Re-name Old Crisis to get a Nifty New One

Wow! ‘Alarm Fatigue’. A new buzzword!

Did we need another buzzword, or would some boring old word describe this situation better…

WORCESTER, Mass. (AP) – UMass Memorial Medical Center in Worcester is stepping up efforts to prevent nurses from tuning out monitor warning alarms following the death of a patient whose alarms signaling a fast heart rate and potential breathing problems went unanswered for nearly an hour.

The patient who died was a sixty year old man. He should not have gone ten minutes without a nurse responding to his serious symptoms.

Why did an epidemic of ‘alarm fatigue’ break out in that hospital? Why so many alarms? To allow a stretched staff to monitor the maximum number of patients possible on an average shift, without reserve capacity for a bad shift where all the alarms are going off at once– that’s my guess.

When corporations brag about getting ‘lean and mean’, you better worry that things can get thin and nasty.

Alarms are dumb. They do not have the power of reason or any of the perception of a trained human being who comes to the bedside. They have their place, but are not a substitute for adequate staffing.

‘Understaffing’ is a boring old word we are tired of hearing, since nurses keep going on about it for decades of labor disputes and public lobbying. It’s hard to get a catchy headline going about understaffing. We’ve heard it all before.

But look at the obvious. When there’s constant screaming alarms and the staff is fatigued they need more staff.

Chocolate Kiss

Theresa Brown, RN captures the feeling of a busy hospital unit and the temptations that lurk in the break room…

A Hershey’s kiss can be exactly what I need to make the day feel better, especially since lunchtime has long passed and I haven’t had time to eat.

The truth is, though, I try to eat sparingly because I learned early in the job that stress eating is an occupational hazard. Having our conference room filled with doughnuts and caramel corn makes it all too easy to, as we say, “eat my feelings,” rather than just feeling them.

She thanks the patients and families who show their appreciation with home-made cookies or a box of candy. With all the stress patients and families go through it is really amazing how often they take time to give a word of thanks and encouragement to the staff.

The last time I worked inpatient, in a nursing home, I kind of dreaded the holidays. With the kindest of intentions families would send boxes of chocolate that I seldom managed to resist for the full eight hours. Especially when it was so often impossible to find time for a meal break.

Reading between the lines, Ms. Brown describes a work pace that is taxing, constant, and stressful, without time to rest, eat or drink some water. Heck, there’s hardly time to go to the bathroom. I used to kind of envy the smokers, because they managed to take their ten minutes off the unit.

Skipping break was not a badge of honor. You tried to be efficient enough to have time to eat. You didn’t advertise that shift after shift you used that thirty minutes just to keep up.

In the normal course of things, there will be times when a lot of people are sick all at once and everyone is flat out busy. When every day is like that there’s something wrong. Nurses work, and not only RN’s but LPN’s and CNA’s, is overloaded, with staff spread thin.

You really see the best of people when you work in nursing. The courage of patients and families stays with me. Even sitting here with nothing worse than a bad cold I think of the people I meet who feel sick every day, and how seldom they complain.

One of the commenters to Ms.Brown’s article suggests that families might want to send a card or a note to the unit and the boss, and I second that. While all acts of kindness are appreciated, these notes are read and have an impact. When some consultant comes along and decides to make the staff ‘leaner and meaner’ they will go over every aspect of the job looking for ‘fat to trim’. Those cards and letters mean a great deal then.