Alarm Fatigue

I came across this article titled ‘Alarm fatigue’ can kill, hospital group says, and smiled knowingly, thinking it’s about time someone finally said it. The premise is essentially that there are so many different alarms going off (for valid reasons and for malfunctions or errors) in a hospital patient’s room at one time – for heart rate, blood pressure, fall sensors, you name it, that medical staff just become numb to their sounds, and like the boy who cried wolf, when there truly is an emergency, they are ignored because there are too many false alarms.

My own personal experience shows how ridiculous some of these controls are. I delivered Alex via c-section at around 10:00 in the morning. He was my fourth c-section so I pretty much knew the drill. I’d be fairly intensely monitored overnight until IVs, monitors, catheters, and all the fun stuff was removed. I knew that I’d be interrupted every couple of hours for vital signs and some poking and prodding. His was a planned procedure so it really wasn’t fair that I had gone into mild labor the night before, and not wanting to disturb anyone, stuck it out until it was time to go to the hospital in the morning. So by 10:00pm it had been about 40 hours since I’d really slept, unless you count a half hour or so in the recovery room many hours earlier. I was exhausted.

I’m a model patient. I’m polite to nurses, aides, volunteers, doctors, lab techs, and housekeepers. I follow orders. I don’t ask for help unless I really need it. I’m not demanding. I don’t have hordes of visitors in and out disturbing the floor at all hours of the day. I clean up after myself. Really I’m a nurse’s dream.

But at 10:00pm when I just wanted to sleep, and the drugs are making my eyes so heavy, and I’m about to finally drift off for a moment’s peace, knowing that when I go home I’ll have four children to contend with, and I’m thinking of my new sweet little Alex resting quietly in the nursery, and BEEPBEEPBEEPBEEPBEEPBEEPBEEPBEEPBEEPBEEPBEEPBEEPBEEPBEEPBEEPBEEPBEEPBEEPBEEPBEEPBEEPBEEPBEEPBEEP! Holy CRAP, what is that??? Some fool alarm is going off, I don’t know why. It takes ten minutes to get someone in my room to reset it.

Repeat this scene three times and you’ll turn an upstanding patient into a snarling monster. The aide explained that it was a pulse ox monitor, and that my oxygen saturation was supposed to remain above 90. Turns out I’m a shallow breather when I sleep, and every time I drifted off, my sats would drop to 87 or 88 and set off the alarm. The third time it happened, I begged her to just turn it off. She couldn’t, so I asked her to send my nurse in.

When my nurse finally came in around 11:00, I asked her why the monitor was necessary, as I didn’t recall being monitored previously. Apparently I was given subcutaneous morphine during my surgery, which required my O-sats to be monitored continuously. Great, that’s fine and dandy, but obviously the threshold needs to be lower  because I’m setting the alarm off every time I fall asleep, but I am fine. The nurse was a total bitch. She would not listen to my reasoned argument that a.) I’m never going to sleep if this stupid thing goes off every time I fall asleep, b.) Your staff is going to be in and out of here all night turning this damn alarm off, and c.) Since every time it goes off it takes someone at least ten minutes to respond to it, if I were truly in respiratory distress, the alarm wouldn’t be serving any purpose anyway.

She had no solutions, was unsympathetic, snotty, offered no comfort, and wouldn’t hear me out, so I had no other option to start hysterical and hormonal sobbing, demanding to speak to her house supervisor, and telling her she was a cold-hearted bitch. Finally she relented and agreed to lower the alarm trigger to 88. I knew this wouldn’t be effective, but I’m smarter than everyone in the room, and carefully watched as she and another aide recalibrated the monitor. When they left, and the alarm went off again because I’d dropped to 87, I pulled the monitor over to my bed, and reset that bastard to 50. I was determined that this alarm wouldn’t go off again unless I was fucking dead.

When I woke up in the morning I quietly reset the alarm back to the original level before the nurse came in to check on me. And then I apologized to her for being difficult, because that’s what I do, even though afterwards I was pissed off because she should have been the one apologizing to me.

So anyway, yeah, alarm fatigue. It’s real. It’s dangerous. And hospitals should find a way to make alarms actually serve their real purpose.

© Jennifer Alys Windholz, 2013

 

 

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