Am I asking for too much

[mvm2]

Before I start I want to make it known that I hate conflict, I hate being a bug. And I know that the Nurses and CNA's that work in LTC do not have it easy, and I know many of you are under staffed and very busy. Hense why I don't like to be a complainer. I don't want to be one of those family members that give people a hard time.

My mother in law is in a LTC as a rehab patient, and Well needless to say we have been concern with her level of care there and wondered if we should pull her out and find something else, or is it like this everywhere as far as LTC go.

Is it too much to ask that a nurse help my mother in law find something without getting snippy with her and say listen I am not coming in here every 5 minutes, and then blame her when she gets into trouble for her attitude

Is it too much to ask that my mother in laws room have some air ventlation without the DON saying something about the kitchen is pulling all the air and they are looking into it. while by the way there are empty rooms avalable that DO have some air venting and are less hot. My mother in law has COPD and CHF which is not helping with her room being hot and humid and her oxygen level was at a 85. Oh and when we talked to the doctor on staff about it that the humid room is making my mothers breathing worse he tryed to say oh that is not true. Well I have a slight asthma problem and I can tell this doctor that humid air DOES make it harder to breath.

Is it too much to ask that when her lunch tray comes and the person accidently spills her juice all over her bed and says she will come back after the trays are past out that she NOT forget my mother. The poor thing had her leg in wettness for three hours without anyone cleaning it up. And at last when they did put her in her wheelchair and changed the bedding they did not wash her sticky leg off. which normally no big deal but my mother has diabetes, and history of infections on her legs including the flesh eating bacteria that almost took her life in 2000.

The Don when seeing us go in my mother in laws room came up to us and tried to smooth everything, saying we are fine we are doing great, before we even knew what was going on. By the way All this happened in LESS then a 24 hour period!!

So what are all your thoughts about this. Those that know what is going on. Am I being way to overly concern, and over protective and this was just how it is. Or are these signs of run and don't look back

[JZ_RN]

PS your family member got the room that was covered for her, that's why they didn't move her, unless you're willing to pay for a different room that won't be covered. And if she truly has COPD 85 is not that bad an oxygen reading. Was she cyanotic? Was she using accessory muscles? I doubt it. You want nursing care, you're there and getting it, don't get your nurses in trouble for nonsense like this. You do realize that now you sound like a troublesome family member that all nurses dread dealing with.

[RunnerRN2015, ASN, RN]

Unfortunately there are snotty CNAs and nurses at all facilities. There is no excuse for their snarky attitude. My DON would have been beyond upset with whomever was responsible for not cleaning up the resident and juice spill ASAP. As a CNA, my job is to make sure the resident is safe, clean, and dry and do it without copping an attitude. I hope things get better for your mother (and you, too)!

[BrandonLPN, LPN]

I wasn't trying to be offensive in my post, just trying to tell you how it really is. And in the world of LTC, the truth isn't as pleasant as we'd like it to be.

I know you think you're being an advocate, but reporting little things

like this (and, sorry, they *are* little within the bigger picture) will only get you the labels we've mentioned. And some we can't mention in polite company.

In the scenario you mentioned, I would clean my mother up and then discretly let the aide know "I just cleaned mom up, there was some juice on her." the aide will be embarrassed and say "oh my gosh, I'm so sorry" problem solved. DO NOT take something like this to the nurse on duty! The CNA will resent it. And to be honest, if a family member told me that (as the nurse) it'd be in one ear, ou the other.

You really should cut the poor aides

a break. Think about it: you say it's unacceptable for her to be wet for three hours. Well, if she were living with you, in your house could you honestly say there would never be a three hour span where she was wet? Really? I doubt it. And there

she would be getting 1:1 care. Now this girl where your mom lives has, like, 12 OTHER PEOPLE to care for!! It is VERY VERY VERY easy to be sidetracked for hours in this line of work.

As for the "humid room makes mom's COPD worse" bit, well, unless they're keeping mom in the basement or something, I'm sure she's fine. As JZRN said her SPO2 was fine. And, trust me, when you say we need to move her to another room cause it's too humid, we are all laughing hysterically in our heads. And don't try telling a doctor you know more about COPD then he does, trust me... You don't.

[mvm2]

You are missing my points entirely!! I am NOT calling the state for goodness sakes. I only said IF the state was going through one of their NORMAL inspections and saw that would they be upset?

And I did know it was three hours because when I got there at 3:00 I felt for myself the bed was soaked and asked her what happened and she said the CNA accidently spilt it while giving her, her tray at around 12:00 (and my mother in law has all her faculties I asure you, so I can take her word that it did happen then.)

And again i DID NOT SAY A THING TO ANYONE THERE ABOUT THE SPILL, or report it! and I cleaned her up without saying a word. We just were taking mental notes about what we were seeing and hearing. I just did not like it and was concerned and so I came here and was wondered if things like sitting in wetness for 3 hours and having a non ventalated room while there were empty rooms with ventalation was typical of all LTC or if these were warning signs that this was not a good situation for her to be in. That is all this post was about. We did not go there and get anyone in trouble.

And if you read some of my posts later you will see that they did change her to a better room after our POLITE REQUEST(not demanding) and everything has been going well since so far. You have to understand that when I started all this, all these things happened within the first 24 hours she was there and I was upset and wanted to make sure from those of you that work in LTC if these things were typical or you would say get her out of there she is not safe.

[BrandonLPN, LPN]

Why on earth would you think it's "unsafe"? Your big issues are that a CNA spilled some juice and then forgot about it, and that it took them a little over 24 hours to cater to your request and get her the exact room you wanted. I think every LTC nurse here would agree that this sounds like a decent nursing home and that they are bending over backwards to accommodate you....

[CoffeeRTC, BSN, RN]

Hmmm...I want to jump in on this one and start off by saying, lets all take a step back.

OP, just wondering..are you a nure or in nursing?

I'm going to say that a lot of what you were asking about just could happen everywhere. It is how the staff are dealing with these issues.

Stuffy room.....a lot of these centers were built years ago and don't have the best AC around. We have a few rooms like that either because of the residnts in the room or the AC itself. We recomend the family bring in a small fan (most COPDers like one anyway) or we will try to move rooms. Room assignments are different than in the hospital. Even when we have empty rooms, they can be bed holds where the family is paying to hold a room or maybe the other person in there could have an infection that they can only be grouped with like patients etc. We really try to accomodate room changes the best we can. Just yesterday I moved around 3 rooms, cleaned them and moved the residents around to make everyone happy. (gotta love no housekeeping on the weekend)

Spilled juice...3 hrs is a long time but hahah, I'm wondering why it didn't dry up on its own since it was so hot. Srsly..since MIL is with it, she could have used the call bell to call for some assistance in changing the sheets. The CNA really probably just forgot about it and it could have slipped her mind to wash her up afterwards (was the juice stain visible?) again..could you remind your MIL to ask for help on this one?

As far as the multiple requests for help looking for this or that........Im sure your MIL doesn't want to be a pest, but the staff probably perceived her as that. They were wrong in acting snotty etc. You have rude people everywhere you go. I always remind the CNAs to make sure they ask "Anything else I can help you with now?" or "I will be back in about an hr to check on you" I'm sure MIL wasn't asking for any help when it was something she could have done herself. I also make sure that things they might want is all within reach..move tray table around etc.

As far as wondering what the "state" would think...did it have the potential to cause harm? (prob not unless she had a dressing on that area or an open wound)..did it cause harm? no...dignity issue? eh..that one might be a wishy wash one...so no..the state can't cite over every spilled item or the delay in getting it changed.

Keep visiting and keep looking after MIL care.

[mvm2]

No I am not a nurse, I am a HHA going for my CNA in Oct. and working in Home care. Which is why I wanted to ask all you who actually work in the LTC. I am not going to pretend I even know anything about proper procedures in a LTC. This is why I had the questions because I know the perfect world is not there. I hear of all the problems of short staff, extra. I hear about the wonderful LTCs and the ones that people say i would not put a dog I liked in that one. I just truely felt a little uneasy about it all, and I did not want to jump to conclusions. I also did not want to ignore them either and then something worse happen to her, and then later people telling me ahh the first 24 hrs with all that happened to her was a sign of a not so good LTC and you should have gotten her out of there before the more serious thing happened. I love my mother in law and she has gone through so much these last 3 years I can not even begin to tell you. I did not want to have things worse if there were signs that she was not being taken care of properly.

Yeah it would have been hard for the juice to dry up because it happened to be on the bed spread, and the bed spread was woded up and her leg was on top of the warm, damp thing. her mattress pad was wet as well because it was not getting any air to dry it out.. You can know as well she is unable to lift, or even shift her leg. She is almost imoble with it. So she could not try to kick it out of her way either. I asked her about the call light too and wondered why she did not ring earlier, and she said because of the run in with the one nurse she said she was scared to call because she was afraid she would have been seen as a nuisance, and she said that she was afraid that when we would be gone they would abuse or neglect her if she raised to much of a fuss. Trust me that broke my heart to even have her feel that way. I did try to reasure her that I do not think that would have happened, and I truely believed they would not have gone that far. I also told her if things like this happen for her own good she has to use that call light.

That is intresting about the empty rooms. I never knew about that. thank you. Also out of curiosity is a 77 bed facility considered small, average of big.

Some of you have been very kind and I thank you. I honestly just came here for some advise and knowledge about LTC's.

[CapeCodMermaid, RN]

My last facility had 181 beds. My current one has 152. I'd call a 77 bed facility small.

[Bringonthenight]

I think that since you are such an EXPERT in providing patient care (even more knowledgable then an MD! Wow!) you should absolutely get her out of that place and provide 1:1 gold standard care at your house. I imagine everyone that works in that facility would support that decision. Then multiply the tasks and time you spend on her by 20 (a common LTC ratio) and see how much time you have to get everything done.

Side note, while your sitting in your mom's room thinking of your next complaint how about you grab a face cloth, wet it and wipe your mom's leg clean of that dangerous sticky juice!

Keep up the good work Florence Nightingale!

[BrandonLPN, LPN]

To be fair she did explain that she DID clean her mother in law up herself and she didn't "report" the CNA or anything. Her expectations were unrealistic, but I find most family member's are at first. Part of the blame goes to the admissions "salespeople" who promise everything under the sun in order to fill the beds.

[Bringonthenight]

I take back the part about cleaning her up after I read that she did do that. Apologies.

But I stand by the rest. Demanding family members drive me crazy. The OP demands were extremely unrealistic not to mention insinuating that she knew more about COPD then the patients' doctor!

It's so obvious that she's not a nurse/CNA.

Sorry for rant

[Isitpossible, LPN, LVN]

To the OP: I hope your MIL is doing better now and the situation is more comfortable for her. I am a RN (new) in a LTC. I really wish I had the time to devote to my patients but its simply not going to happen. The staff do alot with minimal bodies to do it. I do understand your concern about her being left wet for 3 hours. Yes it was juice, but truthfully it could have been urine or feces. The sad reality is nurse nor CNAs have adequate time to devote to patients. Only mgmt can change that. So if you do have problems in the future and decide to question someone, please question mgmt about the staff to patient ratios...