Feb 19Liked by PulmCCM

I think the limited resources should be focused on appropriate nursing staffing and patient monitoring. After all it is the nurse's job to monitor the patient and call for help immediately if he/she deems it necessary. I think the chronic understaffing in hospitals since Covid contributes to the nurses not being able to do this job appropriately (this is not criticism, they are overworked and underpaid, generally). Certainly, in most hospitals, empowering all patients to call rapids would stress the mechanics of the RRT and perhaps skew their patient evaluations.

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Feb 21Liked by PulmCCM

A different perspective on this: these things can and do already happen. We have seen families that are very bold, hit the code blue buttons on the wall when they felt they were in a dire situation. Nearly every time it was a valid reason albeit, we had questions just like the nurse did. Who hit the code button? Why?

This is not necessarily “bad”, however it did become concerning only one time in my experience when family indicated their rationale for doing so was the nurse call button wasn’t getting them what they wanted after multiple attempts. Water. They wanted a glass of water. 12 people rolling in hot, heavy and deep to deliver a glass of water (absolutely not). They received a sternly worded message, delivered by the entire team (no one was dismissed for emphasis to drive the point home for this family). Education and stern reinforcement of proper use of resources was implicitly stated.

We have also seen patients call out for help for their roommates because “they didn’t sound right” or “they stopped talking” or “were choking”. This action by the roommates started either an RRT or code and saved their lives.

Bottom line, they will find a way, so give it to them. Education and boundaries must always exist.

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Feb 19Liked by PulmCCM

WHEN the families are at the bedside and have been there a given period of time, they gain that longitudinal perspective on the physical condition of their loved one.

In my experience and observation over time, they often already coming out to the desk to “sound the alarm” about the changing condition of their family member.

As well, there are bedside monitors connected to central monitoring systems now available (Edwards, for example) that provide an early warning system for impending problems. I think the phrasing of “deputizing the family” is very accurate, and only serves as a poor (albeit economical) solution to the larger problems : volume and age of pts (demographics), pt complexity, staff shortages/ burnout, and inadequate hospital infrastructures (which includes inefficient EMRs, quality metrics which are misguided).



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