A Hospital Nightmare: Nursing Negligence in a Near Death Experience

The operation was performed in February 2006 without complications. Because of the nightmare that follows, I may not continue my career as a nurse. I am not one of those overbearing RN visitors who try to tell others how to do their job or interfere with their duties. I have had some of those and vowed never to act in that fashion. I was a healthcare surrogate and acted as such.

When "Gary" returned to the ward after surgery, the young new nurse wanted to give him a Demerol shot. I informed her that he does not like needles and asked if she could get the order changed to another drug IV, she stated she called the doctor and he wants it given intramuscular. I couldn't remember the last time I had given an IM analgesic, this route was extremely outdated, mainly because of the absorption rate.

I imagine she informed nurses that are more experienced because he never received another intramuscular injection. She was very offensive just by my asking for clarification of order.

When Gary began getting out of bed and ambulating, I thought, we were progressing for discharge in a few days. Then he began vomiting when his diet was advanced to full liquids. Nurses were documenting assessment notes but no one ever listened to his lungs and bowel sounds or the functioning of his colostomy.

In fact, nurses avoided touching him all together. I allowed Gary's nurses to do their job without criticizing them in any way. I know how relatives can be so I tried not to disturb them unless it was important.

The horror story began on day 4 after surgery when Gary began requiring Morphine injections again after switching to pain pills over the last 2 days. I tried to explain to the nurses that this was unusual; he could not eat and his pain worsened. Initially they thought Gary was only seeking narcotics.

That night, Gary began with the loudest hiccups I have ever heard. They were painful to his surgical site. Patients and visitors could hear them all the way to the elevator. The only ones they did not bother were the nurses.

His abdominal pain worsened but the nurses wanted to give him an analgesic instead of exploring the etiology of this pain and hiccups. They sought to put him to sleep but with true severe pain, the sleeping medication was ineffective.

When the doctor visited, he rather minimized the hiccups and of course, Gary was not hiccupping as much on his visit. On his 5^th day after surgery, his belly began to swell and become taut. He was very nauseated and his colostomy had no drainage for 5 days. Even the doctor did not notice.

During a severe episode of hiccups, I asked for the doctor, the nurse claimed to have called and came in with Benadryl for the hiccups. I allowed it to be given but knew it was not for that purpose. After the second dose, I asked that the nurse call the doctor for an effective medication. The nurse refused and called charge nurse to speak with me.

The charge nurse stated he was not going to call the doctor back at that time of night and Gary would just have to take the narcotic until the doctor comes in the morning. I called the supervisor who agreed with the charge nurse and hung up on me. I was viewed as a troublemaker. Gary was becoming increasingly confused and agitated.

When he began spitting up coffee ground emesis, I asked the nurse to request a nasogastric tube to drain his stomach. She refused stating "I get the feeling you don't think I am doing my job" and she called her supervisor.

By this time, Gary's sister and I were livid because the nurses seemed to be upset with me but punishing Gary. I begged the supervisor to obtain an order for a NG tube to drain his distended abdomen. It is actually true that I had to beg these people to do their job.

I left the ward while the nurse inserted the tube. Upon returning, I noticed the suction canister was very full for the second time with old bloody drainage. I was informed that Gary vomited so much it was like a puddle in his bed.

I asked the supervisor to have the doctor order a complete blood count to check if he needed blood. Once the test was done, I asked Gary's nurse for the results at approximately 8pm and was told she had not checked it because she had charting to do.

I had also informed the supervisor that Gary had a Port O Cath (IV in his chest) to use but the nurses did not know how to access it. They used his arms, he needed a new IV every other shift, and in addition, his arms were so bruised and swollen.

I called the supervisor who stated the nurse would call the doctor after she talk with her. Turns out that Gary's blood count was very low and he needed 2 pints of blood. It seemed the nurses became angrier that I noticed these things before they did but I was there to be Gary's surrogate for healthcare. I promised him that he would walk out of there.

The next morning, I spent all day trying to get the nurses to call the doctor. I had this foreboding sense of doom (during my 27 years as a nurse, I was usually right on) and I needed the doctor to come in at that moment. The nurses went so far as to have 4 security guards escort his sister and I out of the hospital even as I explained my role as his surrogate. Gary was very confused by this time and tearing out tubing.

To illustrate how uncaring the staff was, I had had surgery on my hand the month before so I had trouble using it. Gary began tearing out tubing and dressings while the nurse aide was refilling the glove box. Instead of helping me keep him in bed, she left the room while I tried to reach the emergency button. Another nurse could not help because he was taking a towel to his ambulatory patient who had just walked by the room.

I cried in the hallway asking for a doctor. I was told the ER doctor would see Gary who was requiring Morphine every 45 minutes alternating with Demerol. This made him more confused. The ER doctor never arrived. The nurse refused to see the fact that Gary should have gone home as expected, but he required more and more pain medication, which did not help. Something is definitely wrong.

I just could not get help until I called the doctor myself. He stated, "You want me to drive 8 miles?" I stated that if he did not come in, Gary would be dead by morning. A lawyer informed me of a malpractice case in progress against this doctor.

Nurses worked hard to remove me from his bedside instead of assessing his condition. Once I thought the ER doctor was coming to Gary's room but he stopped short to order one pain pill for another patient whose daughters were at the nursing station.

People were telling me to calm down but I did not have any recourse because the nursing supervisor was also very rude. His heart rate was 152, blood pressure elevated and he was in severe pain. No one wanted to monitor his vital signs so they turned the cuff off. I was escorted to waiting room.

In the meantime, the doctor finally arrived and sent Gary for an emergency CAT scan. It was discovered that a large portion of his bowels slipped through the mesh, strangling. This would have caused death within hours. According to the doctor, a large portion of his bowel slipped through a hole, which closed, to the size of a pencil.

The doctor was quite agitated with the lack of care and assessment by the nurses. Everyone felt bad for the manner, which they treated the family and me; they finally realized that my main purpose was the see that Gary receives quality care not to upstage them. I only wanted them to do their job.

While I waited for Gary to come out of emergency surgery, the security guards were very apologetic and so was the oncoming nurse who refused to do anything but remove blood pressure cuff and hide while receiving report. It was my birthday and Gary had surgery to remove even more bowel.

I was no longer allowed to stay in his room but when I visited him the 2^nd morning, he was very agitated and in pain. Apparently, the nurse wrote the time he was due for pain medication and he was instructed not to call until then. Well, it turns out that the pain in his back was because his mattress was not fully inflated and he was lying on the metal frame.

When the doctor arrived to look at his now functioning colostomy, his gown, abdomen, and linen were covered with feces. The nurses never assessed and performed colostomy care.

I had no choice but to report the hospital and staff to the Joint Commission for the Accreditation of Hospitals who oversee the licensing for hospitals to remain open. They investigated but were unable to tell me anything discovered due to confidentiality.

I am a patient's advocate and will do the same for my own patients if I did not think quality care was provided.

This was a nightmare, which could have cost a life unnecessarily. I worked at this hospital for 5 years in the 80s but I will never go there again.