Question for hospital Nurses

[JoiseyMom]

If a family of a patient says they can't put in a foley (they tried 2x and couldn't do it, and the 100 year old patient was SCREAMING in pain), can they turn around, after the family leaves and do it anyway? Isn't that violating the patients rights?

 

[dzneelvr]

This truly is not a question that could be answered by anyone not directly involved in the program of care for this specific patient. You should be asking the care providers at the facility the patient was treated in.

 

[JoiseyMom]

This truly is not a question that could be answered by anyone not directly involved in the program of care for this specific patient. You should be asking the care providers at the facility the patient was treated in.

You mean the nasty women who have given my DH lots of lies and excuses and now ignoring him? Seriously?

So rules are different in different hospitals? Some will ignore what a patient wants and others will not?

 

[Handbag Lady]

You mean the nasty women who have given my DH lots of lies and excuses and now ignoring him? Seriously?

So rules are different in different hospitals? Some will ignore what a patient wants and others will not?

Go to a hospital administrator and find out. You need to go above the caregivers.

 

[happygirl]

You mean the nasty women who have given my DH lots of lies and excuses and now ignoring him? Seriously?

So rules are different in different hospitals? Some will ignore what a patient wants and others will not?

I think her care plan needs to be followed. some patients can;t make good choices for themselves.

 

[RitaE]

The hospital should have a patient advocate. That is who you need to contact.

It is hard to say anything without knowing the specifics of the patient and the care received.

 

[MomRN]

Generally, alert and oriented patients have the right to refuse anything. I would need more information to express my opinion on whether putting the catheter in was justified, which may include conversations that occurred after family left.

Take it to the nursing care manager of the unit.

 

[NewmanFamily6]

As a RN absolutely not they should not go against family wishes even if the physician ordered it. Nurses are patient advocates. She is 100 yrs old and screaming in pain. If she is unable to make decisions it is up to the family. Go to hospital administration.

 

[BearcatsFan]

If a family of a patient says they can't put in a foley (they tried 2x and couldn't do it, and the 100 year old patient was SCREAMING in pain), can they turn around, after the family leaves and do it anyway? Isn't that violating the patients rights?

I don't have any advice. I just want to say I'm sorry for what your family is going through.

 

[abbadackerygirl]

Our 84 year old grandmother got bedsores because she was neglected at a supposedly great hospital. We contacted the head nurse and she was horrified at the lack of care her nurses were giving. I would definitely contact the administrator, and if you get nowhere with that, contact his/her boss. Keep going up until you get what you want from them.

Unfortunately though, they may have had no choice but to administer a foley if she wasn't able to urinate on her own. Was she able to use a bed pan?

 

[badblackpug]

there are way to many variables missing from this story to give an opinion.

1) Why did she need the foley?
2) Is she mentally competent
B) If not, does she have a durable power of attorney?
3) Does she have an advanced directive or living will that states what procedures are acceptable and what are not?
4) Who placed the foley?

 

[disfan07]

there are way to many variables missing from this story to give an opinion.

1) Why did she need the foley?
2) Is she mentally competent
B) If not, does she have a durable power of attorney?
3) Does she have an advanced directive or living will that states what procedures are acceptable and what are not?
4) Who placed the foley?

If she has an advance directive that states only comfort measures, the foley might actually be a comfort measure. If she cannot urinate, that can also be excruciatingly painful (believe me...been there done that).

Who is responsible for her care? She should have an advance directive at that age....everyone should have an advance directive. I have an advance directive at age 23 because of my chronic health issues.

The problem is, if she is not mentally competent, no advance directive and no POA, etc, things could get sticky.....

There's no clear cut answer and it's not as simple as yes or no. Wheni was creating my advance directive it was amazing the things we had to consider (pain meds, ventilator, foley cath, fluids, addition meds, CPR, etc) it's definitely not cut and dry.

This is why, no matter how difficult of a conversation it is, EVERYONE needs to have this discussion abut their medical wishes and create an advance directive.

 

[shinysparklybubbles]

Every time my son was in the hospital there was a paper posted in every room with a number to call if you were unhappy with care. Take a look around in the drawers or bathroom for a number.

 

[epcotfan]

Depends on Dr's orders and the patient care plan/advance directives. Who is their advocate if they are mentally incompetent of making decisions for their care?

 

[LoserMomma]

Hospitals are obligated to tell you who to contact if you're not satisfied. Being that it's a weekend, that individual is probably not on site until Monday. However, there is usually a nursing supervisor on duty during non-business hours. I'd take this route: nurse, charge nurse, nursing supervisor


They may have also found someone who was more skilled with difficult insertions who could get it in without as much discomfort. If the patient is competent, it's not the family's decision, it's the patients.

 

[Disney Doll]

If a family of a patient says they can't put in a foley (they tried 2x and couldn't do it, and the 100 year old patient was SCREAMING in pain), can they turn around, after the family leaves and do it anyway? Isn't that violating the patients rights?

Not necessarily.
But there's not enough information to make any kind of judgement.

Some things that would play into the decision to attempt again to insert a Foley:
1. What are the consequences/how much discomfort will there be if we don't insert a Foley? Sometimes 5 minutes of discomfort is worth it to prevent severe complications.
2. Can the Foley be inserted by someone else who might have a better technique for a difficult insertion?
3. Is the patient competent? If so, what the family thinks has no bearing.

Since you are calling the nurses nasty women who are ignoring your husband, I'm guessing we're not going to get a real unbiased amount of information.

I'm also guessing that the nurses might be a bit more willing to talk to your husband if they weren't being referred to as "nasty women".

I wish your family member well.

 

[JoiseyMom]

there are way to many variables missing from this story to give an opinion.

1) Why did she need the foley?
2) Is she mentally competent
B) If not, does she have a durable power of attorney?
3) Does she have an advanced directive or living will that states what procedures are acceptable and what are not?
4) Who placed the foley?

She broke her hip and was in the ER where they tried to insert it the first time and could not. Once she was admitted the asst. nurse manager tried to and could not.

No, she is not mentally competent.
Yes, she does, her son (who is my fil) has it. He was in FL, and gave told them my DH and BIL have the right to deal with her care. (Yes he should have done this before he went to FL, and I am going to make sure if she survives surgery tomorrow (broken hip) that he give DH and BIL medical poa when he is not here).
She has a DNR.
It was placed after DH went home, and he thinks it was the asst. nurse manager. But she was told not to try again since she was fighting it.

She can not use a bed pan, she is in adult diapers.

 

[JoiseyMom]

Not necessarily.
But there's not enough information to make any kind of judgement.

Some things that would play into the decision to attempt again to insert a Foley:
1. What are the consequences/how much discomfort will there be if we don't insert a Foley? Sometimes 5 minutes of discomfort is worth it to prevent severe complications.
2. Can the Foley be inserted by someone else who might have a better technique for a difficult insertion? Well no, since the one who tried to do it said she was the master at it, and couldn't.
3. Is the patient competent? If so, what the family thinks has no bearing.
No she isn't.

Since you are calling the nurses nasty women who are ignoring your husband, I'm guessing we're not going to get a real unbiased amount of information.

I'm also guessing that the nurses might be a bit more willing to talk to your husband if they weren't being referred to as "nasty women".

I wish your family member well.

First of all DH didn't call them nasty to their faces. He was texting me his frustrations. And there was no reason for them to be nasty and unprofessional to my DH. NONE. Beleive me, my DH is not one to complain about behavior unless it is really bad. DH had been nice and great and sweet, but not when his wishes for his grandmothers care aren't being listened too. That is frustrating. His grandmother is 100 years old, has a broken hip, that if they don't fix, she will probably die in bed in a few months (medical opinion), but there is a good chance she won't survive the surgery, but has to have it. So he is dealing with the fact that his grandmother is going to die very soon. He is dealing with all the care since his father is out of town, and couldn't get in until this evening. He is stressed, and sad, and frustrated. And when he told them not to, they should have listened and not given him attitude and ignored him after wards.

And yes, I gave him the number of the advocate (they are there over the weekend). We also know the chief of the ER, and I wish he would have called him, but DH hates playing that card unless he has too. I want him to file a complaint, but it is up to him to do it. We have been taking turns at the hospital and I wasn't there when this happened. Even her private aides had gone home.

DH went tonite to pick up his dad, and I stayed there with her to make sure she was ok, until he brought his dad there. They changed shifts while I was there and the night nurse seemed nice. Heck, visiting hours end at 8 pm and we were there until 11:30 PM. Heck my DS and DIL came after 10 PM.But what is done is done. I know I really wasn't comfortable leaving her alone there tonight, but it isn't my call. I have spent more time in the hospital over the past two days then I have with my kids.

Sorry for venting, I know nurses work hard and there are alot of you there, but this is frustrating which I why I asked if there was a procedure. Before this happened, DH was very happy with the nursing care.

Ok...off to sleep, tomorrow is going to be a long day.

 

[badblackpug]

First of all DH didn't call them nasty to their faces. He was texting me his frustrations. And there was no reason for them to be nasty and unprofessional to my DH. NONE. Beleive me, my DH is not one to complain about behavior unless it is really bad. DH had been nice and great and sweet, but not when his wishes for his grandmothers care aren't being listened too. That is frustrating. His grandmother is 100 years old, has a broken hip, that if they don't fix, she will probably die in bed in a few months (medical opinion), but there is a good chance she won't survive the surgery, but has to have it. So he is dealing with the fact that his grandmother is going to die very soon. He is dealing with all the care since his father is out of town, and couldn't get in until this evening. He is stressed, and sad, and frustrated. And when he told them not to, they should have listened and not given him attitude and ignored him after wards.

And yes, I gave him the number of the advocate (they are there over the weekend). We also know the chief of the ER, and I wish he would have called him, but DH hates playing that card unless he has too. I want him to file a complaint, but it is up to him to do it. We have been taking turns at the hospital and I wasn't there when this happened. Even her private aides had gone home.

DH went tonite to pick up his dad, and I stayed there with her to make sure she was ok, until he brought his dad there. They changed shifts while I was there and the night nurse seemed nice. Heck, visiting hours end at 8 pm and we were there until 11:30 PM. Heck my DS and DIL came after 10 PM.But what is done is done. I know I really wasn't comfortable leaving her alone there tonight, but it isn't my call. I have spent more time in the hospital over the past two days then I have with my kids.

Sorry for venting, I know nurses work hard and there are alot of you there, but this is frustrating which I why I asked if there was a procedure. Before this happened, DH was very happy with the nursing care.

Ok...off to sleep, tomorrow is going to be a long day.

Okay, with a little more information. No, whomever placed the foley shouldn't have if your husband told them explicitly "no foley," (unless they cleared it with his father) but the reason they did probably place it was for her comfort. With a broken hip it is very, very painful to roll her to change her pamper every time she is wet. With the foley, it was a one-time pain. I'm not excusing them doing something against your wishes, just explaining that they were, probably, doing it with her comfort in mind.

Regardless of your husband's relationship with the EM chief, if the foley was placed on the floor, or by another department other than the ER he can't do anything for you.

Broken hips in someone so elderly is such a rotten thing. (as an aside, if she lives in a nursing home please investigate how she fell) That really stinks to have to go through this.

Most importantly, make sure she is getting adequate pain relief. If she has dementia she may not ask for pain medicine.

Good luck.

 

[chloelovesdisney]

If she has a broken hip, she's much better off with a foley in place. Perhaps they gave her some pain medicine and she was more relaxed so they were able to insert it with less difficulty. I assure you, it would be much worse for her and more painful to continually have her diaper changed with a broken hip.