Presentation short and brief

Part of the problem is a for profit health care system that leaves units dangerously under staffed resulting in poor nurse to patient ratios. The system is a failure and the nurses being the lowest on the totem pole become the scapegoats of that systemic failure. It's not just a matter of "one nurse to one patient". Rage the system that creates these situations and not lowest players of it.

Nice vido

Informative video

Hello. Thanks for the presentation. I also work at the VA (Jackson Ms) and I’m a first semester nursing student!

When you get to the point in your nursing career when you are able to look at doctors as coworkers instead of as your boss then it is easier to get over the fear of standing up and advocating for your patient.

WOw...so very sad and absolutely preventable!

The abscence of urine output should have been a huge indicator. Also the absence of blood pressure. After switching out the first machine they should have realized that it was unlikely all machines had issues and that it wasnt the machine especially upon the 7th machine. Also did they not check pulse points, or give manual blood pressure. This is all stuff you learn in literally the very first semester of a nursing program. A physician should have been notified the minute there was any deterioration and upon request. They should have for sure changed their theory of what was happening much sooner with the possibility that there was something else causing the issues. This is so sad. I also wonder how they didnt realize that he was given an adult dose of the medication or that the fluids he was ordered was for a smaller child all of that should have been checked. Why would the residents not have any sort of direct supervision? If you watch the other videos you will see that he also has distention of the stomach and was reporting severe adominal pain at which they said was constipation. His respiratory rate went up to 28 and his heart rate 163. Constipation ignores the other critical vital signs. Someone should of been aware of complications of the medication he was on as well as the symptoms esp as the mother and the patient themselves expressed concern. For those saying oh they should of called the administrator line, how would she know to do that. If the nurses didnt want to ask for help they should have at the very least informed the mother how to do it herself. So many mistakes and so many ways this could have been avoided.

this is why every nurse needs to work on a basic med surge unit for a few years to have experience before specializing in pediatrics maternity etc. they have no idea what to do how to recognize urgent situations

unfortunately it is a part of nursing. the doctors are not always right and you have to stand up for yourself

6:05 the worst kind of nurse. no advocacy for the patient or the family. They think they are always right. instead choose to argue with the family

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Good content, terrible audio quality. Makes it very difficult to process what's being said.

this is good but I wish she used a better mic. The static is distracting.

Aspirin is an antiplatelet or antithrombotic, not a platelet aggregate. @2:30 Probably just a mistake by the instructor, but the student is definitely correct.

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This is due to a fragmented and UNSAFE Healthcare system including the nurses taking care of the patient and lack of experienced healthcare doctors and LACK and BREAKDOWN of COMMUNICATION W/ the ATTENDING MD.. SAD & TRAGIC and SHOULD NOT HAPPENED...

Well I think the nurse is the one to solidify a complaint into medical terms for the doctor, the nurse collects data from lay and translates to medical. Your best action is to define what you are looking at when you say "you're fine", to discuss with the patient what they are feeling, how it is different and always do you want to go to the hospital or do you want to talk to a doctor. Often this leads to a more specific complaint and what organ system is becoming involved. The other day a dialysis patient complained of vague unease SOB, chills. And the nurse saw a decent blood pressure, reasonable HR, no temp and RR 18 and machine settings that were respectable. The nurse kept saying "you're fine" and the patient kept saying "something is wrong" for three hours. Finally done, the patient took herself to the hospital and she was having a type four immune reaction to Heparin given on this her third treatment in the clinic. It can be 20% fatal. The "report" book basically ridiculed the patient as a complainer. In this case, the doctor later failed to tell the clinic to mark the Heparin allergy and had not the 40+ yo patient told us, we would have given those 10000 units yet again.

Well ... the other day a dialysis patient complained of vague unease. And the nurse saw a decent blood pressure, reasonable HR and RR and machine settings that were respectable. The nurse kept saying "you're fine" and the patient kept saying "something is wrong" for three hours. Finally done, the patient took herself to the hospital and she was having a type four immune reaction to Heparin given on this her third treatment in the clinic. The "report" book basically ridiculed the patient as a complainer. Your best action is to define what you are looking at when you say "you're fine", to discuss with the patient what they are feeling, how it is different and always do you want to go to the hospital (basically do you want to talk to a doctor). Often this leads to a more specific complaint and what organ system is becoming involved. I think the nurse is the one to solidify a complaint into medical terms for the doctor, the nurse collects data from lay and translates to medical. In this case, the doctor failed to even tell the clinic to mark the Heparin allergy and had not the patient told us, we would have given those 10000 units yet again.

Thank ogoodness

It was very tragic. The healthcare system totally failed to take the responsibilities of healthcare providers. The quality healthcare services are now in questions. Anyhow, you are appreciated for your great efforts to prevent such careless, dreadful medical errors.

Thank you Ms. Haskell for sharing your heartbreaking story and for being brave enough to persevere and improve the medical system. I will be a nurse in one year and promise to internalize your story and do all I can to be a strong and honest advocate for all of my patients. You have been heard. Rest in Peace, Lewis Blackman.

Great lesson ! Thank you!

OMG this is so awful, and no matter what a lawsuit could win, will not replace this child, or the family. This is very important for me, as a nurse to hear!!!!!!

Hey SEHCON people!

I am sory for your loss mam.

Not nurse bashing....any nurse should know if a pt. hasn't urinated in 24 hrs, there is a big problem!!!! It's cause to find out what is going on. #simplenursing A good majority of people in the hospital have not idea what is going on and do what ever they are told. They assume that the hospital hired nurses that know what they are doing. Can't blame the patient. It was a system problem as well as a nurse problem.

The sad part is that there are still doctors that use intimidation in an attempt to "not be bothered" by the nurse. SMH. Even though I received backlash as a new nurse years ago, I called the doctor no matter what!!!!! Now they are used to me and don't give me half the attitude they use to. Honestly, I would like to think that they have a greater respect for me due to my determination in getting questions answered for my patients. Thank you for being so vigilant in your work for patient advocacy.

this is just so shocking.

Thank you for emphasizing potential risk factors!!!

It is extremely sad

This heartbreaking story is the perfect example of how deficient is the healthcare system is in our country despite the resources and that we possess. We have a system that focuses on documentation rather than patients care. For example, nurses get yelled at because they forgot to document the care have provided, regardless of the care provided “no documentation no care” that is so untrue. Nurses have done a lot more than they documented, do they have time to document every single thing they do “NO, No, NO.” Concerning the Lewis Blackman's story, why did it take two days to get an order change for an iv fluid when the patient was not producing urine output? Moreover, why nurses do not have the authority to administer the fluid without an order? We know the consequences of oliguria. Lewis had no urine output for 24 hours “really” that is one of the major factors that contributed to the failure to rescue that young boy from acute kidney failure. There is an antidote for ketorolac if not they could of detoxifying the kidneys. According to the article "failure to rescue," “Patients display signs and symptoms of impending arrest as early as 72 hours prior to the arrest” (Subbe & Welch, 2013). An addition to no urine output, there was an issue with undetectable blood pressure, that young man’s body was screaming for help, and no nurses or doctors at that hospital figured it out. Failure to call the attending physician despite the parents’ request was another major negligent from those nurses. “We can no longer make decisions for parents” Der Bedrosian (2015). According to IOM, patient-centered care is crucial to quality care. consequently, we must listen to patients and families because they know their loved ones. This story reflects the irresponsible of nurses and doctors in the healthcare system. Unfortunately, we have a long way to go on fixing the healthcare system.

I am so sorry this happened to your son. I promise to do my best and be vigilant.

I am a med/surg nurse and I can tell you we feel out of control too. Without mandatory staff staffing laws like in California there is nothing to safe guard nurses from having way more patients than they can reasonably care for. On one medical floor I was routinely assigned eight patients at night with little CNA help. One night I had six patients, three who were completely unable to move without assistance. My CNA had eighteen patients. I felt so out of control because I was not able to look at their charts thoroughly. I did not know what their labs were or their trending vital signs because I was running all over just trying to keep my confused patients from hurting themselves or pulling out their tubes. Patient centered care is not possible without mandatory safe staffing laws.

Helen, my nurse educator colleagues and I viewed these videos at a QSEN symposium several years ago. We have since integrated them into teaching pre-licensure nursing students near the end of the nursing program. Nurses are the advocates. Patients and their families are vulnerable in a foreign system--the hospital. Thank you for initiating the patient-safety movement in memory of Lewis and for all patients that need front-line advocates.

Now isn’t the time to get defensive over criticisms of certain nursing demographics. That said, young nurses are not the only nurses lacking in appropriate training. Failure to identify the deteriorating patient is a significant concern across the entire hospital system worldwide. This child died unnecessarily and it was a direct result of a failure to identify deterioration by all responsible carers, medical staff included. Possibly a lack of senior supervising staff on a weekend? A bullying culture that prevents the nurse from escalating a concern?

Nurse bashing part 3. try dialing 0 and requesting to speak with the administrator on-call

Ignorantly generalizing nursing education. I feel very bad that her child endured such gross inadequacies. However, there are tremendous disparities in equitable treatment of patients in very different country demographics. Assuming that nurses are ill-prepared is just plain stupidity, narrow-minded, and as offensive as racism.

I have been a nurse 15 years and work in SC. I worked in ICU we worked as a team. Now I work in rehab and I can relate to what she is saying. The nurses are over worked, to many patients and very task oriented. We now have work list with our new computer system. We get an email if we do not check off stuff on the task list. So a lot of new nurses just concentrate on their task list.They just want to get out on time ( some times even leave early) and chart that they do not pay attention to their patients.I also get upset when I hear a doctor tell a nurse NOT to call a rapid, or when a doctor belittles a nurse for calling a rapid.Nurses have become nothing but drug pushers and task masters, this is the reason I am getting out of nursing.Every thing is about the numbers, bottom line, calling off nurses because nurse to patient ratio is low. We no longer are looking at the acuity of the patients. It's all about the money!!!!

Apparently young nurses are incompetent....

the scariest part of this is that there are no comments... wake up, ppl

I've been a nurse for 20 years. I know now how to handle myself at this point in my career, but I can remember being a young nurse and the doctor intimidating me to not bother him! We do need more education on how to deal with these situations. I'm so sorry for your loss. Thank you for these videos ❤️

Tragic, the medical system truly failed your son. Thank you for your efforts in ensuring these mistakes are not repeated.

Concise and informative

What a powerful, thoughtful and devoted mother, dedicated to her son. It seems that you can't help but be a patient advocate and you do it so well. This is such a tragic story but your advocacy and message give it meaning and purpose. Thank you Helen for helping to better our western health care systems. Wishing you and your family all the best. Lewis is so proud of his mom! Sandra (in Ottawa, Ontario, Canada)

I'm wondering if there is a way to promote the "sharing" between sims i.e. cultivate this exchange of info to enhance learning, teamwork, and leadership. Example: class of 16 students, 4 different sims (A, B, C, D) each involving 4 students. Phase I, 4 groups of 4 students experience one sim so that all sims have been experienced. Wait a few days/hours and then Phase II would be testing with groups comprised of a rep from each sim. All students would be responsible for mastering the content while some healthy pressure to take on leadership and followership roles would be inherent in the process (both should be honored) and the sharing of information would naturally flow in the direction of problem-solving and improving learning.

As a new nurse educator, I really appreciate your videos. There is a wealth of information here for nurse educators to use!