple years, I'd say that any patient in a hospital better have a strong family advocate. My father has been in the hospital about five or six times in the past year and we've been lucky that my sister who works for the same corporation knows about hospital procedures and what should be done. The hospital in which my father stayed has a national reputation in its speciality but basic nursing care is there only if one knows what to request - it won't be volunteered. Daily baths, changes of bed linens,massages, turning patients to prevent bedsores etc. are NOT routine. A few years ago one patient who had a mastectomy shared a room with my sister. The hospital discharged this woman after a day and a half even though her relatives didn't understand how they were to help her with the drainage tubes,etc. and the woman was too sedated to comprehend what was being told her.
I think your best bet if the stay is for an elective procedure is to ask questions of the doctor before going in and those should include: what roles do different staff members have? what infection fighting procedures are in place? what can I do to help? (Our family changed the sheets daily for my father and bathed him - that way we were sure it was done, but we also had a sibling who is a nurse.) Patients' families shouldn't be afraid to ask questions, but they should also avoid being Ps-in-the-As, because staff is often short in hospitals and as a patient's advocate one wants to be taken seriously not as a petty whiner.
[ edited by saabsister on Sep 10, 2001 06:41 AM ]
posted on September 10, 2001 06:18:32 AM new
If there is any way I can avoid a stay in the hospital I will for another reason. One of my family went in and died of one of those super - antibiotic resistant bacteria that was unrelated to what he went in for. Another relative went in and soon after coming home developed a life threatening infection of the resistant sort.
I don't think they have good controls to prevent transmission of infection.
posted on September 10, 2001 06:19:19 AM new
Saabsister took the words right out of my mouth. Having an advocate who can speak up for you is very important. When my father was in the Cleveland Clinic last summer, I was amazed at the difference in respect we all received once the doctors and nurses realized they were dealing with informed family members. I had done some research concerning the procedure they hoped to try on my dad, and "name dropping" as it were got their attention.
Personally, I think short staffing is the root cause of many complaints. The bottom line has become more important for many hospitals, and they continue to raise patient/nurse ratios, increase hours per shift, and cut back on aids. I have a couple of friends who are nurses, one an LPN and one a RN. Both are very frustrated with how much less time they actually get to spend with patients due to time contraints and overwork.
posted on September 10, 2001 08:28:38 AM newIt would be great to hear from any nurses or former nurses and get their input on what is happening. Any suggestions on how to get an RN instead of an aide?
posted on September 10, 2001 09:03:35 AM new
Generally what has happened is that women have a lot more career choices than the traditional ones - nurse, teacher, secretary - and they're opting for careers with better working conditions, more advancement, and more respect. The RNs I know are paid well - they work two 12 hour shifts on the weekends and are paid full time. This may be a reflection of a regional nursing shortage but I'll bet it's national as well. If an LPN or nurse's aid can do a job legally, he/she will probably be the one assigned it. Our health care plans are responsible for many of these changes as well. If there's a nurse's station on the floor, ask questions there. Just be aware that just about everyone's family is asking for the same thing.
If you want an RN, it is a good idea to hire one for two or three days and exit the hospital environment as quickly as possible. The nurses station can help recommend a private duty nurse.
Hospitals are dangerous places. As Gravid suggested, it's an environment in which germ resistant infections abound and sick people are especially vulnerable because their immune system may be compromised. Besides risk of infection, medical errors are committed both by doctors and RN's.
It's very important to know as much as the doctor and nurse in order to get out alive. The family and if possible, the patient should know what medications are being used and for what purpose they are prescribed. And heaven help the poor patient without a family or spokesperson.
For the first time, I agree with uaru on this one!!! I will only go to a hospital in an unconscious condition.
posted on September 10, 2001 01:29:04 PM new
Within the last 3 years, I have had occasion to be involved with "drive thru" surgical procedures. In both instances I wound up in ICU overnight due to complications! Both diverse procedures were to be done in the am with departure in the afternoon. I certainly didn't want to stay overnight, but given the circumstances I didn't have a choice. In both instances hemorrhaging was the problem in spite of precautions being taken. I never saw the Dr. on the second go round til 3 the following afternoon in the middle of a blizzard I was released and my husband had to drive over an hour to come and get me. I took two hours to get home! They offered to let me stay overnight as a patient...hubby said no!
posted on September 10, 2001 01:48:06 PM new
in the night strange rituals are performed. dying people are placed on giant turntables and hooked together with healthy people by tubes in their arms. then the table is turned on and begins to rotate faster and faster which makes the blood flow out of the people by centrifigal force to be mixed all together in a trough around the top of the room. when the table is stopped the blood all flows back. after ten minutes all the people are unhooked and many who were sick are cured but some who were healthy are not anymore. some lie dead, only a few, and they are removed by dawn.
posted on September 10, 2001 01:50:14 PM newAny suggestions on how to get an RN instead of an aide?
If you want all care given by an RN, you'll have to call an agency for a private duty RN.
If it's a med/surg floor, the typical assignment for an RN is 8 - 10 patients. Responsibilities include giving meds, invasive nursing procedures such as starting IVs, catheters, ect; care of lines and drains, drawing blood, hanging fluids or blood products, pulmonary care, admissions, discharges, updating nursing care plans, informing MDs of changes in condition, ordering meds and supplies, physical assessments, witnessing consents, and charting all that.
And then, there's the emergencies. That takes top priority.
As to identification, it should be clearly marked on the ID badge. If you can't see it, ask.
I have never heard of hospitals using NAs to perform invasive nursing procedures such as IV insertion or urinary cath insertion, but I'm off in the NICU, where the unit is all RN. I did ask my DH (floor), and he said he hasn't heard of that happening in any of the hospitls he's worked in.
The best infection control measure is good handwashing.
As to staffing, short staffing has been mentioned. Units used to staff by # of patients and acuity (how ill the patients were). Now, acuity isn't taken into account. It is strictly by the #s.
Another big problem I have seen is floating. A supervisor will decide to float a nurse from one unit to another, regardless of experience and qualifications.
posted on September 10, 2001 01:56:11 PM new
As a paramedic, I have lots of friends that are both RNs and LVNs. I've had years of experience in dealing with hospitals, both as a medic and as a family member of patients. Personally, I'd have to be dead before I'd go to a hospital, but that's just my stubborn way!
I could sit here and bore y'all to tears with war stories, both good and bad, and give suggestions till I'm blue in the face...but I'll spare you. The suggestion for an advocate is excellent and probably the most important. That's my role in the family and with friends, and I like to think that I'm very good at it!
Instead of my tirade on the sorry state of healthcare, I would rather recommend a perfect book. It's called "How to Get Out of the Hospital Alive" by Sheldon Blau, MD. He wrote the book after becoming a patient and seeing things run from a patients perspective. I highly recommend it to everyone, whether you are dealing with hospitals presently or not. It's something you want to have looked over before you need it, if possible. (Besides having read it several times myself, it seems to be very effective if you just take it to the hospital room and leave it in plain view on the bedside table, for all to see!)
posted on September 10, 2001 02:47:06 PM new
"How to Get Out of the Hospital Alive" by Sheldon Blau, MD ~ sounds downright frightening...the greatest problem as in my case, I have no advocate, my husband panics so easily that I could not rely on him to make decisions or to follow thru with the DRs. So in the event that I am heavily sedated or comatose I guess it is a "crap shoot"
Special Feature in Sept 2001 Readers Digest:
How Hospitals are Gambling with your Life.
Some pretty scary procedures uncovered in Santa Rosa, Ca and other hospitals across the country being done by unlicensed assistants and aides!
Deep tissue suturing, placing pins in bones by unlic. assist.
Bottom line...stay healthy!
posted on September 10, 2001 03:14:39 PM newSnowy based on the locale and time frame this looks like the same case, in the Digest they referred to the person as an unlicensed assistant performing those procedures. According to a followup of that incident a year later, by Calfironia Healthcare Assoc. revealed that unlicensed staff was assisting in surgery in at least 20 CA. hospitals. The article goes on to tell of other examples across the country of aides, and unlicensed assts. performing duties that should be handled only by RNs.
posted on September 10, 2001 03:29:13 PM new
I read once that many hospitals in the southwest, particularly Texas, have problems with infestations of pharoah ants. These ants are carnivores, and are particularly fond of eating new tissue that forms in patients recuperating from open heart surgery. They also like to dine on the eyelids of newborn infants in the nursery.
(I'm really not making this up. I read the article in Pest Control, an industry trade magazine.)
posted on September 10, 2001 03:33:29 PM new
Were you in a hospital waiting room when you read that Spaz? Brrrrr gruesome! Now you have to bring your on Raid, and a !Bandaid
Brrrrr gruesome! Now you have to bring your on Raid, and a !Bandaid