[germain]

HI Y'all. I've written here before that I have been a long time nurses aide, am currently a nursing student, and volunteer as an ombudsman at a nursing home. I am hoping that some LTC nurses can answer some questions I have about the nursing home I'm a volunteer ombudsman at.

Now, I'm not a stranger to nursing homes and have worked in them for years, but I've never worked with ventilator patients and this facility has a vent unit, one of the only ones in the state. My question is, is it normal that these people NEVER get out of bed? Every time I visit, they are in bed alone, no matter the time of day, and enver get out. I am told as activities they get between 50- 100 minutes of stimulatino therapy a week! They are not all Comatose either. With the help of the speech therapist I have learned that about half of them can communicate, most of them coherently, I'm learning. I'm not seeing a lot of family, either. Like I said, I'm not new to nursing homes, but I feel like this place is the most depressing place I've ever seen.

And even thought I find the staff dismissive and completely unattentive to the residents, and even though the place smells like urine like I've never smelled it before, and even though the cost of nurses, aides, RT's and PT's miust far exceed medicaid payments, I still want to give them something of a benifit of the doubt before I make any complaint that they are not doing enough for their residents. I have one family member making complaints with me, and am conisdering making it a gerneral complaint.

What would normal activites be for someone tied to a ventilator? I know some can get out of bed, and some do every day- I've worked for them. But would some of them be really bed BOUND? If so, why? What about activites? How would you suggest I approach the staff about this? What kind of questions should I ask? Most of all, what are realisic expectations?

Thank YOU

[pricklypear]

germain - I don't work LTC, but I do work with a lot of vent patients in the hospital. I've also worked in home care with kids on long term vent support. I would have to say YES!! Ideally, these patients should be out of bed daily. Whether into a wheel chair or some kind of geri chair at the bedside. Realistically though, it is a lot of work to do that for a large number of patients - and may not be possible at the place where you work. The kids I worked with had vents on their w/cs, but obviously this is probably not possible for patients in a nursing home. Unless they have portable vents, it would be impossible to get them outside unless someone bagged them the whole time. Sounds like a very sad situation - no family visiting? I don't know what else to tell you, except wait for someone on this board to respond who has some experience with this type of unit.

Good luck, you sound like a very compassionate person

[hollyster]

We had a vent dependent quadraplegic pt in the unit for eight months. She had no insurance so none of the LTCs that provided ventilator pt care would accept her. And none of the floors in our hsp would take her. The unit is not exactly homey( no privacy and noisy all the time.) We did get her up in a specialty chair every morning for an hour and then again in the afternoon for two hours. We would bring her to the nurses' station so that she could have some interaction. One of her MDs ordered a portable vent and that she be taken outside everyday. Extremely hard to do when you only have four nurses in a unit with fresh hearts and all the usual unit pts.
They finally found placement for her in a LTC.