I received pretty good care while I was in the hospital, but I still was surprised at some of the grossly inefficient policies I encountered. For example, all the medical staff agreed that I should have my tracheotomy tube changed to remove a possible infection vector. The trouble was that nurses weren’t allowed to perform trach changes. The same prohibition applied to respiratory therapists. Physicians couldn’t change trach tubes unless it was an emergency. They wouldn’t allow any of my nurses to change it because they weren’t hospital employees. The only person allowed to change it was some nurse practitioner in the pediatric ICU who never materialized. Since I knew I would be discharged soon, I waited until I was home to do the procedure. It took five minutes.
I understand that hospitals have legitimate concerns about liability, but policies like the one I described result in needless delay that could impede a patient’s recovery. Furthermore, nurses already perform any number of interventions that could potentially be risky for the patient (establishing an IV, administering meds, lifting a patient). It seems odd to treat this procedure differently.
