Hello to all...Hope you all have had a better day that me. Where to begin, I am a Homecare r.n. and have this one facility that I must go in. The place has never been good since I first walked into it 4 months ago. The patients I am there to see are for the most part decubitus of buttocks due to incontinence and poor care . One patient who is diabetic would be found in a wheelchair leaning out of it, I would support her back up with pillows and after I would leave, she would end up back in a severe lean position. P.T was ordered and I finally got them to get her out of that chair and even eggcrate placed behind her. The point is, way before I started seeing her, she would sit for hours in this chair crooked, a wound to her scapula was created. It cannot heal because of her poorly controlled diabetes. They write down they test her 4 times a day, but I have gone it at 11am and they were just getting her up to breakfast. I told them the late breakfast is not good for a diabetic...Then I see them take ppl totally soaked in urine and put another dirty shirt on them never even washing their backs off. Fungus under breast and groins...AND ALOT MORE...AND YOU CAN BE SURE I EDUCATE WITH EVERY VISIT AND DOCUMENT! The other patient I have there has almost 7 decubes, she is never clean when i see her, duoderm is never on when I change and clean her, Its like impossible to heal her. She sits in a hard chair, she refuses to keep her legs up or sit in another chair, of course these folks have dementia.Then at this same place where the aides spend more time outside smoking than doing anything, they get a resident with a trach, which of course I have because he is new and they have no nursing there but homecare. Sure enough, someone dipped into his percocets over the weekend, but I only know this because I overheard it. The pharmacist called when I was there and said he sent 50 out last week and will not refill them yet. So today was the big day, I told work at case conference this is abuse and neglect and they knew about the care here for years, but they keep taking the money...MONEY MONEY MONEY. So to my surprise our administrator sent up a nurse who knows the ppl who own and run this place and warned them that anytime we see substandard care we will fill out a paper writing about what we found(on any pt, not just who I am there to tx), keeping a copy for ourselves, and if things don't change we are outa there. This is all good but really, will this place ever change??? And of course, I being the nurse who visits the most will now be looked upon as trouble. Its a mess...what do you folks think???? thanks for listening:) ann
