ANY NURSES PLEASE - QUESTION

[curtainchops]

Hi,
A question to any nurses here please ?

Are you allowed to treat a family member at home ?
ie; they're ill with Covid and you put them on a nebuliser and a Sats reader.

Thanks

Before you form a firm opinion about malpractice or something sinister, are you certain whether there were any engagements by primary care or the equivalent of GP/111 depending on where you live? There is a whole spectrum from entirely appropriate care led by GP/primary care to someone going off reservation with a nebuliser until a crash.

There's nothing wrong with asking questions though that can cause issues in emotionally charged circumstances but I'd want to understand the position before implying improper conduct.

Yeah that can't be right - all emergency ambulance patients go via ED - resus if critically ill. They would need to be stabilized before going to ICU or anywhere else OP.

OP your posts are all over the place. Rather than replying on multiple posts with short answers can you just put the entire situation with all the info in one post and then we can see what happened

And there is a range of behaviours than involve non-nursing care at home - we have plenty of patients at home with COVID who are better at home and looked after by family, some of whom deteriorate and get admitted later. Not every family using a nebuliser have a HCP in the house who has gone off-piste, they will just be using prescribed medication and trained to use it in the UK.

Sorry I keep cross-posting!

@AlphaAlpha

Patients on ambulances do not go straight to ICU - unless it's a hospital transfer.

If patients are in a life threatening condition and need immediate treatment, they go into the EDs resus.

That's dependant on the hospital. The hospital I work in as no A&E but has an ICU in which patients are directly admitted into. Some come from other hospitals, some come from home, some come from being found in the street. They have to be referred to the ICU by the Dr/paramedic on scene and then accepted but there's no A&E to go through.

That's the only scenario I can think of where the person the OP is talking about goes straight to ICU.

From reading this you have clearly lose a loved relative or friend and are now questioning in your head if something could of been done sooner or differently and would it of made a difference? Scrutinising this will not bring your loved one back but its only human we react like this. Im a nurse and i bought a sats probe myself to monitor my partner. The thing is you have to look at the bigger clinical picture he was 34 and no medical history and was coping with sats of say 92 but they would fluctuate and go up and down. He ended up in hospital aswell on day 7 when he got significantly worse. I too was holding out for him to turn a corner and tried to manage his symtpoms at home until i knew he needed medical intervention something i could not provide, he was severly dehydrated from d+v, lost half a stone in that week alone and was still spiking temps and unable to keep down any medication to help bring down his temp so i knew nows the time to go. The fact this person was treated on a ward for 7 days to me implies they where meating the right criteria for ward based care. I.e. didnt need 1:1 monitorong, advanced breathing support or specialist drugs. I think no matter how soon you got this person into hospital in my head they would of had access to all the same drugs and equipment every other patient was having. Unfortunately some people respond better than others for a whole host of reasons. It sounds like they where then esculated to itu when the treatment they tried wasnt as effective as theyd hoped so they esculated the level of care which is normal. I am sorry for the loss of this person, i know it is hard but please try and not think what if or buts. We dont know the whole story. Is it a case of a relative was trying to keep this person at home or a district nurse? Who prescribed the nebulisers etc and also what was their condition like when they approached hospital and how long had they been like that. I feel that this is much more complicated than a mumsnet thread but i understand you are trying to search for answers and understand everything.

It sounds OK to me. It is pretty common for family members to provide care, I do for my chronically ill partner, and obviously I use my skills as a nurse within that. I'm not able to be part of the professional care team, but you wouldn't have to be to give meds (by nebuliser or otherwise) or to monitor. Presumably the equipment would have been provided by a professional service?

Sats reaching 90% is a common bar for seeking emergency help, so I wouldn't be concerned about that.

Lots of hospitals can admit direct to ITU.

Regardless he was admitted straight to ITU even if he went via A and E - it really doesn't make much difference. You don't get admitted to A and E, A and E admit to wards.

OP, is this person a relative of yours?

I'm sorry I'm confused.

At one of these posts your loved one was on a ward for 7 days, in the next they went straight to ITU.

Monitoring someone's sats and seeking help once they drop below 90% would be considered reasonable for most people. Is there a reason you appear to think it isn't?

Are you the nurse OP?

I think OP is saying the person was looked after at home for 7 days, then taken straight to ICU.

So OP is wondering whether the person should have gone to hospital sooner.

He was not on a ward.
She looked after him at home for 7 days.
She rang the ambulance on the day and he went straight into ICU.
She worked at the hospital (apparently) that he went into.

I just wanted to ask if it was ok to do this, or whether it was misconduct.

I don't want to say anymore because someone may know her.

I never said he was on a ward.

Do you not like this nurse?

@bagofconkers

I think OP is saying the person was looked after at home for 7 days, then taken straight to ICU.

So OP is wondering whether the person should have gone to hospital sooner.

Exactly !

My brother died.
None of our family trust her.
She said the hospital killed him after he passed.

She nuts

What makes you think it was misconduct? Was the patient able to make their own decisions?

In your posts you say that he was on a hospital ward for 7 days before going to ITU

@MayThePawsBeWithYou

In your posts you say that he was on a hospital ward for 7 days before going to ITU

NO ! never said that !

Someone else posting on here implied it.

He got ill a week previously. After about 5 days he phoned her as they don't live together.

She went to get him a day later. She looked after him at her house for 7 days, with sats machine and oxygen (although she said nebuliser).
on the 7th day he was slumped and blueish. She called and ambulance and he went straight into icu.
He was on cpap.
they tried to intubate him 4 nights later and he died 2 hours after that.

I am sorry for your loss. If it helps my cleaner's husband's 02 went down to 88 - they called an ambulance and when the ambulance came they were not super worried as they said it was clear the results were down to covid. Suggested my friend drive her husband to the hospital which she did the next morning. Previously sats of lower than 95 would have freaked me out.

Sorry my post is wrong to an extent as i thought you implied was in hospital for 7 days. It still depends on so many factors. If this person had capacity they could have said themselves i want or need to go to hospital, we dont know the full context of the conversations they may of had. Also vaccination status. In a home environment it is impossible to see the full clinical picture you cant check blood gases to see oxygen levels, infection markers or monitor other organ functions. Having a sats probe is basic and can be helpful but you need to look at the whole picture including medical history, general condition and health of the person, resp rate etc. In theory there is nothing wrong with as an individual buying a sats probe online and using it as a guide for saturations only whether a nurse or not i know a lot of people who did this. We will never be able to know for sure with just this information as to whether someone acted incorrectly. Could there or also been discussions with 111? The only person who can decide if this person was negligent would be a judge, they may have justifications for believeing this person wasnt as ill as they where.

In what way is she 'nuts'?