Hospital's responsibilities when treating patients with APNEA

[Gryphon]

Just thought I'd ask to see how others felt on this topic.

If you are in a prolonged stay (or even a few nights) in a hospital - were your mental faculties or ability to assist your self with masking up would be compromised. What sort of responsibilities do you feel the hospital staff has in helping to make sure your on your machine if your sleeping?


"Like I just underwent surgery and I'm on pain meds that have me all loopy so I keep drifting in and out of sleep for a few days... All that time I'm not using my CPAP and I'm having horrible sleep right when I need it most so my body can recover and heal."

(My father's Finally home from the hospital and I went through the numbers on his machine and all I can say is I'm Ticked off - Would rather use another word but I'm at work and it's not nice. If all goes well in about 3 to 4 weeks he has to go back into the hospital for more surgery. I can say I'm going to have a lot to say about the CPAP aspect of his care next time he's in there.)

There's like 3 days in a row where he got less than 30 min total on his machine for the whole day. Last weeks average was less than 4 hours a day not counting the days where he didn't use it at all. If I ever go into the hospital I know I'm going to have an order put in writing in my chart that if I'm sleeping, appear to be sleeping, or falling asleep, or sleepy... That someone needs to make sure I'm masked up.




Maybe I'm just naive and this is all wishful thinking but I would have thought that if you have a known medical condition and the device to treat it is right there and it doesn't conflict or interact with anything else they're doing to you, during your hospital stay. Doesn't it make sense that they help you use it? I'm banging my head against the wall here...

If you have me all doped up on morphine and I don't know my hand from my foot and I'm drifting in and out of sleep - I'd really like someone to help make sure I'm on my machine. I was making sure he was on it when I was there... and my Mom was making sure he was on it when she was there... but she'd leave they'd come in and wake him up for something (a blood draw or whatever) and then he'd drift off without it and no one made sure he had it back on.

When he was on one floor, in particular, they wouldn't even put water in his machine. It's like "O it's not ours so we're not responsible for it" We're back to the - you have to use our hospital issued piece of junk without a humidifier so we'll even touch it but if it's your machine you can go pound sand. I found out about this yesterday.

I'm not happy but I have a feeling this sort of thing happens all the time.

Should they or shouldn't they be helping make sure you are on your machine when asleep or drifting in and out of consciousness.

What sort of experience have any of you had when in a long or multi-night hospital stay. Were things way different for you? or is this kind of par for the course?



I mean he's all hooked up to monitors and stuff. He'd have de-sats unto the 80's when we were there enough to make the monitors alarm. (drifting off, falling asleep) and I'd make sure he masked back up, then his stats would go right back into the mid to high 90's after that. Nurses weren't coming to see what was going on with him either when those alarms were going off... I know 7 years ago when he had his other knee replaced and his monitors alarmed they would get all sorts of excited about it and wanted to make sure he was on his machine or they were monitoring his oxygen intake etc.. Not so much this time.

I guess if he's not masked up, he's at least on monitors so he wouldn't DIE... but that's not saying much for his comfort or quality of sleep which he would need to heal. Seriously frustrated here. Maybe I'm getting more upset about it then I should but, don't know. Even best case scenario if he recovers well he's still going back in the hospital in a month for more surgery. I just don't want to see this sort of thing continue. I know if I wasn't able to use my machine properly it would decimate me physically and mentally. Not sure how bad my father's apnea effects him but, darn it I shouldn't have to worry about this, it should be common sense.

Let me know what you think.

Thanks

Rest well.

Gryphon

[ChicagoGranny]

I have a feeling this sort of thing happens all the time.

I'm sure you are correct.

I visited a cousin in the hospital. While I was there, a nurse came in with an insulin shot. I protested, "She has Type II diabetes and only takes metformin not insulin."

The nurse said they like to keep tight control of blood sugar so that the healing is quicker.

Well, hell, don't you heal quicker if you are sleeping well and have no oxygen desats? Of course.

May you have a better experience with your father's next surgery.

[squid13]

I've had 2 nine day stays in the hospital in the last three years. The first stay after the hospital it was 30 days in the hospitals rehab hospital. First you don't sleep in the place cause there's to much going on around you. As far as cpap I tried using mine and finally just put my bed to 45 degrees and with the oxygen thru the nose piece I had no problem sleeping when I wasn't being woke up to have something done to me.

[Julie]

I think the thing to have done was talk to his main doctor and ask him to be explicit whether in talk or notes with nursing staff re the machine... to e.g. take instructions from you (or wife, etc) re putting it on, doing the water, and being hugely careful about it all... if necessary giving a mini session to head night nurse to pass on to others. Whether your MD will do that or not of course is up to them, but might be worth a try next time.

[chunkyfrog]

(Making a note to give my doctor a detailed instruction page when I see him next week)
This so scary!

[D.H.]

It seems that if more people with Sleep Apnea were diagnosed and CPAP compliant, hospital staff would be more familiar with these devices and more aware of hoe important they are to overall care. Imagine if the on duty nurse used it herself or her spouse did!

[knothead]

When I had my surgery in January I told them beforehand I was bringing my Apap with me. Since I was unable to move around my dear wife got it all ready for me and I donned my mask and slept whenever I could, pretty much left it on when I could during the day because the pain meds had me jacked....but I had my Pappy. When mask was off it was right beside me. Dr and nurses thought it very nice my wife would do that for me, I told them she wants me around a lot longer...

[Okie bipap]

When I was in the hospital for knee surgery, I would have oxygen desaturation if I fell asleep without having the oxygen cannula on. If I had it on, I did not have the desaturation. The day I got home, my doctor had an oxygen concentrator delivered to the house to use ehen sleeping until I could have my sleep studies and get on a machine.

[ChicagoGranny]

I had no problem sleeping when I wasn't being woke up to have something done to me.

Let me guess. They woke you up every hour to give you a sleeping pill?

[Okie bipap]

The three times I have been in for major surgery, they never offered me anything to help me sleep. They simply kept me drugged up to the point I didn't care if I slept or not.

[raisedfist]

You are ultimately responsible for your own health. On intake when they document your medical history, make it known that you have obstructive sleep apnea. Repeat that to the first physician who sees you. Then to the first nurse you see once you're assigned a room.

Sure in a perfect world it will all work out, but a hospital is a crazy environment and often the staff are overwhelmed and things do slip by.

[Janknitz]

A lot of it comes down to doctor's orders. If the doctor orders it, they are required to do it. But often, doctors either don't order it, or they don't put enough information in it so the staff knows what to do and when to do it. And no orders, no CPAP, because it's a medical treatment and nobody may administer it without a doctor's order--they may prevent you and your family members from setting it up too--just like you are not allowed to take a Tylenol you brought from home unless the doctor's order says so.

And then there's the whole thing about WHO is responsible. Nurses are often unfamiliar with CPAP's (even the hospital machines and definitely private machines which are not all the same). They may decide it's respiratory therapy's responsibility to set it up and even put it on you, so they might call respiratory therapy who will get to you when they get to you, whenever that may be.

Somewhere floating around this site is a detailed sample doctor's order that you can ask the doctor to sign as part of your pre-admission orders if your hospital stay is anticipated. If your hospitalization is not expected, it may be more difficult to get usable orders in place.

I have talked to my husband about how to EMPTY the humidifier first, then pack up the CPAP and ALL of the parts, to bring to me if I'm ever hospitalized. He won't remember and I've been meaning to put it all in writing in the case. Whether he would remember enough to set it up for me in the hospital is doubtful. And if we are injured in the same car accident (G-d forbid!) I'm completely out of luck. But I still think it's a good idea to train a family member in case you cannot do it yourself or communicate to the staff.

[chunkyfrog]

Re: emptying tank for hospital--my spare, DRY tank is already in the case.
The wet tank stays at home.

Re: Once I was awakened to take a sleeping pill.
I cussed them out and refused to take it!

[squid13]

Let me guess. They woke you up every hour to give you a sleeping pill?

I Was like some of the others doped up. I was paralyzed from the waist down and was receiving a lot of antibiotics thru a pic in my arm plus pain medication also so i had no problem sleeping, just a bad time in my life.

[palerider]

Let me guess. They woke you up every hour to give you a sleeping pill?

I Was like some of the others doped up. I was paralyzed from the waist down and was receiving a lot of antibiotics thru a pic in my arm plus pain medication also so i had no problem sleeping, just a bad time in my life.

Been there, done that, except without the paralysis. Didn't get much sleep though.