Do they have to bill per Bing! or does the machine automatically spit out a 20 every time it goes Bing!?

Probably more likely lawsuit avoidance. "And, ladies and gentlemen of the jury, my client is a widow because the hospital neglected even the most simple act of monitoring him..."

I work as a BMET and this is so true. Our hospital currently has this setup whenever there is a bedside alarm event.

1) Alarms at the bedside.
2) Light outside the door flashes and beeps
3) Marquee signs flash and beep, these are located in the ceilings throughout the unit
4) Vocera (its a walkie talkie that nurses wear around there necks) gives the nurse a vocal alarm
5) The central station alarms

We had one marquee sign that was down over a month and NO one on the floor knew it was broken because they ignored it. Alarm fatigue is very real.

As someone who has spent a few years monitoring patients on these machines, I'd say that false alarms aren't even the biggest issue. It's the patients who pull them off either accidentally or intentionally dozens of times a night that cause the the most monitor fatigue. That and staring at those screens for nearly 12 hours straight.

That's one of the benefits of socialized healthcare: we can't afford any of that!

(the other benefit being that it's "free")

("free" is in quotes because we all pay for it through our tax dollars)

Your job is being replaced by a computer. Hope you don't mind living in a box.

ltdanman44: I work as a BMET and this is so true. Our hospital currently has this setup whenever there is a bedside alarm event.

1) Alarms at the bedside.
2) Light outside the door flashes and beeps
3) Marquee signs flash and beep, these are located in the ceilings throughout the unit
4) Vocera (its a walkie talkie that nurses wear around there necks) gives the nurse a vocal alarm
5) The central station alarms

We had one marquee sign that was down over a month and NO one on the floor knew it was broken because they ignored it. Alarm fatigue is very real.

indeed. much better to have a couple of nurses in short alternating shifts monitoring EKG banks on monitors in the nurse's station. The VA has this setup and the floor is quieter, and the nurses actually know their arrhythmias down pat too.

/would probably not if the nurse monitoring was the one that showed me a PVC and asked me if that was an ST segment elevation.

ltdanman44: I work as a BMET and this is so true. Our hospital currently has this setup whenever there is a bedside alarm event.

1) Alarms at the bedside.
2) Light outside the door flashes and beeps
3) Marquee signs flash and beep, these are located in the ceilings throughout the unit
4) Vocera (its a walkie talkie that nurses wear around there necks) gives the nurse a vocal alarm
5) The central station alarms

We had one marquee sign that was down over a month and NO one on the floor knew it was broken because they ignored it. Alarm fatigue is very real.

Good God almighty! That's overkill. We had an alarm at the central telemetry monitors where I sat and one at the nurses station. I'd clear out the junk alarms, and call the nursing staff
directly for anything real. Of course after hours of getting ignored on sub-critical problems I'd tend to get fatigued about the whole thing too.

rga184: ltdanman44: I work as a BMET and this is so true. Our hospital currently has this setup whenever there is a bedside alarm event.

1) Alarms at the bedside.
2) Light outside the door flashes and beeps
3) Marquee signs flash and beep, these are located in the ceilings throughout the unit
4) Vocera (its a walkie talkie that nurses wear around there necks) gives the nurse a vocal alarm
5) The central station alarms

We had one marquee sign that was down over a month and NO one on the floor knew it was broken because they ignored it. Alarm fatigue is very real.

indeed. much better to have a couple of nurses in short alternating shifts monitoring EKG banks on monitors in the nurse's station. The VA has this setup and the floor is quieter, and the nurses actually know their arrhythmias down pat too.

/would probably not if the nurse monitoring was the one that showed me a PVC and asked me if that was an ST segment elevation.

Yeah.. It was fun teaching RNs what V. Tach was and why they might want to be concerned.

djh0101010: Probably more likely lawsuit avoidance. "And, ladies and gentlemen of the jury, my client is a widow because the hospital neglected even the most simple act of monitoring him..."

Or lawsuit creation. "Doctor, isn't it true that on the morning of April 6, the patient's bedside heart monitor sounded? And at no point did you order an EKG, echocardiogram, or even basic bloodwork? And no less than 18 months later he died of unknown causes? And you expect us to believe that this heart condition that you left untreated and unevaluated did not lead to his demise?"

Life_is_a_carnivore: "Ahhh, I see you have the machine that goes BING!."

Came to say this.

Leaving happy.

I spent a night for observation for a possible heart attack a couple months ago. The stupid monitor went off every time I fell asleep because my heart rate would go below a preset limit. Every time it went off it woke me up. Never had a nurse show up to investigate.

I did, however, get billed for it.

Franko: That's one of the benefits of socialized healthcare: we can't afford any of that!

(the other benefit being that it's "free")

("free" is in quotes because we all pay for it through our tax dollars)

We can't afford any of that either! But our insurance companies sure can!

As long as I can get a recording on VHS, Betamax or super 8
I'm OK with this

The majority of monitor alarms - nearly 80 percent in a recent California study - are triggered not by life-threatening heart problems but by unimportant changes triggered by nothing more than a patient coughing or sitting up in bed.

^ That is your problem. Not there being too many monitors. You can never have too much data, but if you're going to have a lot of data, you need to prioritize it in a sane fashion. IMHO, there's nothing wrong with attaching one on everyone as long as the guy with the heart condition has a much different alarm than the "just because" patient. It sounds like they need to seriously work on how data and alarms are presented to staff, but minimizing monitor use doesn't seem like the right approach.

I was hospitalized for a few days a while back for a severe alergic reaction. The monitors and other crap the doctors ordered were mind boggling. They wanted me on a heart monitor and EKG 24/7 as well as some inflatable knee length sock things. I refused each and every thing that was ordered unless someone, anyone, could explain to me it's purpose. "It's hospital policy" didn't cut it either.

The doctor actually looked at me and told me that I needed to get up and move around as much as possible to keep the blood flowing (makes sense) and that the anti-thrombosis stockings he'd ordered would prevent blood clots that might form from staying in bed for several days. Well, which is it? Use your damn head. I'm not 80. I'm not going to lay in the damn bed for days if my legs work. I'm in here to keep from dying if my f'ing tongue swells up again and I cant breath and for someone to figure out why it's happening. (that last part never happened and I still cary an epi-pen in case it happens again).

In the end I agreed to a blood pressure cuff and a pulse-ox monitor as both were useful in my case. The old lady socks had no purpose. The few times alarms did go off, the nurses were in there INSTANTLY and treated me like gold. As I checked out several came by and expressed how they wish more people would stand up for themselves and not assume that doctors are geniuses who have thought everything through. So many decisions are made by people behind desks based on money, not people.

Oh and the hospital billed for all that crap and I happily informed my insurance company that I'd refused them and discussed it with the attending doctor. They loved that.

I spent 2 hours in an ER for - it turns out - SVT (on metroprolol now) hooked up to a monitor. It kept alarming because one of the leads wouldn't stay connected. They weren't busy (did I mention an exurban ER is a good place to go on a Tuesday morning?), but the third time, they pretty much stopped rushing to check me.

itsfullofstars: I was hospitalized for a few days a while back for a severe alergic reaction. The monitors and other crap the doctors ordered were mind boggling. They wanted me on a heart monitor and EKG 24/7 as well as some inflatable knee length sock things. I refused each and every thing that was ordered unless someone, anyone, could explain to me it's purpose. "It's hospital policy" didn't cut it either.

The doctor actually looked at me and told me that I needed to get up and move around as much as possible to keep the blood flowing (makes sense) and that the anti-thrombosis stockings he'd ordered would prevent blood clots that might form from staying in bed for several days. Well, which is it? Use your damn head. I'm not 80. I'm not going to lay in the damn bed for days if my legs work. I'm in here to keep from dying if my f'ing tongue swells up again and I cant breath and for someone to figure out why it's happening. (that last part never happened and I still cary an epi-pen in case it happens again).

In the end I agreed to a blood pressure cuff and a pulse-ox monitor as both were useful in my case. The old lady socks had no purpose. The few times alarms did go off, the nurses were in there INSTANTLY and treated me like gold. As I checked out several came by and expressed how they wish more people would stand up for themselves and not assume that doctors are geniuses who have thought everything through. So many decisions are made by people behind desks based on money, not people.

Oh and the hospital billed for all that crap and I happily informed my insurance company that I'd refused them and discussed it with the attending doctor. They loved that.

Healthcare should not be an industry. Health insurance companies should not exist.

But, they do. Not sure why other than people are stupid and hurr durr vote for other, rich people who love rape and stealing your money.

But an expanding group of researchers, many of them nurses, are questioning the proliferation of monitoring, saying it is a prime cause of the dangerous problem of alarm fatigue. The more patients there are on monitors, they say, the more the machines' warning alarms blare, leading nurses to become desensitized to the beeps and tune them out.

It took me two years and seven reports to our CIO before anyone at my office believed this was a real problem, and we just monitor servers. Management wanted alarms for everything, from low memory, millisecond delays in service, failover servers going down for patch reboots - you name it, it was monitored. We had alerts if someone wrote more than a gig of data to any server in the data center even if the farking server was used for storing large amounts of data.

Our sysadmins were getting, on average, 44 alerts per night about shiat that either fixed itself by morning or had no business alerting in the first place. So what did they do? They turned their goddamn phones off and missed critical alerts because they wanted some sleep. It took us another year to prioritize what SHOULD alert and then setting up dependency models so the admins wouldn't get 50 alerts if a box went down. If the box is down, send one alert about it, you can assume the 50 services you monitor on the box are also down.

/learned more about Nagios in a year than I thought possible.
//Wish the company would have just paid for a product

Primum: itsfullofstars:
Healthcare should not be an industry. Health insurance companies should not exist.

But, they do. Not sure why other than people are stupid and hurr durr vote for other, rich people who love rape and stealing your money.

Want to know something sad? I work for a major healthcare equipment sales/distribution company. This year my company drastically reduced our health insurance program.

(wait for it...wait for it....there it is!)

itsfullofstars: I was hospitalized for a few days a while back for a severe alergic reaction. The monitors and other crap the doctors ordered were mind boggling. They wanted me on a heart monitor and EKG 24/7 as well as some inflatable knee length sock things. I refused each and every thing that was ordered unless someone, anyone, could explain to me it's purpose. "It's hospital policy" didn't cut it either.

The doctor actually looked at me and told me that I needed to get up and move around as much as possible to keep the blood flowing (makes sense) and that the anti-thrombosis stockings he'd ordered would prevent blood clots that might form from staying in bed for several days. Well, which is it? Use your damn head. I'm not 80. I'm not going to lay in the damn bed for days if my legs work. I'm in here to keep from dying if my f'ing tongue swells up again and I cant breath and for someone to figure out why it's happening. (that last part never happened and I still cary an epi-pen in case it happens again).

In the end I agreed to a blood pressure cuff and a pulse-ox monitor as both were useful in my case. The old lady socks had no purpose. The few times alarms did go off, the nurses were in there INSTANTLY and treated me like gold. As I checked out several came by and expressed how they wish more people would stand up for themselves and not assume that doctors are geniuses who have thought everything through. So many decisions are made by people behind desks based on money, not people.

Oh and the hospital billed for all that crap and I happily informed my insurance company that I'd refused them and discussed it with the attending doctor. They loved that.

I can see the page now...Dr. could you step away from admitting and treating the patient in unstable a-fib to explain to this other patient why he or she needs compression stockings?

There's all types of doctors and all types of nurses--good and bad. The nurses you had, the ones that were incapable of explaining why you need compression stockings without actually having to call your doctor to come to your bedside and hold your hand don't sound like good ones.

Most order sets for admission have a DVT/PE prophylaxis section where you either check "ambulate at least three times per day" or "compression stockings". Not sure if maybe your doctor thought you weren't going to be able to walk around if your tongue was swollen up and couldn't breathe well, but demanding to have your doctor come in and explain everything to you personally smells of prima donna patient.

/I don't miss my intern year one bit.

Just wait until Obamacare:



/you thought it was because he cared! HAHAHAHAHAHAHAHAHA!

I wonder if masturbation sets them off.

rga184: I can see the page now...Dr. could you step away from admitting and treating the patient in unstable a-fib to explain to this other patient why he or she needs compression stockings?

There's all types of doctors and all types of nurses--good and bad. The nurses you had, the ones that were incapable of explaining why you need compression stockings without actually having to call your doctor to come to your bedside and hold your hand don't sound like good ones.

Most order sets for admission have a DVT/PE prophylaxis section where you either check "ambulate at least three times per day" or "compression stockings". Not sure if maybe your doctor thought you weren't going to be able to walk around if your tongue was swollen up and couldn't breathe well, but demanding to have your doctor come in and explain everything to you personally smells of prima donna patient.

No, I patiently waited until the doctor came by on rounds, but I wouldn't accept something because it was on some print out. Not because I'm a prima donna but because I know damn well that print out includes a more than the doctor ordered. You know it too, at least I hope you do.

The compression stockings were ordered because it was "hospital policy" just the heart monitors in TFA are to be ordered for all patients. Not because it make sense but because it make money, either through billing to patients/insurance or in malpractice insurance savings through overwrought blood clot preventative efforts.

If wanting to know how someone else is spending your money and asking some questions is prima donna, then I'll wear that label proudly.

Irritation with a patient asking questions smells of a God complex doctor.

UsikFark: I wonder if masturbation sets them off.

I don't know about that, but my father-in-law got bored in intensive care and figured out that if he shook the wires he could get the alarms to go off. At least he got someone to come visit him for a moment or two.

rga184: itsfullofstars: I was hospitalized for a few days a while back for a severe alergic reaction. The monitors and other crap the doctors ordered were mind boggling. They wanted me on a heart monitor and EKG 24/7 as well as some inflatable knee length sock things. I refused each and every thing that was ordered unless someone, anyone, could explain to me it's purpose. "It's hospital policy" didn't cut it either.

The doctor actually looked at me and told me that I needed to get up and move around as much as possible to keep the blood flowing (makes sense) and that the anti-thrombosis stockings he'd ordered would prevent blood clots that might form from staying in bed for several days. Well, which is it? Use your damn head. I'm not 80. I'm not going to lay in the damn bed for days if my legs work. I'm in here to keep from dying if my f'ing tongue swells up again and I cant breath and for someone to figure out why it's happening. (that last part never happened and I still cary an epi-pen in case it happens again).

In the end I agreed to a blood pressure cuff and a pulse-ox monitor as both were useful in my case. The old lady socks had no purpose. The few times alarms did go off, the nurses were in there INSTANTLY and treated me like gold. As I checked out several came by and expressed how they wish more people would stand up for themselves and not assume that doctors are geniuses who have thought everything through. So many decisions are made by people behind desks based on money, not people.

Oh and the hospital billed for all that crap and I happily informed my insurance company that I'd refused them and discussed it with the attending doctor. They loved that.

I can see the page now...Dr. could you step away from admitting and treating the patient in unstable a-fib to explain to this other patient why he or she needs compression stockings?

There's all types of doctors and all types of nurses--good and bad. The nurses you had, the ones that were incapable of explaining why you need compression stockings without actually having to call your doctor to come to your bedside and hold your hand don't sound like good ones.

Most order sets for admission have a DVT/PE prophylaxis section where you either check "ambulate at least three times per day" or "compression stockings". Not sure if maybe your doctor thought you weren't going to be able to walk around if your tongue was swollen up and couldn't breathe well, but demanding to have your doctor come in and explain everything to you personally smells of prima donna patient.

/I don't miss my intern year one bit.

If more doctors would try a little customer service and drop the God complex for a few minutes people might take them more seriously.

Done

In

One

itsfullofstars: I know damn well that print out includes a more than the doctor ordered. You know it too, at least I hope you do.

That printout is the doctor's orders, so no, it doesn't

.itsfullofstars: The compression stockings were ordered because it was "hospital policy" just the heart monitors in TFA are to be ordered for all patients. Not because it make sense but because it make money, either through billing to patients/insurance or in malpractice insurance savings through overwrought blood clot preventative efforts.

Universal thromboprophylaxis precautions save a ton of money. And lives, but you seem less concerned about that. There are any number of studies that show that. If you were having a severe allergic reaction you were at a much higher risk of developing a blood clot. Fortunately for you, that risk is still pretty small and it didn't catch up with you.

itsfullofstars: rga184: I can see the page now...Dr. could you step away from admitting and treating the patient in unstable a-fib to explain to this other patient why he or she needs compression stockings?

There's all types of doctors and all types of nurses--good and bad. The nurses you had, the ones that were incapable of explaining why you need compression stockings without actually having to call your doctor to come to your bedside and hold your hand don't sound like good ones.

Most order sets for admission have a DVT/PE prophylaxis section where you either check "ambulate at least three times per day" or "compression stockings". Not sure if maybe your doctor thought you weren't going to be able to walk around if your tongue was swollen up and couldn't breathe well, but demanding to have your doctor come in and explain everything to you personally smells of prima donna patient.

No, I patiently waited until the doctor came by on rounds, but I wouldn't accept something because it was on some print out. Not because I'm a prima donna but because I know damn well that print out includes a more than the doctor ordered. You know it too, at least I hope you do.

The compression stockings were ordered because it was "hospital policy" just the heart monitors in TFA are to be ordered for all patients. Not because it make sense but because it make money, either through billing to patients/insurance or in malpractice insurance savings through overwrought blood clot preventative efforts.

If wanting to know how someone else is spending your money and asking some questions is prima donna, then I'll wear that label proudly.

Irritation with a patient asking questions smells of a God complex doctor.

Not opposed to asking questions, but rather demanding that it be your doctor that answers them, when a good nurse is fully capable of explaining what a compression stocking is for. Answering "hospital policy" for a simple question like that is shameful, and yet youre painting your nursing care as being good.

My mistake if you did actually wait until rounds to discuss it. Sorry. It was my experience as an intern that we were paged for crap like this in the middle of a busy evening admitting unstable pts. Trust me when I tell you that when youve been a doctor for six months, and you are on your own admitting very sick people, god complex is the last thing on your mind. You are tired, constantly distracted, and deathly afraid of missing something that could kill a pt. In that context, YES, being asked to drop what you're doing so you can go hold somebody's hand because the nurse couldnt be bothered with an answer beyond "hospital policy" is incredibly annoying.

Not painting a picture for people to feel sorry for anybody, but I have memories of patient care suffering because i was distracted by endless pages generated by prima donna pts. Nobody died, and i am well beyond that stage in my career, but it worries me that it continues to this day.

I've spent a few nights in the hospital over the years and monitor and pump alarms are always going off when the batteries start running down. Here's an idea, nurses: Ensure the machines are plugged in when your shift begins.

/Tired of getting out of bed and making sure my roommate's devices are all plugged in.

rga184: itsfullofstars: I was hospitalized for a few days a while back for a severe alergic reaction. The monitors and other crap the doctors ordered were mind boggling. They wanted me on a heart monitor and EKG 24/7 as well as some inflatable knee length sock things. I refused each and every thing that was ordered unless someone, anyone, could explain to me it's purpose. "It's hospital policy" didn't cut it either.

The doctor actually looked at me and told me that I needed to get up and move around as much as possible to keep the blood flowing (makes sense) and that the anti-thrombosis stockings he'd ordered would prevent blood clots that might form from staying in bed for several days. Well, which is it? Use your damn head. I'm not 80. I'm not going to lay in the damn bed for days if my legs work. I'm in here to keep from dying if my f'ing tongue swells up again and I cant breath and for someone to figure out why it's happening. (that last part never happened and I still cary an epi-pen in case it happens again).

In the end I agreed to a blood pressure cuff and a pulse-ox monitor as both were useful in my case. The old lady socks had no purpose. The few times alarms did go off, the nurses were in there INSTANTLY and treated me like gold. As I checked out several came by and expressed how they wish more people would stand up for themselves and not assume that doctors are geniuses who have thought everything through. So many decisions are made by people behind desks based on money, not people.

Oh and the hospital billed for all that crap and I happily informed my insurance company that I'd refused them and discussed it with the attending doctor. They loved that.

I can see the page now...Dr. could you step away from admitting and treating the patient in unstable a-fib to explain to this other patient why he or she needs compression stockings?

There's all types of doctors and all types of nurses--good and bad. The nurses you had, the ones that were incapable of explaining why you need compression stockings without actually having to call your doctor to come to your bedside and hold your hand don't sound like good ones.

Most order sets for admission have a DVT/PE prophylaxis section where you either check "ambulate at least three times per day" or "compression stockings". Not sure if maybe your doctor thought you weren't going to be able to walk around if your tongue was swollen up and couldn't breathe well, but demanding to have your doctor come in and explain everything to you personally smells of prima donna patient.

/I don't miss my intern year one bit.

REALLY? Are you seriously calling someone who wants to be informed on the procedures performed on them a diva? Wow, I know physicians have the reputation for having a god complex but damn dude.

For years when I worked in the ICU I would hear a Puritan Bennett ventilator alarm whenever I stepped into the shower at home.

davidphogan: rga184: itsfullofstars: I was hospitalized for a few days a while back for a severe alergic reaction. The monitors and other crap the doctors ordered were mind boggling. They wanted me on a heart monitor and EKG 24/7 as well as some inflatable knee length sock things. I refused each and every thing that was ordered unless someone, anyone, could explain to me it's purpose. "It's hospital policy" didn't cut it either.

The doctor actually looked at me and told me that I needed to get up and move around as much as possible to keep the blood flowing (makes sense) and that the anti-thrombosis stockings he'd ordered would prevent blood clots that might form from staying in bed for several days. Well, which is it? Use your damn head. I'm not 80. I'm not going to lay in the damn bed for days if my legs work. I'm in here to keep from dying if my f'ing tongue swells up again and I cant breath and for someone to figure out why it's happening. (that last part never happened and I still cary an epi-pen in case it happens again).

In the end I agreed to a blood pressure cuff and a pulse-ox monitor as both were useful in my case. The old lady socks had no purpose. The few times alarms did go off, the nurses were in there INSTANTLY and treated me like gold. As I checked out several came by and expressed how they wish more people would stand up for themselves and not assume that doctors are geniuses who have thought everything through. So many decisions are made by people behind desks based on money, not people.

Oh and the hospital billed for all that crap and I happily informed my insurance company that I'd refused them and discussed it with the attending doctor. They loved that.

I can see the page now...Dr. could you step away from admitting and treating the patient in unstable a-fib to explain to this other patient why he or she needs compression stockings?

There's all types of doctors and all types of nurses--good and bad. The nurses you had, the ones that were incapable of explaining why you need compression stockings without actually having to call your doctor to come to your bedside and hold your hand don't sound like good ones.

Most order sets for admission have a DVT/PE prophylaxis section where you either check "ambulate at least three times per day" or "compression stockings". Not sure if maybe your doctor thought you weren't going to be able to walk around if your tongue was swollen up and couldn't breathe well, but demanding to have your doctor come in and explain everything to you personally smells of prima donna patient.

/I don't miss my intern year one bit.

If more doctors would try a little customer service and drop the God complex for a few minutes people might take them more seriously.

As i just posted, not opposed to people asking questions, but demanding an explanation from a doctor for every routine thing is a bit too much. Especially when a nurse is fully capable of understanding why those things are ordered. Or maybe it was just some of the nurses I knew, because its frequent on rounds that a nurse may ask if the stockings can be discontinued because the pt is now ambulating.

Ive been complimented on my bedside manner and my pt care, but if a high maintenance pt distracts me from taking care of somebody who is critically ill (remember, that could be you or your loved one), your idea "customer service" takes a back seat. The reason why is exactly because i am capable of mistakes. But you can call it a god complex if you like.

itsfullofstars: I was hospitalized for a few days a while back for a severe alergic reaction. The monitors and other crap the doctors ordered were mind boggling. They wanted me on a heart monitor and EKG 24/7 as well as some inflatable knee length sock things. I refused each and every thing that was ordered unless someone, anyone, could explain to me it's purpose. "It's hospital policy" didn't cut it either.

The doctor actually looked at me and told me that I needed to get up and move around as much as possible to keep the blood flowing (makes sense) and that the anti-thrombosis stockings he'd ordered would prevent blood clots that might form from staying in bed for several days. Well, which is it? Use your damn head. I'm not 80. I'm not going to lay in the damn bed for days if my legs work. I'm in here to keep from dying if my f'ing tongue swells up again and I cant breath and for someone to figure out why it's happening. (that last part never happened and I still cary an epi-pen in case it happens again).

In the end I agreed to a blood pressure cuff and a pulse-ox monitor as both were useful in my case. The old lady socks had no purpose. The few times alarms did go off, the nurses were in there INSTANTLY and treated me like gold. As I checked out several came by and expressed how they wish more people would stand up for themselves and not assume that doctors are geniuses who have thought everything through. So many decisions are made by people behind desks based on money, not people.

Oh and the hospital billed for all that crap and I happily informed my insurance company that I'd refused them and discussed it with the attending doctor. They loved that.

They check your insurance before deciding how sick you are and what tests they can rape you with. This frequently makes people more ill.

I spent a week in the hospital early last year. They had the heart monitors set so if one went off in any room on the floor, every one on the floor alerted and displayed which one was the problem. I guess that makes a modicum of sense in that if a nurse is in my room and someone flatlines in another room, my nurse oughtta know about it, but the thing that pissed me off was that there was NO WAY to mute the alarms from other rooms. So, trying to sleep, which was hard enough in an unfamiliar bed, and the damn thing would just go off at random times and wake me up. It sucked.

Lsherm: It took me two years and seven reports to our CIO before anyone at my office believed this was a real problem, and we just monitor servers. Management wanted alarms for everything, from low memory, millisecond delays in service, failover servers going down for patch reboots - you name it, it was monitored. We had alerts if someone wrote more than a gig of data to any server in the data center even if the farking server was used for storing large amounts of data.

Our sysadmins were getting, on average, 44 alerts per night about shiat that either fixed itself by morning or had no business alerting in the first place. So what did they do? They turned their goddamn phones off and missed critical alerts because they wanted some sleep. It took us another year to prioritize what SHOULD alert and then setting up dependency models so the admins wouldn't get 50 alerts if a box went down. If the box is down, send one alert about it, you can assume the 50 services you monitor on the box are also down.

Lsherm is right, too. My company spams the shiat out of itself with useless notifications. I get hundreds per day in my e-mail, which I have Outlook set to sort off so I can ignore them, because most of it is completely useless. Why? 'Just in case.' Another department's phones ring through to ours, though we NEVER answer their line. Why? 'Just in case they get busy.' I haven't had to answer their calls from my own office once in ten years with the company. If they need bodies, I go over there. It's maddening. I absolutely refuse to let the company send notifications to my personal phone, or to accept a company smartphone, or I'd be getting that shiat at home, too. Lsherm, can I have copies of what you said to convince your bosses of how crappy overmonitoring is? lol.

robodog: rga184: itsfullofstars: I was hospitalized for a few days a while back for a severe alergic reaction. The monitors and other crap the doctors ordered were mind boggling. They wanted me on a heart monitor and EKG 24/7 as well as some inflatable knee length sock things. I refused each and every thing that was ordered unless someone, anyone, could explain to me it's purpose. "It's hospital policy" didn't cut it either.

The doctor actually looked at me and told me that I needed to get up and move around as much as possible to keep the blood flowing (makes sense) and that the anti-thrombosis stockings he'd ordered would prevent blood clots that might form from staying in bed for several days. Well, which is it? Use your damn head. I'm not 80. I'm not going to lay in the damn bed for days if my legs work. I'm in here to keep from dying if my f'ing tongue swells up again and I cant breath and for someone to figure out why it's happening. (that last part never happened and I still cary an epi-pen in case it happens again).

In the end I agreed to a blood pressure cuff and a pulse-ox monitor as both were useful in my case. The old lady socks had no purpose. The few times alarms did go off, the nurses were in there INSTANTLY and treated me like gold. As I checked out several came by and expressed how they wish more people would stand up for themselves and not assume that doctors are geniuses who have thought everything through. So many decisions are made by people behind desks based on money, not people.

Oh and the hospital billed for all that crap and I happily informed my insurance company that I'd refused them and discussed it with the attending doctor. They loved that.

I can see the page now...Dr. could you step away from admitting and treating the patient in unstable a-fib to explain to this other patient why he or she needs compression stockings?

There's all types of doctors and all types of nurses--good and bad. The nurses you had, the ones that were i ...

Dude, Doctors hate it when you open your mouth to ask questions. Some of the better ones will listen for a little while before cutting you off. One of the Peds docs that I work with routinely cites a study (not sure if it actually exists) that the average time a doctor will let you talk before cutting you off is 11 seconds, and that is during an office visit. Good luck talking with a doc that long on rounds in the morning. That said, I'm sure that medical providers get jaded pretty quickly when dealing with patients that complain about every little thing.

The best thing you can do is be an informed patient, if you've got a chronic condition, you need to be an expert too. Talk to people in the medical field when you get a chance to pick up pointers. If you have to get a little "diva" on a provider to get information, do so. Ultimately, it is your health, and you need to do what you can. To the providers, it is just another day on the job.

And alarms can really be a problem in an ICU or other wing. It depends on the nursing staff watching it though. My favorite example is on the Burn Unit, blood pressure on a patient dropped quickly, which triggered an alarm. The nurse looked up at the monitoring station and said "Wow, looks like so and so just took a huge dump." 30 seconds later our guess was confirmed as we were assaulted by the smell.

itsfullofstars: rga184: I can see the page now...Dr. could you step away from admitting and treating the patient in unstable a-fib to explain to this other patient why he or she needs compression stockings?

There's all types of doctors and all types of nurses--good and bad. The nurses you had, the ones that were incapable of explaining why you need compression stockings without actually having to call your doctor to come to your bedside and hold your hand don't sound like good ones.

Most order sets for admission have a DVT/PE prophylaxis section where you either check "ambulate at least three times per day" or "compression stockings". Not sure if maybe your doctor thought you weren't going to be able to walk around if your tongue was swollen up and couldn't breathe well, but demanding to have your doctor come in and explain everything to you personally smells of prima donna patient.

No, I patiently waited until the doctor came by on rounds, but I wouldn't accept something because it was on some print out. Not because I'm a prima donna but because I know damn well that print out includes a more than the doctor ordered. You know it too, at least I hope you do.

The compression stockings were ordered because it was "hospital policy" just the heart monitors in TFA are to be ordered for all patients. Not because it make sense but because it make money, either through billing to patients/insurance or in malpractice insurance savings through overwrought blood clot preventative efforts.

If wanting to know how someone else is spending your money and asking some questions is prima donna, then I'll wear that label proudly.

Irritation with a patient asking questions smells of a God complex doctor.

DVT prophylaxis is certainly not a money maker--it is an order set/protocol based off a scoring/risk mechanism--and yes even young, healthy individuals can experience a DVT/PE in an acute hospital setting. Science supports the use and there are many risk factors to consider (Many of which most people would not consider 'risky') but like any medication/treatment, there are grey areas and patients have the right to refuse. Any nurse (and most nursing aides) could explain that to you--although I doubt you asked.

robodog: rga184: itsfullofstars: I was hospitalized for a few days a while back for a severe alergic reaction. The monitors and other crap the doctors ordered were mind boggling. They wanted me on a heart monitor and EKG 24/7 as well as some inflatable knee length sock things. I refused each and every thing that was ordered unless someone, anyone, could explain to me it's purpose. "It's hospital policy" didn't cut it either.

The doctor actually looked at me and told me that I needed to get up and move around as much as possible to keep the blood flowing (makes sense) and that the anti-thrombosis stockings he'd ordered would prevent blood clots that might form from staying in bed for several days. Well, which is it? Use your damn head. I'm not 80. I'm not going to lay in the damn bed for days if my legs work. I'm in here to keep from dying if my f'ing tongue swells up again and I cant breath and for someone to figure out why it's happening. (that last part never happened and I still cary an epi-pen in case it happens again).

In the end I agreed to a blood pressure cuff and a pulse-ox monitor as both were useful in my case. The old lady socks had no purpose. The few times alarms did go off, the nurses were in there INSTANTLY and treated me like gold. As I checked out several came by and expressed how they wish more people would stand up for themselves and not assume that doctors are geniuses who have thought everything through. So many decisions are made by people behind desks based on money, not people.

Oh and the hospital billed for all that crap and I happily informed my insurance company that I'd refused them and discussed it with the attending doctor. They loved that.

I can see the page now...Dr. could you step away from admitting and treating the patient in unstable a-fib to explain to this other patient why he or she needs compression stockings?

There's all types of doctors and all types of nurses--good and bad. The nurses you had, the ones that were incapable of explaining why you need compression stockings without actually having to call your doctor to come to your bedside and hold your hand don't sound like good ones.

Most order sets for admission have a DVT/PE prophylaxis section where you either check "ambulate at least three times per day" or "compression stockings". Not sure if maybe your doctor thought you weren't going to be able to walk around if your tongue was swollen up and couldn't breathe well, but demanding to have your doctor come in and explain everything to you personally smells of prima donna patient.

/I don't miss my intern year one bit.

REALLY? Are you seriously calling someone who wants to be informed on the procedures performed on them a diva? Wow, I know physicians have the reputation for having a god complex but damn dude.

They werent asking for an explanation on a procedure. "Refused each and every thing that was ordered unless someone, anyone, explained to me its purpose" is what was posted. Yeah, that does sound excessive.

TheAgeOfEgos: DVT prophylaxis is certainly not a money maker--it is an order set/protocol based off a scoring/risk mechanism--and yes even young, healthy individuals can experience a DVT/PE in an acute hospital setting. Science supports the use and there are many risk factors to consider (Many of which most people would not consider 'risky') but like any medication/treatment, there are grey areas and patients have the right to refuse. Any nurse (and most nursing aides) could explain that to you--although I doubt you asked.

Yes I asked the nurses, they didn't know either and suggested I wait to talk to the doctor. Every indication I got from the nurses and doctors was that they weren't the only ones making decisions here. Perhaps it was statistics doing the decision making as you suggest.. But I'm a person, not a statistic. Perhaps this is why the doctor said "I dont know why that was ordered, you dont need it".


I also dont get a flu shot anymore. The CDC and statistics say I'm supposed to but they always make me really really sick for about 2 weeks so I stopped.

I thought it was humorous when I went into the ER with sinus tachycardia and the little blood pressure/pulse rate machine went into alarm as soon as they hooked me up and turned me on. That got me tossed into a freaking hospital wheelchair. Nothing like making you feel great.

5 doctors later they still haven't figured out where it is coming from. Apparently I very healthy other than that...

ltdanman44: I work as a BMET and this is so true. Our hospital currently has this setup whenever there is a bedside alarm event.

1) Alarms at the bedside.
2) Light outside the door flashes and beeps
3) Marquee signs flash and beep, these are located in the ceilings throughout the unit
4) Vocera (its a walkie talkie that nurses wear around there necks) gives the nurse a vocal alarm
5) The central station alarms

We had one marquee sign that was down over a month and NO one on the floor knew it was broken because they ignored it. Alarm fatigue is very real.

Yeah, no shiat. My mother had a massive stroke and spent two weeks in a coma in INOVAs Neuro ICU several years ago (the best in the area). I spent a few hundred hours there and it was all beeps and alarms 24/7.

Every single one of my family that rotated our time there agrees that she would have died if we weren't there in shifts to make sure she got proper care. Hospitals are really farked up and as clueless as the rest of at times.

/she's doing great all things considered and thanks for asking

Franko: ("free" is in quotes because we all pay for it through our tax dollars)

You're shiatting me. Is that how it works? really?

Non story

Calamormine: Holy motherfark. CSB:

My daughter had to have open heart surgery to repair a condition called Tetralogy of Fallot. She was two months old, so my wife and I basically lived in the hospital room for the next two weeks while she recovered. Without fail, an alarm would sound every fifteen or so minutes saying either her O2 sats were too low, or her respiratory rate was too high or her heart stopped beating, or there was a leprechaun in the room, or whatever else those damned things monitor. They were, not once, legitimate. And the nurse told us at around day three that we should just hit the silence button on the monitor when they go off because they're not REAL alarms. Hmmm, so if you're confident they're not legitimate alarms, then why have the damn alarms in the first place? Needless to say, there was very little sleep to be had those two weeks.

/CSB

When my daughter was in the NICU the nurses told us that whenever an alarm sounded we were supposed to look at her because she'd be purple if something were really wrong with her. Still those things jangled my nerves until I discovered the silence button.

This is my "Everything's OK" alarm!

(squeee!) THIS WILL SOUND... (squeee!) EVERY THREE SECONDS... (squee!) UNLESS SOMETHING ISN'T OKAY!