Parents: Silence Can Be Deadly
Posted by realityrounds on August 6, 2009
I story in the WSJ Blog really resonated with me. The story concerned medical errors in hospitalized children. A medical error in a child is all the more dangerous than that of an adult, because there is less room for error. Because of a child’s small body size and mass, even small drug errors can have devastating consequences. Infants are more prone to infections than the rest of the population, due to their immature immune systems. If staff do not wash their hands between patients, a deadly infection for that child can result.
According to the WSJ blog: “In a bid to get parents to take a more active role in keeping their hosptialized kids safe, the Joint Commission is launching a new pediatric effort as part of its long-running “Speak Up” campaign, which encourages patients to say something if they see a potential error or problem with their care.”
This makes perfect sense, but most of the parents I encounter would be way to intimidated or embarrassed to interrupt a health care professional to ask them what they are doing.
We, the health care professionals, should be the ones to Speak Up. When parents are at the bedside we should explain and show them how we wash our hands before touching their baby. I always show the parents the drug I am administering, tell them the dose, and what it is for. We should explain all procedures, and if possible, let the parent stay at the bedside while we perform them.
I can’t imagine the pain and guilt a parent would feel if their child was harmed in a medical error. It will happen, but we can all take steps to prevent it. Parents should stay with their child as much as possible during their hospitalization. You know your kids best, we are mere helpers. Health care professionals should explain and demonstrate everything they are doing for that child. Be open and honest, not intimidated by the parent’s questions.
Working as a team with the parents will help to decrease medical errors. It is a culture shift we need to get used to .
RR
Kathy said
My brother-in-law’s nephew was permanently disabled due to a medication error at a hospital. He was about 10 months old (but already talking and walking, according to his grandmother — I’m saying he was saying “bye-bye” and recognizing a lot of other words; and beginning to toddle pretty well — she makes it sound like he was 3 y/o or something!), and became dehydrated and was taken to the hospital for care. The nurse gave him a saline solution in his IV instead of a glucose solution. It didn’t kill him, but it has rendered him in a near-vegetative state. No crawling, walking, or other ability to move himself much if at all; he can vocalize but can’t speak. He’s still “in there” (if you will) — if people come over, he doesn’t like to be put into another room, and will “talk” and cry out to be where the action is; possibly if someone changes the channel of something he’s watching on TV to something he doesn’t like, he will similarly protest. He eats by a tube in his stomach, I think. Very sad. I think he’s probably about 13 y/o now, and has been this way since 10 months, and won’t get any better. Of course, they sued and got a nice, fat settlement to cover his medical expenses, but that doesn’t change the fact that a bright, active, normal 10 month old became a severely brain-damaged, immobile vegetable for the rest of his life.
realityrounds said
I have heard hundred of stories like these, and have even witnessed a few major medical errors in my long career. It saddens me to no end. I do try and show the parents the meds and the IV fluids if they are in the room, and explain to them what I am doing and what it is for. I feel it takes the burden off of them to have to ask me.
There are many safegaurds in place since your family members medical error happened. We now “scan” medications and IV fluids against the patients ID band, to make sure it is the right drug for the right patient. (It is exactly like grocery scanner). I lot has been computerized. In the end though, human error can still happen, and all safety nets need to be intact, including the parents being a safety net for their own child.
lpnmon said
When my son was hospitalized a couple years ago (pna, RSV, and bronchitis, poor guy) I was surprised at how few parents I saw when I was there. (yeah, I was nosy and peeked in rooms as I walked past) The nurses were surprised, too. More than one said “oh, you’re still here?” Well, yeah-my not yet 2 year old is in the hospital, of COURSE I’m still here!
The staff were all wonderful explaining everything. Funny how all the medical knowledge I have disappeared as soon as my kid got sick.
Great reminder-I hope it prevents some errors.
realityrounds said
In our peds unit, we try and make it mandatory that the parents stay with their child. We know this can be hard to do if there are other kids at home etc. It is so much better for the kid to have a parent/loved one with them at all times.
nickdupree said
My used to question a lot. And was hated and demonized for it.
realityrounds said
Nick,
Thanks for commenting. Whenever I see a medical professional getting pissed off because a patient is asking questions, it is usually because a)they may not know the answer. b) they are defensive and think the patient is judging them (“how dare they question my smartness”) or c)they resent the time taken up by the questions. There may be even more reasons why, but I can’t think of them right now.
I will be honest and admit that I have gotten annoyed at patient’s questions. There are times I have answered the same question over and over again, and I get impatient (I am only human). I get the stress patients are under, and information given to them may not absorb. Not saying I am proud of my impatience.
Joy said
I completely agree! This isn’t exactly the same but I took my 4-yr-old to the eye doctor this week. I was amazed at how they just tried doing things to her without explaining things to her first and it made me angry. And I did speak up. At one point the doctor put on this huge helmet thing with funky doodads and lights on it. My daughter, who was across the room, lit up with fear! So her MOTHER, not the DOCTOR, had to reassure her. The doctor didn’t say a darn word. And this was at a pediatric hospital.
Another time the nurse wanted to dilate her eyes with eyedrops and didn’t explain what she was doing. My daughter screamed out, “WHY?” right before the nurse got to her to put the drops in and did nothing to really reassure my daughter. My child is FOUR, she doesn’t understand what the heck these people are doing.
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nickdupree said
RR:
in the 80s my mom wasn’t allowed to stay overnight with my baby brother in the hospital, she was ejected after visiting hours were over. Things have improved some, but tightly enforced visiting hours are still all too common, especially in adult hospitals.