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Re: Hospital IGNORED my doc's PAP order!!!

Posted: Tue Jun 19, 2012 1:45 pm
by Slinky
Hmmm, and thru all this I thought it was the anesthesiologist who was the deciding factor on your "condition" in surgery and in recovery.

Re: Hospital IGNORED my doc's PAP order!!!

Posted: Tue Jun 19, 2012 2:48 pm
by greatunclebill
chunkyfrog wrote:So, a presurgery consult with the surgeon is a must.
i find it hard to believe that a surgeon would do a normally scheduled procedure without meeting with the patient first. that would have been the time to discuss the cpap.

Re: Hospital IGNORED my doc's PAP order!!!

Posted: Tue Jun 19, 2012 3:47 pm
by BlackSpinner
I am no longer shocked about hospitals.
I was in my accountant's waiting room last winter and they had the local BIG research hospitals magazine there. In it they trumpeted how they now use a special kind of check list before surgery. It includes things like the patients name and what the operation is supposed to be and who is supposed to be there doing it. Apparently the reading out loud of this check list has reduced error and increased patients successful recovery. WTF were they doing before? Why was there no check list before 2010? (Apparently using a check list was considered unprofessional before and strenuously resisted)

Re: Hospital IGNORED my doc's PAP order!!!

Posted: Tue Jun 19, 2012 5:03 pm
by jen4700
My mom was sick with cancer for a year, in and out of hospitals and cancer center. Then my grandmother broker her hip and was sent to a care facility after the surgery. My family learned A LOT about medical care during these times.

1) Have a family member with the patient at all times, especially when the doctor visits.
2) Have all copies of DNR or other health care directives every time you go see someone.
3) Don't think twice about getting a second opinion.
4) Keep a list of all the patients meds at all times. Have family member check meds before letting nurses give anything to patient.
5) ASK questions. Write things down when they tell you.
6) If you don't understand, ASK AGAIN. Make them explain things until you understand.
7) Review patient status with EVERYONE who has interaction with the patient. The shift nurse (each time shift changes), the rehab person, the x-ray person, etc.
ASK everyone's name. When you interact with any medical staff using their name they will treat you better.
9) Be nice to the techs sometimes they will be able to "finagle" things better than even the docs. Mostly things that will make the patient's experience (or the family's) more comfortable.
10) Be patient. Bring something to read/do and eat. Rotate family members so they don't get burned out.

Re: Hospital IGNORED my doc's PAP order!!!

Posted: Tue Jun 19, 2012 5:14 pm
by DoriC
chunkyfrog wrote:Q: What do you call the person who averaged a C- in medical school?
A: Doctor.
Not everyone is lucky enough to get the valedictorian of his class.
Some of us wind up with the guy who barely graduated--or the one who cheated his way through;
or even the guy who is jaded, depressed, and just doesn't give a crap any more.
Umm, Can I just take a minute? My son came in third on his NY Boards. I wonder who the other two were? Sorry, couldn't help myself!

Re: Hospital IGNORED my doc's PAP order!!!

Posted: Tue Jun 19, 2012 5:23 pm
by Sleep2Die4
Komodo wrote:I had my gall bladder surgicaly removed yesterday.
I have had three surgeries since I started using CPAP. My CPAP went along with me on all three surgeries. I would say all three surgeries were longer and more difficult than a gall bladder removal without complications.

CPAP was not used in any of the surgeries. The recovery room attendant took good care of me in each case. They were aware I have sleep apnea and made sure to position and reposition me so that I kept breathing.

I was a little shocked they did not mask me up the first time but the attendant explained he was always there and saw me stop breathing a few times but always quickly jostled or repositioned me and I restarted breathing. They also said my O2 stats remained consistently good throughout the surgery.

So Komodo, what ill effects did you suffer from lack of CPAP?

Sounds like you are overreacting.

No harm, no foul.

Re: Hospital IGNORED my doc's PAP order!!!

Posted: Tue Jun 19, 2012 5:34 pm
by BlackSpinner
Sleep2Die4 wrote: CPAP was not used in any of the surgeries. The recovery room attendant took good care of me in each case. They were aware I have sleep apnea and made sure to position and reposition me so that I kept breathing.

I was a little shocked they did not mask me up the first time but the attendant explained he was always there and saw me stop breathing a few times but always quickly jostled or repositioned me and I restarted breathing. They also said my O2 stats remained consistently good throughout the surgery.
Oh really good - recovery sleep while constantly being jostled - I am sure that helped a lot. The attendant needs some eduction with regard to OSA. Suppose someone else had had some problems and there wasn't time to sit beside your bed and jostle you every 2 minutes?
Your O2 stats are of course ok during surgery - they have a breathing tube down you.

Re: Hospital IGNORED my doc's PAP order!!!

Posted: Tue Jun 19, 2012 7:01 pm
by Sleep2Die4
BlackSpinner wrote:

Oh really good - recovery sleep while constantly being jostled - I am sure that helped a lot. The attendant needs some eduction with regard to OSA. Suppose someone else had had some problems and there wasn't time to sit beside your bed and jostle you every 2 minutes?
Your O2 stats are of course ok during surgery - they have a breathing tube down you.
Sleep is not needed for the anesthesia to wear off. Only time and normal body functions.

I felt very well upon awakening in the recovery room from all three surgeries. No harm, no foul.
Suppose someone else had had some problems and there wasn't time to sit beside your bed and jostle you every 2 minutes?
Every surgery I had you are assigned your own personal recovery attendant. There are people available at the desk to be called in case your recovery attendant has to go, for example, to the restroom.

Your argument holds no water unless you can show some harm to Komodo by failure to apply the CPAP. He has not indicated any harm, only a righteous indignation that his sweet CPAP was not used.

Re: Hospital IGNORED my doc's PAP order!!!

Posted: Tue Jun 19, 2012 7:14 pm
by BlackSpinner
Sleep2Die4 wrote:
Sleep is not needed for the anesthesia to wear off. Only time and normal body functions.


Your argument holds no water unless you can show some harm to Komodo by failure to apply the CPAP. He has not indicated any harm, only a righteous indignation that his sweet CPAP was not used.
There would be no need to put the body through the stress of apneas if the cpap was on. The last thing you need when recovering from an operation is your body to experience the stress of OSA. If it was me lieing there they would be shaking me constantly, because the slightest doze and my O2 drops to below 78% and there is no point in providing O2 if I am not breathing it.

Re: Hospital IGNORED my doc's PAP order!!!

Posted: Tue Jun 19, 2012 10:32 pm
by Bookbear
BlackSpinner wrote:I am no longer shocked about hospitals.
I was in my accountant's waiting room last winter and they had the local BIG research hospitals magazine there. In it they trumpeted how they now use a special kind of check list before surgery. It includes things like the patients name and what the operation is supposed to be and who is supposed to be there doing it. Apparently the reading out loud of this check list has reduced error and increased patients successful recovery. WTF were they doing before? Why was there no check list before 2010? (Apparently using a check list was considered unprofessional before and strenuously resisted)
I recently had surgery. EVERY person who touched me asked my name and date of birth, what procedure I was in for (excision of malignant melanoma on my leg), and which leg it was. my wife ad a special password that was to be used by her when asking for information about my status, and I had to sign and initial each paragraph on a long document saying who information could be given to, including.......

wait for it.....


The Media!

When I woke up, I dryly croaked, "Alert the media."

Time certainly have changed Hospitals, doctors, and nurses seem to have to spend as much time covering their butts as they do caring for patients.

Re: Hospital IGNORED my doc's PAP order!!!

Posted: Wed Jun 20, 2012 12:58 am
by kteague
Bookbear wrote: I recently had surgery...
Hey Bookbear, sure hope your recovery is swift and complete!

Many (25?) years ago I had minor surgery that required anesthesia, and I remember them keeping me several hours in recovery and they told me afterward that it was because my oxygen kept dropping. Good grief, one more reason to suspect I've had OSA nearly forever.

Re: Hospital IGNORED my doc's PAP order!!!

Posted: Wed Jun 20, 2012 1:18 am
by kteague
Been looking for an old thread about studies showing post operative healing improved in OSA patients who used CPAP post surgery vs those who did not. I think the forum member may have been having a total knee done. Anyone remember that thread? Did it also say there was a shorter time in recovery or was it there was a shorter recovery time? Just wish I had my facts straight, but I couldn't locate the thread. Where does the nurse's responsibility to follow the doctor's orders end - with cpap, with meds, with protocol for observation and monitoring? It's a slippery slope. I personally want any nurse attending me to follow doctor's orders to the letter with the only exception being for my safety, not their convenience. It's a matter of principle.

Re: Hospital IGNORED my doc's PAP order!!!

Posted: Wed Jun 20, 2012 6:05 am
by Sleep2Die4
BlackSpinner wrote:

There would be no need to put the body through the stress of apneas if the cpap was on. The last thing you need when recovering from an operation is your body to experience the stress of OSA. If it was me lieing there they would be shaking me constantly, because the slightest doze and my O2 drops to below 78% and there is no point in providing O2 if I am not breathing it.
You have no idea that Komodo even experienced one apnea and he has not indicated one bit of harm other than to his delicate attitude about his CPAP.

Hospitals hire additional staff such as Patient Representatives to deal with this type of whining and the cost goes up and the quality comes down for all of us.

The United States of the Offended!

Re: Hospital IGNORED my doc's PAP order!!!

Posted: Wed Jun 20, 2012 6:06 am
by ChicagoGranny
Sleep2Die4 wrote: No harm, no foul.

Show me the beef!

Re: Hospital IGNORED my doc's PAP order!!!

Posted: Wed Jun 20, 2012 6:51 am
by Komodo
Sleep2Die4 wrote:I have had three surgeries since I started using CPAP. My CPAP went along with me on all three surgeries. I would say all three surgeries were longer and more difficult than a gall bladder removal without complications.

CPAP was not used in any of the surgeries. The recovery room attendant took good care of me in each case. They were aware I have sleep apnea and made sure to position and reposition me so that I kept breathing.

I was a little shocked they did not mask me up the first time but the attendant explained he was always there and saw me stop breathing a few times but always quickly jostled or repositioned me and I restarted breathing. They also said my O2 stats remained consistently good throughout the surgery.

So Komodo, what ill effects did you suffer from lack of CPAP?

Sounds like you are overreacting.

No harm, no foul.
Perhaps your surgeries were more serious, or you were in a better hospital than I was in, but I didn't have an "attendant" to always be there.
If I had, they would have seen that I was having trouble breathing prior to me waking up. BTW, the O2 alarm was going off when I woke, so I was in some distress at the time.

In addition to OSA, I have severe COPD, which is why my surgeon insisted on my getting clearance from my Pulmonoligist. The order for PAP was based on my OSA AND COPD. I spoke with my surgeon just prior to the surgery about my PAP, as well as the anesthesiologist, and both of them were on board with my Pulmonologists orders.

Did I suffer any long lasting harm? No I didn't.
Am I over reacting? I don't think so. A single nurse took it upon herself to ignore the orders that were signed off on by 4 different doctors. What if she ignores a more serious order for someone else?

Not to say that OSA isn't a serious condition in itself. The "regular" Recovery Room (where I went after the post-op RR) held me an additional TWO HOURS because I have OSA and they wanted to make sure I was ok before releasing me.

If you still think I'm over reacting, you should talk to my Pulmonologist. I called him yesterday to inform him what happened. Now there's somebody who even I think is over reacting!!! He is NOT happy and is getting back to me after he clears this mess up.