Sunday, December 21, 2008

Dear Radiology Tech my dear friends over in diagnostic imaging:

I love you guys.  You are usually very quick to come and get the patients, are willing to wait a minute or two when I'm in the middle of something or when I'm coming in to give some pain meds, and never complain about having to unhook the patient from the monitor or having to put them back on the monitor when they are back.

That said, I have two questions for you:

1.  Why is it that not a single one of y'all is capable of parking the stretcher straight.  At first I just thought that maybe I happened to get the drunk DI tech, but no: it seems like every single time a patient comes back from DI, the stretcher is parked at some kind of diagonal angle.  What gives?

2.  Okay, so this isn't so much a question as just a complaint:  some DI techs are okay at this, but others will bring the patient back, get them all hooked back up, maybe even park the stretcher straight, and then walk out without giving the patient their call light.  This happens all the time.  Often I catch it quickly, because I always try to go in the room when a patient comes back just to make sure they are doing well and vitals are stable and all that jazz, but sometimes I'm swamped with things to do and can't get in for a while and only find out that the patient doesn't have a call light until someone hears the patient calling out and then yells at me about not giving my patient a call light.

The first point is just a humorous observation.  I don't really care if a stretcher is parked straight or not.  But the second point is a genuine safety concern.

So to all you thousands - nay, millions - of DI techs that read my blog on a daily basis (okay, maybe there are 2 of you...), what can I do without stepping out of bounds to help the DI techs remember to give the patient a call light when they come back?  I don't want to become the DI police, and I'm not much for confrontation, but I do get concerned about patient safety issues.  I think DI is great for the most part and I really love the techs I work with, so I don't want to alienate anybody.

So, Dear Abby, what do I do?


Anonymous said...

at least your patients get put back on the monitor when they come back. Thats more than I can say about our radiology techs. Most of the time they don't get put back on the monitor, oxygen remains plugged into o2 tank, no call light, didn't realize they went get an xray until I see that they aren't on the monitor. We've had people with empty o2 tanks, no pulse ox on, with some serious respiratory problems that were found by the nurses with low o2 sats. I don't know why it is so hard to hook a patient back up to the monitor? It takes 15 seconds.

Bianca Castafiore? said...

Cher, cher Braden, nouveau père et infirmier extraordinaire!

Thank you for this post. I was recently reminded of the frustrations of call lights out of reach, etc.

It's a challenge to be returned to a room or cubicle, or what have you, be put back to bed, then left unattended... only to need something and see your call bell across the way, merrily hanging out... in the sink.

Ah, but all is well, you think, because I came prepared... I brought my grabber and my cane, both excellent devices for snaring the errant call bell.

Encouraged, I scan the bed and bedside table. No grabber. No cane. And no call bell.

Question, if you don't mind. Do nurses, doctors, and "care partners" (the new moniker for CNAs at this hospital) consciously avoid dealing with patients who are in isolation -- due to having to gown and glove, etc? Several times, the call bell was thankfully within reach but the call went unanswered. I don't expect a rapid response to requests that are not urgent -- in this instance, I needed to take a certain med (Starlix) before a meal, and was told to call when the meal arrived.

Braden, it was a succulent turkey sausage and mushroom omelet, with a fresh fruit cup and a yogurt -- rounded out with a fat-free vanilla pudding... We stared each other down, that meal and I.

skyE said...

You could try something like this:
"Dear Valued DI Techs"
In keeping with our common interest in pt safety, if would be much appreciated if you could give the patient their call light upon returning them to Emerg. This will allow the pt to notify us if they are in distress. If you have an extra moment, it would be even more appreciated if you could reattach the patient's monitors and O2 upon their return as well. Thank you for continuing efforts to maintain the highest pt saftey and comfort levels possible.
Your ER staff." as to why they don't there are various reasons:
-someone told them not to (in ER or their own manager)
-they forget or are busy like everyone else
-they feel like they are overstepping boundaries.
I am curious as to why this is expected? Has anyone communicated this to them?
I would hate to leave a pt on too high of O2, you know? Maybe they honestly don't know this is expected or wished for?

Braden said...

RN - I agree. And even if they don't have the time to hook the pt up, at least find me and let me know you are back and have to run.

Bianca - When someone who is not in isolation puts the call light on, you pop in, do what you gotta do, and get on your way. When the same simple request comes from someone in isolation, it is a whole production. I try not to ignore my isolation patients, but I think if nurses are being honest, then we have to admit that all things being equal, we probably are a little more reluctant to just pop our heads in the isolation room.

skye - I brought it up in our staff meeting a few weeks ago and the manager said she would talk to DI. We'll see what happens. As far as your reasons for why: even if they can't do it or do not feel comfortable doing it, then please come and find me or find the tech so that we can do it. In any case, I can't imagine any good reason for not grabbing the call light and putting it within the reach of the patient, even if you don't want to mess with the monitor and the oxygen.