Nurses and Patients' Rights

[luvmy3jewels]

I think it was probably a new nurse on orientation. Usually orientation lasts anywhere from 8-16 weeks and then the nurse is on their own. After 12 weeks of orientation, the nurse is just about ready to work on their own without a preceptor (the male nurse), so really at that point he is just there for support.

Yes, I think you are correct in that she was probably in the orienation phase. The thing that scared my sister the most was how unsure she was of what she was doing. It wasn't just one thing that happened, it was all day seeing her fumble. With a baby as critical as theirs is, it was just really frightening for them.

Wuh oh...my cousin is a nurse at a North Carolina coastal hospital. Hope he wasn't the one causing the problem.

This hospital is in VA, so no worries that it was your cousin

I am typing from my DD's hospital room at Children's Nat'l Medical Center.
OP....I will say a prayer for your precious niece.

Thank you. She can use all the prayers she can get. I will say a prayer for your dd as well. I don't think anyone can truly understand how stressful it is to see their child hospitalized unless they go through it.

I will add tho that it angers me when people want to be at a teaching hospital because they are the best then don't want to be "taught" on.

If you don't want students working on you go to a non-teaching hospital.

Also in an ICU sometimes nurses are assigned to patients because they are better with that particular illness or surgery and I think charge nurses should be allowed to do this over and above who the parents want.
Just because Mary has great bed side manner and Bob doesn't if Bob has his certification in whatever my child has that is who should be caring for my critically ill child not the nurse who I think is nicer.

First of all, the parents of this baby were never given a choice about what hospital the baby was transferred to. This hospital was the closest that had a NICU and she is not stable enough to be transferred anywhere else. It also happens to have a reputation for being an excellent hospital so they were shocked at the way they were treated yesterday. Other than that, the nursing care they have recieved has been exceptional. (By the way, I would think the charge nurse would want to make sure that the most critical babies had experienced care and not a nurse that is still in orientation.)

The good news is that this morning the baby is doing better and has been switched down to a regular vent. My sister says that everyone there is being extra nice today.

Oh and in regards to the comment about patients' rights being posted in the hospital. They are posted on the wall in the pump room and state "it is the patient's right to refuse care."

 

[npmommie]

glad to hear things are better today

 

[arminnie]

I am SO sorry that they have had to go through all of this. It is never easy to have a child in NICU.

But remember the medical's staff's FIRST priority is to keep the child healthy and alive. Unfortunately "keeping the parents happy" may not even by on the list.

 

[tlbwriter]

Oh and in regards to the comment about patients' rights being posted in the hospital. They are posted on the wall in the pump room and state "it is the patient's right to refuse care."

Unfortunately, that means the right to refuse care at all (such as a DNR order). It doesn't really imply the right to refuse care from a particular caregiver and request another instead. However, there *should* be patient rights about the way they are treated, and it's hard to imagine those were not violated.

I'm glad your niece is doing better! I know a 30 weeker and a 28 weeker and they're both doing great - and that was with the level of care you got 10 years ago!

 

[MomRN]

I would also assume that the "new" nurse was a nurse on orientation. When I was in nursing school our NICU rotation was 4 hours of nurses breathing down our necks (as they should) and that was a lower level NICU.

As the PP said, go to the nursing care manager first. Then go up the chain.

 

[chloelovesdisney]

Your sister has EVERY RIGHT to refuse a student nurse in the care of her baby in that NICU.
Where was the school nursing clinical supervisor? normally they are right there on the unit too most times.
she can also speak to them.
she should inform the nursing supervisor on duty for the hospital that she does not want a student caring for her baby. done deal.


Speaking from experience, yes it can be nerve wracking when you are new to nursing, you are being watched, and you know what to do but yes still a little unsure.
but if the patient is in any way uncomfortable with a student they certainly can refuse.

It sounds like a nurse on orientation with a preceptor, not a student nurse.

 

[chloelovesdisney]

I promise you, you can absolutely refuse a particular nurse. If the charge nurse won't help you then ask for the nurse manager of the unit, then the nursing supervisor, then the administrator on call. Also go and speak with patient services. Assignments can be switched when need be and certainly a different nurse can be assigned in future shifts. They were just being ornery for some reason.

On a separate note, just because the nurse on orientation was nervous and fumbling (which I promise you she was even more so because your sister and her dh were watching her every move which can be anxiety producing in the best of situations and their unhappiness was probably evident making her even more nervous) does not mean she did not know what she was doing or was doing anything wrong in the least. Also, because the preceptor was sitting in the chair observing does not mean he wasn't aware of what she was doing the entire time and my guess is that there is a central monitor he can watch the baby's vital signs from. If there's any issues with the ventilator you can hear that from a mile away so I promise you the baby was not in any danger or not being watched carefully.

After 12 weeks on orientation with a preceptor you are usually spending most of the shift caring for the patient alone with your preceptor observing and available for questions or issues. The preceptor is NOT supposed to be on top of the nurse on orientation by that point in time.

All that aside, even if everything is fine and the baby is getting good care, if the parents aren't comfortable it's best for everyone to assign a different nurse and I would also do so.

Also remember a more senior nurse that is very calm doesn't necessarily give the best care, but it may appear so to the outside observer.

I'm very happy to hear the baby is improving today, I'm sure she'll be home shortly.

 

[minkydog]

I highly doubt this was a student nurse. It's pretty hard to get on in a NICU without some significant peds or adult ICU or ER experience. That said, you are completely within your rights to request a different nurse. There may be times when switching nurses is simply not possible due to patient acuity or crises on the unit. But it doesn't sound as if that was the problem that particular night.

I worked in a well respected specialty NICU for over 10 years. We cared for the sickest of the sick--most of our babies had undergone surgical interventions to save their lives. Even though I was a very experienced veteran, I have had a parent request a different nurse. I had a very critical, very early premie patient (NICU patients are ALL critical). Two nights in a row, she "crashed" on me. Even though it wasn't my fault, the parents (understandably) lost faith in me and requested another nurse. I totally understood--they were throughly spooked.I recognize that having a child in critical care is most likely the absolute worst experience a parent can have, short of losing a child. I switched assignments and didn't take it personally. The baby eventually smoothed out and did okay, but not without crashing several more times over the following 10 weeks. It was very hard on the parents and they really struggled with the whole experience. Often they blamed the nurses when things went wrong. But that's the nature of critical care. Sometimes things go wrong no matter how much experience you have, no matter how hard you work to keep them stable.

 

[xCourxCorex]

I agree with PPs who said that the nurse is most likely a new RN, 12 weeks into his/her orientation with the hospital.
I'm in nursing school now (Maternity rotation) and we are not even allowed to do ANYTHING in the NICU. We get to go down and look around, talk with the nurses and observe them, but we are never assigned a patient or do any direct care, so I highly doubt it is a student nurse.

I also think that the supervisor/preceptor nurse is behaving unprofessionally, whether it's just with your sister and her family, or if that's how he is with other families too, it doesn't seem acceptable. She should definitely talk to someone about requesting a different nurse if possible. Good luck to them

 

[LovableGluttons]

I'm a nurse and have no problem requesting someone else if it makes me more comfortable. Having a rapport with both the patients and their family is important!

 

[C.Ann]

You've received good advice here.. Just wanted to say that I will be keeping your family and this precious baby in my prayers..