Note to Parents of Hospitalized Kids: Be Vigilant

[Ellen]

http://blogs.wsj.com/health/2009/08/05/note-to-parents-of-hospitalized-kids-be-vigilant/

[czardoust]

this is true. Thank you for posting this. I remember when Katerina was dx'ed, a nursing student came in to give Kat a dose of Novolog - this was on day 3 of her 7 day stay.... she tried to do the math formula for the BS-100 over 100 plus carbs, 1 unit for every 15 blah blah blah. She came up with Kat needing 40 units - not 4 but 40. I was like...thats not right. This was my first time doing the formula myself. I did it and I was like its 4 units. If I had not intervened the student could have killed her. :(

[heamwdevine]

this is true. Thank you for posting this. I remember when Katerina was dx'ed, a nursing student came in to give Kat a dose of Novolog - this was on day 3 of her 7 day stay.... she tried to do the math formula for the BS-100 over 100 plus carbs, 1 unit for every 15 blah blah blah. She came up with Kat needing 40 units - not 4 but 40. I was like...thats not right. This was my first time doing the formula myself. I did it and I was like its 4 units. If I had not intervened the student could have killed her. :(


OMG. That is so scary! Glad you questioned her.

[cindyrn6617]

As a nurse, I always tell patients to speak up. It's your right. Question the nurses/doctors/lab/xray techs. Ask for second opinions if you want too.

As a mom, I have on more than one occasion, run into problems because I have questioned the doctors/nurses. For example, the last time Ryan was in the hospital, the resident had spoken to the endo and wanted me to change his pump site because his ketones were slow to fall and they were thinking the site was bad. The hospital does only urine and I had my blood ketone meter. I refused to put Ryan thru a site change when the blood ketones were starting to fall. Sure enough, next time they checked the urine was down.

Also, he had to stay overnight for his pump start...not sure why that's mandatory? But, for some reason the nurse said the endo did not want to treat for a low unless it dropped below 55...I was like wth...no, as soon as she walked out of the room, I would give him food/drinks. It never made sense to me. Needless to say, that nurse and I butted heads. She still works there and to this day, I do not like her. The other nurses didn't do that.

[joy orz]

It's not just medicine that you need to watch out for. EVERY meal that they sent to Ava had a problem with it. She has celiac and I can't tell you how many times they sent a burger with a wheat bun on top. I never left her room, but what if a hungry kid was there when the food arrived and the parent had stepped out to grab a shower or cup of coffee?

Assume that if your child has celiac and has a hospital stay, that the food service staff (mostly min wage, hourly workers) will make a mistake on the menu.

[jcanolson]

It's not just medicine that you need to watch out for. EVERY meal that they sent to Ava had a problem with it. She has celiac and I can't tell you how many times they sent a burger with a wheat bun on top. I never left her room, but what if a hungry kid was there when the food arrived and the parent had stepped out to grab a shower or cup of coffee?

Assume that if your child has celiac and has a hospital stay, that the food service staff (mostly min wage, hourly workers) will make a mistake on the menu.

We'll be taking our own food after last time. It was a nightmare dealing with the dietician who was sure she could have Rice Krispies. :mad:

[Kaylee's Mommy]

March of 08 a hospital put Kaylee into DKA and almost killed her. If it weren't for me or her endo (endo was not associated with this hospital so she wasn't in charge of her care..) We probably wouldn't have Kaylee today. The day after Kaylee was admitted (she shouldn't have been admitted, it was the hospital's mistake, they should have hooked her up to an IV asap, instead athey waited 6 hours..) I met with the hostpial lawyer early the next morning. Since then I've met with the hostpial and independent board.. changes have been made, the hospital fully admits to all mistakes, and didn't charge us for her 3 day stay. Even will all the changes that are made and new protocol that is in place, I'll never bring her back to that hospital, ever.

[Reese'sMom]

Ha! I can go on about the mistakes during Reese's in-patient stays for cancer: hospital pharmacy put the wrong size dosage of prednisone pills in the bottle (bottle was labeled for the correct amount, we just noticed the pills had a different number stamped on them), hospital was continuing to give Reese IV fluids with sugar while his blood sugar was soaring (this was before the D diagnosis, so we had no clue), one Onc. told me it wasn't going to hurt him to have his blood sugar be a little high (200's and 300's) during his week-long prednisone pulse for chemo because he didn't want me having to poke his finger all day long and give him more shots for insulin (the endo we finally consulted with was shocked and angry...wanted names etc.), after chemo when I told the Dr. that Reese was not eating and had low energy no one bothered to notice that his bg was also creeping back up to almost 200 again.

Learn all you can from the internet and check everything on the blood tests and ask what each medication is before they give it to your child. It can be exhausting and may make you very anxious, but there are just way too many mistakes and issues that will be overlooked by the staff at hospitals.

[Leece]

Well at dx the resident dr was going to send us home. The dr on call asked us 3 times if how dd was acting was normal when she was sick. She ordered x-rays and blood work just in case and thought if anything she could get an IV to replace the 6lbs of fluid she had lost in the past week. I never listen to residents anymore. I usually try to bring my MIL with me because she has some medical background.

I went to emerg after an operation because I was in extreme pain and I told them I was allergic to morphine so then they try to give me synthetic version. What part of allergic didn't they get. I can never figure out why with all the pain medication out there why they always push the crappy ones. or don't want to give the alterative ones to you.

I found you have to be quite vocal to get stuff done.

[sarahspins]

I can never figure out why with all the pain medication out there why they always push the crappy ones. or don't want to give the alterative ones to you.

I think it has to do with costs... better drugs cost more, and I think the reimbursement is proportionally smaller on average. So that may be why.

I am not afraid to ask for drugs by name though.. I've been labeled as a drug seeker more than once because I seem to "know too much".. had to have nice little chats with social workers. I just explain that I don't like the side effects of morphine (I am not allergic, but it's not pleasant), BOTH my mom and step mom are nurses, and at that, my mom was a palliative care specialist (she's retired). I know there is a vast array of pain control options past what they immediately want to offer... and it's not because I've ever abused any of it.

[Melissa]

Ellen, thanks for posting! I learned this leason the hard way.

The night of dd's dx, Dh went to get himself dinner & I was left with dd in the ER. Her BG was 357 & was 32lbs at dx. The nurse came into to give dd her first 2 shots of insulin. I asked how much and she said "10units of each Lantus & Humalog." And then she gave her the shots. In the back of my mind it didn't sound right, but she was the nurse and I didn't question it.
DH came back from dinner and I told him about the shots. He said, "wow, that's alot. I take 16u Lantus & about 6-7units of Humalog at meals. But they know what they are doing - we don't want to be the parents that think they know more about diabetes than the doctors."

Well, the first BG check after moving Maddie to her room was in the 50's. She should have gotten 1 unit of each NOT 10units. They quickly move her to the PICU and everything turned out fine in the end.

I now question EVERYTHING!

[Heather(CA)]

http://blogs.wsj.com/health/2009/08/05/note-to-parents-of-hospitalized-kids-be-vigilant/

Any time any of my boys have been in the Hosp...I don't leave. Period:cwds:

[liasmommy2000]

In Cheating Destiny the author mentioned that when his son was diagnosed and they left the hospital that the prescriptions were written wrong. Only because the author has type 1 did they realize the mistake and call the nurse. I don't remember exactly how it was wrong as I think they used ultra lente and I'm not really familiar with that but I think they were instructed to give the fast acting at bed time instead of with dinner.

[Annapolis Mom]

We had an experience very similar to Carolyn's. Hannah needed 3.5 units of humalog. The person reading the dose on the computer thought it said 35 units, and the student nurse who was going to adminster the dose repeated what she said: 35 units. Thank God my husband was there to stop them. What if my parents had been there to give us a chance to eat breakfast together?

[Mimi]

As a nurse, I always tell patients to speak up. It's your right. Question the nurses/doctors/lab/xray techs. Ask for second opinions if you want too.

My best girlfriend is a nurse and she says the same thing. She also says she is never offended/upset or ticked off if a patient questions a dose/medicine/procedure etc. She just double checks. It reassures her and the patient.

Too bad everyone in the medical community doesn't feel the same way. :(

[funnygrl]

this is true. Thank you for posting this. I remember when Katerina was dx'ed, a nursing student came in to give Kat a dose of Novolog - this was on day 3 of her 7 day stay.... she tried to do the math formula for the BS-100 over 100 plus carbs, 1 unit for every 15 blah blah blah. She came up with Kat needing 40 units - not 4 but 40. I was like...thats not right. This was my first time doing the formula myself. I did it and I was like its 4 units. If I had not intervened the student could have killed her. :(

Where was her professor? I can't imagine any of my professors letting me go, calculate her dose, draw it up, and give it by myself in when I was in nursing school. Actually, I still can't. Insulin needs to be double checked with a second nurse.

[Emmas Mom]

When Emma was in the ICU the nurse had to administer a 1/4 unit and spent about 10 mins trying to measure it out. She then (as policy) had to have another nurse check which took another 10 mins. I totally thought they were incompetent so I asked what was going on but even after explanation I didn't get why it was such an ordeal. I then got home and tried to do it myself...they became my heroes :)

[Seansmommy]

Hi all I can't really say any specifics because of hospital rules. I work at a hospital as a housekeeper, we are the unseen who have seen it all. You would be amazed what people say and do in front of us. I would never and I do mean NEVER leave my child or family member who wasn't completely there, at the hospital alone. Never worry about being an advocate for someone you love. Do it and make sure all staff know you are being their advocate. It does make a difference. There are some absolutely wonderful Dr and nurses. But still be an advocate. I can not stress that enough.

[Kaylee's Mommy]

Where was her professor? I can't imagine any of my professors letting me go, calculate her dose, draw it up, and give it by myself in when I was in nursing school. Actually, I still can't. Insulin needs to be double checked with a second nurse.

yes, insulin is one of those meds that are suppose to be double checked by a second nurse.. when they finally figured out what they were doing with Kaylee they were double and triple checking her dose, and I was checking and questioning it all.. the ONLY person that did anything right while we were there was ONE nurse.. she's the ONLY one I trusted with anything..

[MReinhardt]

Any time any of my boys have been in the Hosp...I don't leave. Period:cwds:


I dont leave Chell either! Chell was down to 77, blood sugar check, and the nurse wanted to know "how much insulin are going gonna give her" Ah, NON!

During of of Chell's colon surgeries, I had ask them to check Chell, and let me know, so I can advise them on how much insulin to give her if needed. Chell is also very insulin sensitive when she is NPO. They didnt ask me, Guess what, they gave her 4 units of insulin, and as she was coming out of recovery room, she is bottoming out to 57 and dropping (CGMS going). Told the Endo, for now on, please make sure that I am contacted before ANY insulin is give. There is a big note in her chart that MOM is to manage all diabetes care for now on.

This last hospitalization, I handled it all. The endo wanted to change some things, I told him no, and my reasonings behind why I said no. So he listen to me, and then agreed, no changes are to be made. Checked back the next day, and still agreed on what I had said. I like it when drs ACTUALLY listen to parents.

[cindyrn6617]

Where was her professor? I can't imagine any of my professors letting me go, calculate her dose, draw it up, and give it by myself in when I was in nursing school. Actually, I still can't. Insulin needs to be double checked with a second nurse.

That's what I'd like to know, where's the professor? And, every hospital I've worked at medications have to be checked by 2 nurses to try and stop errors.