Angry Patient: Baby covered in Poo and Vomit

Casebank Counselling
1

Who are you
You are F2 in Paediatrics

Who the patient is
Mother of 1 month old baby, came to see her child, who has been admitted to the hospital since birth as she was born at 26 weeks of gestation.

Other information
She is angry and has some concerns.

What you must do
Please talk to the mother and address her concerns

Background information

  • 1 month old baby
  • The baby was in ICU several weeks and recently shifted to the paediatric ward.
  • Mother not happy cause the child is not being looked after properly. She found the child covered in poo and some occasion in vomit. Therefore, she would like to take the child to private hospital, so the child can get better care.
  • Mother also has concerns related to some locum nurses, who haven’t been looking after the child routinely and she wish to not have those nurses, look after again.

GRIPS

  • The mother has made the appointment to speak to you or somebody, so you don’t know what’s the reason for this appointment. Therefore start with, How can I help you?
  • Actively listen to mother’s concerns, let her speak and avoid asking lot of questions in the beginning.

Validate:

  1. Any mother would be upset in your position from what you noticed.
  2. Any parent would be upset with what you have just told me.

Approach

D: I need to ask you some questions to get better understanding of what has happened.

  1. Address the emotions.
  2. Data gathering:
    – When did this happen?
    – What exactly did you see?
    – Did you speak to anyone about this?
    – Had this ever happened before?

Management

Explanation

  • I am sorry for what has happened
  • This should not have happened
  • It is not normal, it is not what we stand for, this is not the standard that represent this hospital
  • We will talk to the nursing staff, we’ll look into the problem
  • We are very disappointed with what has happened
  • We will ensure that this does not happen again

Solutions

  • We don’t have all the answers at the moment, how and why it happened. It’s most likely be an individual mistake. But we’ll review what has happened and get to the bottom of it.
  • We’ll also talk to the nurse (or sister) incharge or team, to see who was on duty and why this has happened.
  • I will also talk to the consultant
  • We will look into

Answer the questions

Question 1

P: Can we have 1 nurse to look after the child?
D: I can understand why you feel this way. Unfortunately, 1 nurse cannot work a 24 hours shift so others will also need to be working but our requirement for the standard of care is the same regardless which nurse is looking after your child. We will ensure that our standard to not slip down again The standard of care should not be any lower.

Question 2

P: I do not want the locum nurses look after my baby?
D: Usually, locum nurses are needed if our regular nurses fall unwell or cannot work for one reason or another. They are used as cover to our regular nurses but even them, our standard are the same. What has happened should not have happened.

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