What to do when nurses won't listen
Sometimes you have to be firm to get proper nursing and physician care
It is scary to think about, but hospitals can be dangerous places.
Any time that I know someone who is hospitalized, I encourage them to have a friend or family member with them around the clock. It is a simple truth that patients fall through the cracks, but we have all heard about how the squeaky wheel gets the grease. Family members and friends can provide important information to the health care team—if the doctors and nurses are just willing to listen.
Sometimes, though, health care providers do not take family members’ complaints as seriously as they should. I saw this first-hand when I recently took the deposition of a registered nurse who works at a hospital in The Woodlands, Texas. To preserve confidentiality, I will call her Nurse Smith.
During her deposition, Nurse Smith provided some alarming testimony about the value or reliability some healthcare providers place on information provided by their patients' loved ones.
Nurse Smith was assigned to take care of a hospitalized elderly lady who had broken her hip. This precious grandmother had been admitted to the hospital and was awaiting a hip replacement surgery.
One of the well-known risks in patients with a hip fracture is the development of an embolus, which is a blood clot that is dislodged and travels through the bloodstream. It can end up blocking a main artery and cause a heart attack or death. This serious, life-threatening risk is one of the reasons that nurses need to watch closely their patients with hip fractures for signs of a problem.
The night after this lady was admitted to the hospital, her son noticed that she was acting strange. His mother was calling people by the wrong names, was in a lot of pain and was restless. The son told Nurse Smith several times during the night that he was concerned about his mother and what he had noticed.
What that son observed were signs and symptoms of a change in mental status. As a family member, he knew when his mother was acting in a different manner and did his part by telling the nurse. While these are non-specific signs and symptoms, they very important and require the nurse to report them to the physician. Even Nurse Smith testified that ‘It’s possible’ that a change in mental status could be a sign and symptom of a potential embolus in a patient with a hip fracture.
Nurse Smith remembered this patient’s son telling her several times about his concerns over his mother’s condition. Yet, Nurse Smith chose not to call the doctor. In fact, she did not even document in the medical records any of the conversations that she had with her patient's son. The nurse went further and testified that even if one of the hospital’s nurse’s aides (a PCA) saw the same thing as the loved one, and told Nurse Smith, she still would not even write about it in the medical record.
Despite all of the son’s reports, Nurse Smith chose not to do a thorough assessment of her patient’s mental status during her entire shift and never called a doctor.
A nurse’s decision on whether or not to inform a doctor about a change in mental status can mean the difference between life and death. Unfortunately, the patient in this case died. Our physician expert believes she died because an embolus from her broken hip became dislodged and caused the cardiac arrest. We believe that with the warning signs that the patient's son provided to Nurse Smith, this could have been avoided.
This family member did the right thing by reporting his loved one’s change in mental status to the nurse. If you find yourself in this situation, it is always appropriate to report what you see and to ask for help. If the nurse seems disinterested or hesitant, ask to speak to a charge nurse or the administrator on duty.
If you or someone you care about has been harmed by medical malpractice, Painter Law Firm’s medical malpractice attorneys are here to help you. You can reach us at 281-580-8800.
Robert Painter is a medical malpractice lawyer at Painter Law Firm PLLC.
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A physician has to supervise the care and prescriptions of nurse practitioners and physician assistants under written, signed agreements
On 4/1/2018, the new law will end the current practice where doctors can secretly enter a DNR order against patient and family wishes
This article was originally published in the September/October 2017 edition of "The Houston Lawyer" magazine
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