When a patient’s condition worsens, the priority is preventing further harm. This is the time to speak up; don’t worry about offending someone.
If the patient is having trouble breathing, is unresponsive, or is rapidly getting worse, press the call button and tell staff you need immediate help. If no one responds promptly, go directly to the nurses’ station and ask for the charge nurse or rapid-response team.
Family members may notice changes that hospital staff have not seen. You know what the patient normally looks and sounds like. Do not assume someone else has reported a change.
“His condition has changed. He is having trouble breathing, and I am concerned that he is in immediate danger. He needs to be examined now.”
All hospitals have a rapid-response team that can assess a patient whose condition is deteriorating. It may not be widely known that approximately 62% of surveyed U.S. hospitals with rapid response systems allow family members to directly activate a rapid response team.
Ask staff if you can activate the team and how to do it.
If you cannot call the team directly and help is not arriving, ask the charge nurse to request a rapid response. Ask who is coming to examine the patient and when. Continue to seek immediate help if the patient’s condition is getting worse.
If the patient may need expertise the current team does not have, ask whether a specialist should examine them. Depending on the condition, that might be a cardiologist, neurologist, surgeon, infectious-disease physician, or another specialist.
You may also request an examination by another physician if you believe serious symptoms are being overlooked. Ask the attending physician, charge nurse, or medical director how to make that request. The hospital may not be able to provide a particular doctor, but you can ask for another qualified physician to review the patient.
If the hospital cannot provide the care the patient needs, ask the physician whether transfer to another hospital is appropriate. Ask:
Do not try to move a seriously ill patient in a private vehicle without medical guidance. A safe transfer requires planning for the patient’s condition, the receiving hospital, relevant records, and appropriate transportation.
You do not need to prove that an error occurred before asking for help. Describe what has changed, ask for an immediate evaluation, and seek help from the charge nurse or rapid-response team if the patient is getting worse.
When a patient may be in danger, timely action matters more than avoiding an uncomfortable conversation.
