My previous two columns described challenges with care when a relative was in a hospital on the east coast.  The nurse on one shift left the patient in severe, untreated pain for hours, despite the doctor’s orders, and made many other questionable choices.

When does it make sense to raise the alarm?  After, say, three problems?  Only after you’ve made several unsuccessful attempts to deal with the situation yourself directly with the nurse?  Only for problems that you feel are life-threatening?  Interestingly, hospitals today don’t favor putting any such speed bumps in your way.

Diane Drexler, Chief Nursing Officer at Yavapai Regional Medical Center (YRMC), explained that if patients are not comfortable or not satisfied – whether they think the issue is of huge significance or not – they should speak up.

 “If the patient or the patient care giver [family member] is concerned, that would be the time.  It’s really individual.  It’s based on their comfort level.” 

Handouts from the hospital on the east coast made a similar point:  “Tell a staff member if someone or something makes you feel uneasy.”

Do you need to know to ask for the “charge nurse” or the “nursing supervisor”?

Drexler said, “Not necessarily.  Even if you go to McDonald’s and you’re not happy, you could ask to speak to a supervisor. It’s really the same thing:  ‘Who’s your supervisor for today?’”

Once you explain your concerns, the charge nurse or nursing supervisor may ask for your okay to talk with the nurse in question.  Like everyone else, nurses may not realize how their actions are perceived, so that feedback is critical.

The supervisor may change which nurse is assigned to the patient; in some cases, the charge nurse might take care of the patient directly for the balance of the shift.

If the patient and/or family members aren’t satisfied with the response from the charge nurse, they can ask to speak to the next level of supervision.  Nights and weekends, YRMC has a nursing supervisor on duty who can address issues anywhere in the hospital.  Patients and family members can also raise concerns to the director of the relevant hospital unit (such as the ICU, surgery, or the cardiac catheterization lab) or to the clinical coordinator of such a unit. These people will typically introduce themselves to newly admitted patients and leave their contact information. 

Drexler concluded, “Truly, organizations want to know.  If people aren’t comfortable or we aren’t meeting their needs, we want to know so we can correct that.  We do post-discharge phone calls on all of our patients.  We want to know how you are doing clinically [medically], but also how well we did from a service perspective.”

In short, speak up!