Discharged To LTC on Friday @0230...with ^ temp of 101.8???

Check the residents code status, many times that tells the whole story. I have had residents die within minutes of returning from the hospital. And when that happens, I really get PI**ed off!!!!! I even heard a doctor say once, "They're old, they can't live forever!" What a crock of crap!!!!!!!!

Just becasue some one is a DNR doesn't mean you ignore symtoms that could mean impending doom!!-unless they are "terminal". It ticks me off when i call a MD at night because someone has a temp or is in respiratory distress and I get asked, "What is their code status." Then they say, "do nothing, comfort care, notify the family, etc." I can see an attitude like that is they are full of CA or end stage cardiac or respiratory disease, but not just because they are elderly and have decided that should they cardiac arrest they don't want someone jumping up and down on their chest!!

this did happen to me. I came on at 11 pm this lady had come in around 3 pm, when I checked on her she had some wheezing. gave her a breathing treatment, it helped and she went to sleep. about 3 hrs later she woke and was going into CHF. BP thru the roof. called the MD. gave her an extra bp med, but didn't want to send her to hosp. called her grandaughter, to let her know what was going on, she flipped out on me, " can't believe you gave her more bp med with her bad heart!!!!" on and on. "I knew that nursing home was going to kill her, she needs to be in the hospital." I'm going to sue that dr that discharged her," on and on. In the meantime, I have my one CNA for 40+ people tied up with this lady because she is so apprehensive. and her condition is worsening. call the MD back tell him whats going on and about grandaughter wanting her to go to hospital and he says " well she can die there as easy as at the hospital but if they insist send her out" niiiiiice. the grandaughter shows up and starts saying that we aren't and haven't done anything for the resident. finally get the resident out to hospital and they diuresed her and kept her in ICU for a few days then she went back home. what a waste of taxpayers dollars, for ambulance rides, etc. the truck driver grandaughter is still practicing nursing on her grandma. the ambulance driver felt so bad for us that she came back to tell us what was going on with the resident and to not worry about grandaughter as we had done every thing we could for the resident. that was the weekend from hell. three out to hospital and 2 dying at the NH. oh well, at least it wasn't boring!!!! lol

I have also experience this scenario. The patient comes back and ends up going back to the hospital the same night. I have actually gone around with an ER doc to explain to him that DNR does not mean Do not treat. I think alot of times as soon as they see nursing home resident the quality of the care they recieve ans there length of stay shortens dramatically. Pnuemonias and resp distress can be treated. I wonder how they can rationalize sending the patients back to the nursing homw when they are not stable yet. Oh well the probably get more care from us anyway. Keep up the good work!