:angryfire :angryfire :angryfire :angryfire
Okay, here's what happened. My father's health has been declining rapidly for several weeks now. This morning, my mom could not get him out of bed (he's 88, she's 90). My brother left work to be with him, and at my prompting, called for an ambulance.
They took him off to hospital around noon and kept him all day. When he arrived there, he was unresponsive and unable to answer questions. They did a full battery of tests: CT scan, bloodwork and urinalysis. Due to SARS, no family members were allowed in the ER, so my brother and I stayed home with Mom, and kept in contact with the hospital by phone.
Finally, my brother left to go home and get some clothes so he could stay overnight (mom is legally blind, and dependent on my dad to be her eyes.) I called the hospital at 5 pm to get my dad's test results. I was told that he was 'fine' ....coherent, and in his right mind. The nurse 'thought' he was mobile, but wasn't sure. She said they couldn't find anything wrong and 'all tests were negative, so we are sending him home by Ambu transport.'
I pressed her for more information. She said she'd just come on shift at 3 and didn't know anything. She passed me to another nurse, who said my dad 'did not have an infection' and his CT scan was negative. I wasn't terribly happy with their report, but decided to allow them to send him home.
He arrived home around 7 pm. It took two people to get him off the stretcher and into a chair. His legs would not support him. As soon as he stood up, he urinated all over the floor. I got him settled in the chair, brought him some dry clothes, and fed him supper. Yeah, hospital hadn't even bothered to feed him! Mom supervised his meal, while I got on the phone to the hospital, with smoke coming out of my ears!!! Before I did so, I glanced at the papers the hospital had sent home with him. Well, well, well, what have we here?? A script for SEPTRA??? And the nurse told me he did NOT have an infection?? Yeah, RIIIIIGHT!!
Once I got a nurse on the phone, I demanded to know WHY he had been sent home when he wasn't even able to walk without assistance. The nurse responded, "Well, we understood that you had a meeting set up for tomorrow to complete long term care papers."
I angrily informed her that the papers required an examination by a doctor, and just HOW was I going to get him to the doctor's office in the shape he was in?? And, moreover, you cannot get someone into long term care just at the snap of your fingers...it takes time. Meanwhile, we are stuck with him at home. There is NO bathroom on the first floor of the house, and nowhere to put a bed, either. Mom doesn't even have a hideabed couch. So far, we have ONE hour a day of homemaking services to get Dad up and dressed, and that's it. Hardly enough for someone who cannot even walk to the bathroom. And of course, both my brother and I work, and neither one of us lives with Mom and Dad anymore.
She passed me over to another nurse who was more sympathetic and better able to answer my questions. She went to look for dad's chart, to see if she could find out why he had been put on Septra. Meanwhile, I'm glancing at the test results they'd sent home, and figured it out for myself. He had a UTI. Hmmm...no surprise there! He had a cystoscope done last Thursday. I checked my watch, and realized the pharmacy was closing in ....ooops!! FIVE MINUTES!! I dropped the phone, and sprinted for my car. Got there just in time to get the medication.
When I got back my brother had returned, and we decided to get him settled in bed. Dad is just over 6' tall and weighs about 185 lbs. Luckily, my brother is 6' 1' tall, and I'm pretty tall too, and as a result of my nursing, know body mechanics. Between the two of us, we managed to get him upstairs to bed, but there was more than once on the trip when I was sure he was going to topple backwards down the stairs. I did pericare on him, and got him settled. Meantime, he was humming and singing to himself, totally out of it. My brother and I had to use main force to get him to lie down on the bed, as he just wasn't capable of following our instructions.
AAAUUUGGG!! I am SO furious at this! I tell you, E----------General Hospital is going to hear from me tomorrow! I am totally DISGUSTED at what they did to this poor man!
Last edit by Jay-Jay on Apr 30, '03
Apr 30, '03
I can understand and I would also be very angry
I'm not trying to defend anyone or what have you but it was an MD That wrote the order for him to be discharged correct?
I work in a hospital where there is confirmed SARS and really anyone who absolutely does not need to be admitted is sent home. Again not trying to take anything away from you or your situation. Hope your father feels better soon. I know that nurses are capable of bad behaviour and this is clearly an example of that. I'm thinking it might be the extenuating circumstance of the SARS crisis that lead the to abrupt answers. I worked easter weekend and spent far too long on the phone. I understand that the family members are frustrated and upset, however the lenghtly calls meant even less time for me to take care of their mums and dads. Healing thoughts.
Apr 30, '03
I'm so sorry you and your dear family had to go through this.
It's such a shame and such a waste of precious time and energy.
Hope all goes well from here on out and that your Dad gets the care he needs... and deserves.
Hugs to you all.
Apr 30, '03
Jane I hope your dad gets better soon. I've been there.
Why do we have to assert/force/threaten doctors to do what is the obvious?
I often wonder why more nurses and doctors don't catch the link between UTI and confusion. For as long as I can remember that was drilled into my head. I've dealt with the elderly most of my nursing career.
Confusion?=UTI more times than not.
Just last week my sister recognised Mama's behavior indicated just that. She took her to an urgent care center where she had to almost FORCE the doctor to do an in and out cath and do a u/a c&s. It took threatening to call the administrator to get it done.
Now my sis is not a nurse...she's an attendance officer in a school.
Nurses and doctors see a LOT of elderly. WHY don't they recognise this?
Apr 30, '03
Give it to the hospital staff and doctor listed on discharge form with both barrels today. Two weeks ago independent, now total care. Where was CRITICAL THINKING here?? Sending a hug and PM your way.
Apr 30, '03
Another disgusting example of how we devalue our elderly.
So sorry to hear that you and your parents are dealing with this. Thank goodness your brother is helpful, too. (((hugs)))
Apr 30, '03
You have really been lucky your parents have been able to live independently this many years.
I can't believe 90 year olds are still tackling stairs.
Although you all have seemingly not had any problems;
in my work with senior citizens and people approaching their 50's and 60's, we encourage them to start thinking in terms of
the kind of housing they will be able to navigate when they may be
old and infirm.
We advocate single-story houses, grab rails in bathrooms, a place for a hospital bed if needed, etc. We tell people to begin considering these types of home changes in their 5th decade.
We even encourage selling the 2 story and purchasing a single level to enhance the chances of independent living.
Sounds like you all have some big changes and decisions in the near future. Best of luck.
Apr 30, '03
Passing Thru that is a GOOD point. When we added a bedroom and bath we made the door openings W I D E and elevated the toilet. At the time we were in our mid 40s. Who could have known that so quickly (Im 58) it would become necessary.
When I got a new dishwasher my daughter built a platform so I can load/unload without bending. Age takes it toll at different rates.
Jay Jay's parents are so very lucky to have her as their advocate.
Last edit by P_RN on Apr 30, '03
Apr 30, '03
Sending hugs your way Jane. I can undestand fully well why you are frustrated and downright angry. Sounds like someone dropped the ball in a big way this time.
Sending best wishes and prayers to you and your family.
Apr 30, '03
Very sad and unacceptable whatever the level of staffing. I would do as everyone has already said, along with a letter indicating as eloquently as you did to us in your initial post, what happened , and address it to the president or ceo of the hospital, with a copy to the doc, the nursing unit, the board of trustees, and anyone else you deem needing to get a kick start in pt care and concern...Good luck and keep fighting. Remind the staff (docs and nurses), that they work for your father and not the other way around..
Apr 30, '03
Critical Thinking?... Common Sense?... Hospital Protocols?... Patients Rights?...Where were they?...
AIDS, HIV, TB, weren't these UNKNOWNS at onetime? Would anyone even consider sending them home because of an UNKNOWN?
Thoughts are with you.
Apr 30, '03
This is unacceptable -- the hospital was very negligent. I would write a detailed letter to the hospital's CEO, with carbon copies to their Ethics Committee, and I would also send a copy to your state's Ombudsman. Keep the letter professional, detailed, and heartfelt. State the facts. And I would definately document your father's condition when he was returned home -- including the fact that there were witnesses from the ambulance, etc. Do not send a heated letter -- keep it professional and to the point -- but I would definately use the word negligence and malpractice.
I would also call your State Department of Health and report this today -- they can initiate an investigation/review of records, etc. --I can't emphasize how important it is for you to do this. The hospital needs to be accountable -- and you don't want this to happen to any other person.
Did your father ever leave the ED & get admitted to a unit? Was he assessed for home safety? What was documented regarding his ambulation status? Did he get a physical therapy consult/evaluation? Were you ever contacted by the doctor regarding your father's diagnoses, scripts, d/c planning? Was he given a dose of Septra while he was there? What was documented? Since your father was "compromised" -- how was competent, d/c teaching done? What documents did your father/ambulance deliver to you? I'm livid just thinking about this.
I do have some thoughts -- first , speak to your parents about their wishes regarding health care issues. At their ages, it would be prudent for them to have either you or your brother (or both) assigned as health care agents, power of attorney, etc. Next, do they have living wills? If not, discuss with them what their wishes are. You will need an attorney to draw up the legal documents -- very easy to do -- and make copies -- the hospital would be legally bound to contact you regarding health care decisions, etc.
Please follow through with the State, Ombudsman, and letter to the CEO. It is irrelevant whether your father was looking into long-term care or not -- it was the hospital's responsibility to ensure that he was either sent home safely, placed in a safe environment (SNF), or stayed in the facility. Best wishes to your family.