Change in mental status

[essarge]

I work in a hosptal setting and have seen a rise in LTC residents being admitted for "change in mental status". When we get these residents, they present with no fever or any other symptoms. Their chart from the LTC facility states "dimentia" or "Alzheimers" being diagnosed long before there admission with us.

Once the patient is admitted, we have to get a sitter to stay in the room with them so they do not fall or injure themselves or others. They usually stay long enough for the LTC facility to give up their room or refuse to take them back before they are "evaluated" by a mental health person. So then they stay for weeks on end awaiting placement somewhere else.

Now, I understand that someday, we all may be there but, it really upsets me that SOME health care people at the LTC facilities are using the hospitals for a "vacation" from these residents taking up beds for patients that really need to be in the hospital.

Anyone else experiencing this?

[NurseGuyBri]

essarge, First - I am an ADON at LTC and was on the floor, and I want to apologize that you got attacked about your question. You asked a viable question in a viable way, so thanks. Short answer - We always err on the side of safety, so if there is even the smallest change in LOC or Alt Mental status, we send them out to the ER. It's better safe than sorry. FOr all the work and paperwork it takes for us to send them out, we'd rather keep them, trust me! It's a pain. But in the end, when we notice these changes and if we DONT send them out, they can decline so quickly due to frailty. Also, remember that at the LTC, the nurses are not as experienced in emergency care, just as you are probably not as well experienced in LTC- so it scares us when things change. Trust that when you get a resident with alt. mental status, it's because we know you, at the ER, have a better ability to treat this resident if something IS going wrong than if we kept him/her. By the way, THANK YOU for helping our patients through the difficulty, we do trust you.

[rn/writer, RN]

Just wanted to call your attention to the fact the the last post in this thread is from September of 2003. You didn't do anything wrong to post here. But you may not get any responses from past thread participants.