Tuesday, 12 January 2010
Good Things are Happening. I think.
So the first thing that I learned today is that starting tomorrow my ward will be using signs and tabards to protect the staff nurse from interruptions when she is trying to do a complicated and time consuming drug round for a ward full of medical, surgical,elderly, and neuro patients.
It cannot come soon enough. Time to try this idea again.
I hope to god that the visitors take note of it. Interruptions during drug rounds are one of the major causes of errors that hurt hospital patients. When the nurse is with that drug trolley she is concentrating on about 100 different things. She also has to move quickly and medicate/assess a large number of often uncooperative and confused patients with lots of prescribed drugs in a short amount of time. Every patient on the ward is going to be due their drugs at the same time. It can take 2 hours to get through 12 patients for their 8 AM medications.Then 4 hours later they are all due again. Leave her alone unless it is an emergency. Twice I have seen fatal drug errors as a result of the nurse being got at by other patients' visitors (with minor issues/questions and then abuse when they didn't get the answer that they wanted) during drug rounds. It wasn't pretty.
I know it is hard for people to accept but when you are sharing your nurse with lots of other people she cannot be there when you think that she should. I have had many visitors interrupt during drug rounds. If it is an emergency than fine. But they interrupt to ask when Aunt Lola's nursing home will assess her. Then they rationalise it by saying "It's not convienant for me to talk to the nurse later because I have a nail appointment." Um. No. What is not conveniant is the nurse making an error that hurts or kills a patient because you are in her face.
This is even more important to get across to social workers and other health care professionals who do this to the nurses. And these people should know better. I understand the visitors not realising but there is no excuse for any hospital employee to behave like this. Social workers will walk past 3 health care assistants making a bed and tell a nurse who is concentrating on pulling drugs that someone needs a pillow. I am just as happy to fetch a pillow as anyone else but if you stop me during a drug round to request it and I go on a hunt for it and lose my focus, someone might get hurt. Yes, it is so intense that simple requests for pillows could screw it up and do harm, even if you don't want to accept or believe that. Not so with the healthcare assistant however. Not ever.
I have also heard a rumour that we are going to be getting 1 (possibly 2) new staff nurses to replace the 5 we have lost. Real staff nurses. I have heard this before. Let's hope they give them a job this time.
So we have some good news. Nothing major but a step in the direction. It's always good when management does positive things, even if they are small steps.
Should I start a poll to see how many of you think that visitors and allied professionals are going to ignore the tabards and then cry out for the nurses' blood when a drug error occurs?