Inpatient care for individuals with DD

[beckster_01, BSN, RN]

Hello, I am working on a project focusing on improving inpatient care for people with developmental disabilities, and was wondering if any of you DD nurses had any input on the kind of care your patients have recieved in the hospital (with specific examples if you have any). I feel that much of the research and individualized care for this population is focused on an outpatient, group home basis and my patients with DD are not always followed very well by their group home staff/nurses. Do you feel that staff nurses have any education on how to care for this population? What kind of educational programs would you like to see and who could you see doing it? And do you have any ideas for how to improve the communication between group homes and the hospital? In my experience people from group homes will always have a staff sitting with them, but this staff member rarely works with the person at home and therefore doesn't know them any better than the nurses do.

This is not a formal survey by any means, honestly half of the reason I am asking here is because this is an area that I have a lot of interest in and in the far far future I would love to be involved in providing more formal education to hospital nurses in this area (I'm graduating in 2 weeks so as I said, that won't be happening any time soon). Anyways I would love to hear what your thoughts are!

[noreenl]

AS a med surg nurse anytime a patient with this medical hx was admitted for tx such as pneumonia with IV antibx or post op care a member of the group home staff was with that patient 24/7. It was for a competent historian to assist us with communication; and more importantly, for the comfort of the patient. It is hard to assess someone who is fearful and uncooperative because they don't feel safe and adds stress to the healing process.

[beckster_01, BSN, RN]

That is how it has been for me in my experience as a tech. It is also a policy at the group home I work at that the sitter is from the same house as the resident. If a staff must be floated they will float to the house, not the hospital. However as a tech and in clinical I have tried using the staff as a resource (asking what the individual is trying to communicate, if they have food preferences, etc.) and more often than not I am met with a blank stare as they state that this is the first time they have ever worked with the individual.

Having been on both sides of this picture I find it very frustrating when agencies send staff to advocate for a person with DD when they know nothing about the individual, and this is coming from someone who is reasonably comfortable with this population. I can't imagine what it must feel like for a nurse who has not worked with DD to try and care for uncooperative and combative patients when the sitter is not equipped to be an effective advocate. Does anyone have any suggestions on what to do when nurses are faced with these situations? Or examples if they have had similar experiences?

[noreenl]

I have called the group on some occasions! the rights of the patient dont change because they may not understand them and sometimes the group home needs to be reminded that the person they send should be familiar with the patient otherwise my patient is afraid and doesnt feel safe!