Tuesday, April 26, 2011

Cant you see I'm Charting

One of my biggest pet peeves is when more attention is paid to the chart than to the patient. Boy, today I got peeved. I was seeing a patient in one of the units when their asymtomatic tachycardia became very symptomatic with the sudden accumulation of a large amount of blood with froth in the chest tube. At first I thought it was something even more worse than it appeared but I managed to press down on the chest and twist off the chest tube hoping the bleeding would tamponade the lung. While all this is going on I am yelling for help. After four or five yells and trying to use my foot to hit the code alarm I finally heard the nurse yell, "can somebody get that, Im charting!" The RT popped in when the vent alarms went off and helped me. Finally the nurse showed up. After the patient was taken care of, I though about what had happened. If I hadnt been there, the chart would be perfect but the patient would have been dead.


SeaSpray said...

So Throckmorton ...did she live long enough to leave the pts room? Did you reprimand the charting nurse or raise heck with the ADN or write anyone up? Just curious how you handled it.

That was unacceptable!

I can see if others were involved directly in patient care they could not pull away from, but charting?

I would never want to see anyone in trouble, but when life and death is involved ...that just was not acceptable. It is scary to know how easily patient care could go south because staff does not put the patient first.

I have to say, that I cannot imagine any nurses I know that would not have immediately dropped what they were doing to assist you on the first call for help.

Perhaps a breakdown in communication - knowing who was available? Or some staff issue where they all think someone else should do it? Still ..a physician or *anyone* yelling for help? Should be cause for a priority response. Plus code team?

I would r-e-a-l-l-y want to know why the nurse did not consider your request for help important. Sounds like a staff meeting is in order.

I know nurses are often short staffed and additionally put upon with ridiculous amount of paper/computer work. And thank God for all they do.

But ...I just cannot imagine no one would've helped. In the past I know that would n-e-v-e-r have been acceptable - would it?

And second to the obviously emergent situation going on ...what if ...other patients, family and other non medical people witnessed that. It would not instill confidence in care if they realized what was going on. Nor would it be good PR.

Are you able to say how it was handled/corrected?

Allison said...

I don't have a blogger account so I'm using my wife's account. I have to say that I am so amused by your posts. I pop onto your blog about every month or two to catch up. I am a healthcare provider at a military hospital and I feel like you are taking pages from my life journal and writing them down for me so I don't forget. Thank you for all the laughs.