[AtlantaRN]

we have a patient in assisted living, who has been declining since friday.

I've worked 10.25 hours today, I get a call from the facility at 6pm, asking a nurse be sent out to give this patient 5mg morphine elixir as they don't have a nursing during the night (now, the day shift nurse was still there when the administrator made the call-and family is there and able to give med-administrator of the facility wants 24 hour care).

Have you ever run into a facility that didn't have a nurse at night, or even a med tech?

I'm new to this, thank you for your input.

[RNorBust]

I live in Texas and the assisited living centers that we service never have actual nurses available, only med techs. Now they do have the med techs around the clock. Does your company offer Continuous Care? Would the patient qualify for around the clock care?

[AtlantaRN]

patient is in NO distress. Just apnea periods......but no pain. come to find out they DO have 2 med techs at night, just the administrator trying to force continuous care, when patient doesn't qualify..,

[doodlemom]

None of our AL facilities have nurses that work at night - only aides. We will pre-fill syringes for them with Roxanol and ativan. Some have higher licensing requirements and will administer meds that others won't. We have found a good niche for our continuous care team in this arena. Our CC team is kept busy almost every night of the week. The more we use them, the more we need them. It's like a roller coaster.

[EmptytheBoat]

My experience with assisted living is not good, and unless you are willing/able
to provide continuous care, it is unlikely that symptoms will be managed as
the patient's disease progresses. The ALF's I've been involved with require the family to be available to administer prn medications, and only provide
assistance with ADL's on a scheduled basis. I just experienced
a Hospice patient being removed from an ALF because the
family was upset that the ALF was unable to provide the
care they had assured the family they could provide, and then, refused to
reimburse the family's prepayment because the family did not give 30 day notice. Patient went home with 24 hour sitters and died peacefully and
comfortably with very attentive sitters, for approximately the same amount
of per diem the family was paying the ALF. In this area, the number of ALF
Hospice patients is on the rise because Trinity Hospice now owns Sunrise
Assisted Living Facilities.