Yeah, so this is expanding to the entire hospital. Because what is involved happens to the entire hospital.
Once upon a time, at least 30 years ago, the Swatch watch was trending. Only we didn’t call it trending then, we called it cool.
The Swatch watch were colorful plastic watches that kids collected like hotcakes. Well, the cool kids with disposable income collected them. And then they wore ALL of them at once.
Like the stacking bangle trend of the 2010s.
Except they were watches. Some kids I went to high school with wore as many as 6, marching up their arm.
Of course the times were not synced. The extra cool kids synced the times to different major cities around the globe. So they would always know what time it was in New Delhi. Or London. Or Tokyo.
When I was a new nurse, the patients only wore one armband. The one with their name and their medical record number and their birthday on it. These were stamped using their patient admission card that every patient got at admission.
This was WAY pre-EHR.
And then it was thought that we needed to be able to recognize the patients who were DNR more readily. DNR means do not resuscitate. This is usually a personal decision by the patient not to seek CPR, or by the family. I imagine that somewhere a patient who desired to be DNR was not readily identified as a DNR and coded when their heart stopped. Because no one knew they were DNR.
They started putting DNR bracelets on the patients who were DNR and no CPR would be given to them. This is so you can tell at a glance that a patient is a DNR and CPR is not desired. For whatever reason.
And then it was thought that we needed to be able to recognize the patients who were a fall risk. This is so we could take measures to keep them safe. The patients who were labeled a fall risk had certain conditions that precluded them to a fall. These include orthopedic problem, stroke, and, believe it or not, post surgical.
Another bracelet was added to the stack of DNR, patient bracelet, and fall risk.
Again, this was so we could tell at a glance who didn’t want CPR, and who needed to be watched carefully to prevent a fall. As well as who the patient was.
And then some patients should not have an IV or a blood pressure taken on a certain arm. Or their leg had a DVT, which makes the SCD sleeve a contraindication. You guessed it, a bracelet was developed for that. This bracelet was to be worn on the affected side.
This makes 4 possible bracelets- patient identification, fall risk, DNR, and restricted limb.
Are you seeing the trend here?
In the last 4 months, there have been 2 additional possible arm bands added to the possibilities.
The first is for patients who use an insulin pump for administration of insulin. The armband is to alert the staff that this patient doesn’t need insulin and is used to decrease the chances of a hypoglycemic event.
The second is a timing armband for a specific medication that we use in the operating room. This is a long acting local medication. The idea is that no additional local medication should be given to a patient who already has this long acting local medication on board. Once you have seen a local medication toxicity seizure or reaction, you never want to see them again.
This makes 6 possible bracelets. On one arm.
I means it is possible to have the restricted limb bracelet on the other arm and the rest on the arm.
But it is giving the Swatch watch trend from the 80s and 90s.
Did I mention that all the bracelets are different colors to make them easy to identify a patient?
Yeah, you see it now, don’t you.
Google image search what I am talking about and you will never unsee it.
I am sure that there are still additional armbands out there at other facilities. And the information conveyed by the bracelets is good quality information that us healthcare workers need.
But it just seems a bit excessive.
Dispatches from the Evening Shift 