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Permalink Reply by Judy on April 19, 2009 at 7:28pm

Like we've all said, youse a good kid, Rock Hinkle!! Just don't make a habit of it too often and burn yourself out.

And, by the way, since you asked me about COPD information ... that URL Rock Connor gave would be an excellent one for you to print out and read up on at your leisure (when and if you get any leisure!) :-) It really is a good one!

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Permalink Reply by Sugarshirl on April 19, 2009 at 7:56pm

Well, I am a rules and regulations person so you know I am going to answer, "No". I don't think a patient should be allowed to sleep in because this is a test and if it is over, then it is over. I know it sounds harsh, but if a lot of patients felt they should be able to sleep in, then it would be a scheduling nightmare for the sleep clinic. When I was there, I couldn't wait to get out. Don't get me wrong, the tech was wonderful, but it was time to leave and I knew I would be very tired so I had planned ahead to not go to work that day.

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Permalink Reply by RockRpsgt on April 19, 2009 at 8:17pm

I have already added Rock's URL to my folder. Hopefully this week I will have tome to catch up. I have collected quite a few things the last couple of weeks

Judy said:

Like we've all said, youse a good kid, Rock Hinkle!! Just don't make a habit of it too often and burn yourself out.

And, by the way, since you asked me about COPD information ... that URL Rock Connor gave would be an excellent one for you to print out and read up on at your leisure (when and if you get any leisure!) :-) It really is a good one!

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Permalink Reply by Rock Conner RRT on April 19, 2009 at 9:39pm

It's a risk management thing. If pt says he'll be too sleepy, put the responsibility on him to arrange transportation & document the conversation. We let folks sleep in during the week because we have physicians, nurse practitioners, sleep techs, a nurse & a respiratory therapist on campus during office hours. On weekends, though, if a pt expresses concern, then he or she has to make a plan & advise us. Document everything!

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Permalink Reply by Judy on April 19, 2009 at 10:13pm

SugarShirl, I planned on AND went to work after my first two in-lab sleep studies. It never occurred to me not to! At least the first sleep lab had the decency to provide a private bath AND shower. The second facililty didn't even have a sink one could wash their hair in much less a private bath or a shower. One bathroom for 4 sleep rooms and a sink too shallow to even think of washing your hair in. I had to call in and go in to work an hour late so that I could go home and wash the glue outta my hair. Needless to say I REFUSED to go back to that sleep lab!

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Permalink Reply by susan mccord on August 15, 2009 at 9:14am

As a patient, I have mixed feelings about this topic. Having been a clinician in a different field for many years, I totally understand the need for boundaries with patients, and the tremendous need for self-care for professionals. But again, as a patient, I felt very rushed to get up and get out, especially after my titration. It was unsettling. I'd ended up in ER during my initial sleep test due to chest pain and received plenty of TLC from the sleep study staff. Not that I need to be handled with kid gloves--I certainly do not. However, with me, my studies both began at 10:00 p.m. but I wasn't left to "sleep" till well after midnight while they did whatever they were doing. My first tech was compassionate, supportive, and engaging which I greatly appreciated. The second tech was extremely business-like and pretty cold. Maybe she was tired or over-stressed, but any professional knows that's NOT the patient's problem. In any case, being rushed out was disconcerting after not having sufficient time to even fall asleep comfortably.....

Susan McCord

Judy said:

I understood that, Rock Hinkle. I still don't like the attitude of the 5th tech. And that tech is not a tech I would try very hard to hold on to if I were the lab manager/owner. If I had to lay staff off the 5th tech would be the first to go. As lab manager/owner I would be evaluating these responses and be pleased w/the response of the other 4 techs. Assuming their skills are up to par or better I'd work hard to keep these 4. As a patient I appreciate the 4 techs and would be happy w/any of them. I''m willing to bet my instincts would pick up on the 5th tech's attitude even tho I didn't make such a request.

I tend to agree w/Banyon and jnk about a designated driver. We are told that at the time of the scheduling for something like an endoscopy or colonoscopy and the staff actually checks that that person is available at the time you come in for the procedure. And if their driver is NOT available when the patient is ready for release the patient is taken to the family waiting room and not given release papers until the driver shows up. If the patient walks out on their own w/o those release papers it amounts to AMA - against medical advice.

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Permalink Reply by Saz RPSGT on August 15, 2009 at 12:21pm

Ah...memories.

Our lab policy for Saturday mornings (when no day tech comes in) is Tech #3. We consider it legally bound. If a patient fell asleep on the drive home, we feel that we would be at fault. Legally we know we aren't bound to this, but as a faith based organization it is something that is just the right thing to do for us.

Weekdays most people just want to get the heck out of there. We absolutely let them sleep in then.

With the weekend situation, the night tech is going to be getting some double time. This usually acts like a double shot of caffeine infused liquid sunshine when you know your next paycheck is going to cover the bet you lost with your co-worker about whether or not Smurfs have fuzzy little blue tails.......um......for a random example. (they do by the way)

You sparked a "Memory Lane" Rock.

I remember 6 years ago when my night shift was 7pm to 7am, and I had to stay especially long with a special needs patient. He was wheelchair bound, but had a specially designed van he could drive. I ended up leaving with the patient at 9:35am and watched him backup and ram an illegally parked car with his electric wheelchair...no...not on purpose. Then he did it again trying to line up his chair with his ramp. Once he finally got in, he backed up and nearly hit my car. The car next to me wasn't so lucky. After a loud CRACK and a basketball sized dent in the fender his head popped out the side window, "Did I just hit that?"

Um....yes...

"Dang it...not again!"

Jason

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Permalink Reply by RockRpsgt on August 15, 2009 at 2:26pm

I have had some interesting patients myself Jason. It seems so long ago that I wrote this post. I have since switched labs and have a new found confidence in my knowledge of sleep. I think it is important to treat the pt. From scheduling to mask type each pt has very different has individual needs. Are lab will accommodate any scheduling need from shift work to long or short sleepers. So different from that first lab I worked for.

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Permalink Reply by Brett Berry on August 17, 2009 at 3:13pm

Depends on the facility and policies in my opinion. We run 7 nights a week and always have day relief so it's not a big deal to leave one down. Optimally, they are left hooked up and the original recording ended at usual time. A new recording is started for monitoring/safety/liability purposes only. Our physicians see each patient every morning after the study to discuss results, treatment options, etc. So in most cases they want to be awake for that. they start arriving at 0700 but that still gives the patient an extra hour or so at least. The day person will always complain about cleaning wires but they still do it! May be old school but I try to have all our folks to look at like the lesson on the first day of business school "The customer is always right." Within reason, If they wish to sleep late or have a sunday paper with a sausage biscuit and 6 creamers in their coffee, I make it happen. Brett

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Permalink Reply by sleepycarol on August 17, 2009 at 7:26pm

I woke up for a potty break about 4:30 a.m on one of the nights I did my sleep studies and the girl asked if I would mind if I stayed up so she could start the process of removing all the wires. I said sure. BUT I am glad that I had taken the day off from work and ended up coming home and sleeping for a few more hours. I was alert enough to drive the 30 miles home without difficulty.

I applaud those techs that allow one to sleep as late as possible, without having to stay late. :)

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