Today I walked into my rehab/LTC and found one of my patients totally confused and bleeding from "somewhere". The night nurse gave me a very quick report and went on her way. Myself and another nurse found this lady trying to get OOB- She speaks NO ENGLISH- Only Russian and she has dementia- She seemed as if she needed to go to the bathroom and,even though she had a foley in, perhaps a BM was on the way. We removed her brief and - OH MY- She had a completely prolasped uterus- Not a big deal,normally but I was not informed of it- AND she was bleeding from somewhere "down there"- She pulled and pulled on her catheter and, out of fear of her yanking it out, I removed it. After removing it, I noticed a "bloody mass" at the entrance to her meatus- I did not know what it was. I called the doc, and sent her to the ER. I called the family and finally got ahold of the daughter- who speaks broken english- then the granddaughter- who was wonderful and spoke perfect english. The ER calls a few hours later and says "We have a tampon holding in her uterus and the bloody mass is her meatus- she pulled it out by yanking on the catheter. We are leaving the cath out and she is really going to be in pain when she urinates, so be aware." UGH! I cannot communicate with this lady and even if her family translates what I say, she will more than likely forget what she is told. What if she has chest pain or just pain or some other problem?? How will I know? I know hand gestures but they don't seem to work with this lady- and the family cannot be there all the time. She was combative and resistant to care and redirection- It just seems like this facility takes ANYTHING off the street- not that this lady is off the street- but there are several others that have me at this conclusion. Anyone else feel like the admissions dept and soc services don't care who they admit since they don't have to deal with the patients?? We work short alot and unless it is the DON or ADON on a cart, then they don't really try to get us help. I used to love my job- lately, not so much. I hate not being able to give someone the care they deserve. I like to treat each of my patients like they are someones loved one- THEY ARE! Any words of wisdom- I am still a "young" nurse. I don't want to give up yet.