It's Wrong! (A night shift perspective)

Specialties Geriatric

Published

What does it mean when we wake up a sleeping, elderly, demented woman at 0300 in order to place a catheter in her bladder for a UA? When the woman is yelling and can't possibly understand what is going on or why? When in reality she is dying anyway? What is the point of waking people up at 0600 in order to give them a medication such as Prilosec or Synthroid (Tylenol?) - then telling them to "go back to sleep"? (This is done because pharmacy recommends med given at least one hour prior to eating - eating is done at 0700 for the convenience of the kitchen staff.) Where is the sense in placing a frail, 90 year old in an uncomfortable twin sized bed with a plastic covered mattress, in a room with three other people in the same condition? How enjoyable is life when you are hooked up to a feeding tube and cannot taste food or lie flat to sleep because it will kill you? Why must we send a person who is peacefully dying to the ER to undergo some more torture before they finally pass? Why, why why? Where is the gentleness?

The families are not present to see these things - they want "everything done" for their residents - everything except for comfort and dignity and peace. The "corporation" and management only care about what is done on paper, how it will look to the "state", and how many dollars are coming in and also how they can cut staff to the bone to decrease costs and increase their own bonuses. The doctors and nurses must go along with the program in order to not be sued.

I've worked in long term care a long, long time and there is nothing that is right about it and it is all so wrong! I am obviously going crazy at this point and it is obviously time to retire from this madness. Tell me, geriatric nurses, how do you endure?

Specializes in LTC,Hospice/palliative care,acute care.

I don't disagree in principle BUT you are doing Q2 hour rounding and waking them up for that any way.

Specializes in hospice.
I don't disagree in principle BUT you are doing Q2 hour rounding and waking them up for that any way.

How do these poor people ever get a good night's sleep? Because they've entered long term care, do they suddenly have no right to expect that anymore?

Specializes in LTC,Hospice/palliative care,acute care.
How do these poor people ever get a good night's sleep? Because they've entered long term care, do they suddenly have no right to expect that anymore?

Not if they are incontinent or have advanced dementia and can't turn themselves.These are things all family members need to consider when they insist their 98 year old demented, blind and crippled mom should be a full code.

Specializes in ER, Med/Surg.

I work in LTC because I can't get a job where I want.

I really find the "warehousing" of old people just so a corporation can siphon off the

Medicare money pretty disgusting. I said I wouldn't work work in LTC again after I left it the last time.

But you have to do what you have to do to keep food on the table.

Rehab is one thing. But keeping these people who have no idea who they are, who their family is, etc., alive is very

selfish of their family members.

I feel that the practice of medicine has passed the place that it is doing the BEST for the patient. Should we put a feeding tube in an old person who has quit eating? I know there are cases when you might, but most of the time, no. Should someone who is in LTC for good, never going home, etc., be sent to the ER for chest pain? Most of the time I'd say 'No'.

Would YOU want to live where you work? That is what I always go back to; would I want to live here, like this person is? No, I would not.

So, to quote Ian Malcolm, "Your scientists where so preoccupied with whether they COULD, they didn't stop to think if they SHOULD."

Good question, Pat. I certainly would not want to "live" in the place where I now work. It really is warehousing. Perhaps the problem lies in our society, which refuses to accept and deal with aging and dying. I really think that with a little education and help most families would be able to care for their elderly at home. But, that addresses community, which I believe is also a concept lost to our society. Time to take my antidepressant!

Specializes in Gerontology, Med surg, Home Health.

Most families need 2 incomes. Who is left to take care of Mom? I'd live in my facility. Restaurant style meals, plenty to do including drink and dabble....drink wine...paint.... Drink more wine..

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
What is so wrong with calling someone a "Little Old Lady"? Why do you feel it is demeaning to call a woman a "lady"? Guess I am missing something here.

A lot better than geezers, vegetable, or idiots and some of the other things people are called by staff.

Nothing wrong with calling someone a lady. It's the "little" and the "old" that are somewhat condescending.

That sounds like a very nice personal care facility? Do people have their own rooms? In our skilled care, residents can have a drink only on doctor's orders (this rarely occurs). Meals are served on trays from the kitchen. There is an activity dept. which provides bingo and memory jogging quizzes. Occasionally there will be singing groups visiting at holiday time. On Sunday mornings a preacher will give a sermon in the auditorium. Some who are able to smoke without supervision will sit outside during the day. For people who need supervision, getting outside is extremely rare due to shortage of staff. Really not too much else to do except sit in their wheelchairs until someone changes their diaper or it is bedtime. Their days are very long. I think it is a very sad life.

Specializes in School Nursing.
Most families need 2 incomes. Who is left to take care of Mom? I'd live in my facility. Restaurant style meals, plenty to do including drink and dabble....drink wine...paint.... Drink more wine..

Places like yours don't seem to be the norm, CapecodMermaid. Does your facility accept medicaid? How does it compare to the cost of other facilities? In my area, I have noticed the nicest places also come with a hefty price tag.

Specializes in Gerontology, Med surg, Home Health.

Of course we accept Medicaid. It's the philosophy of the company that everyone deserves the best care and the best life regardless of the payer source. We are a very small, family owned corporation so we can pretty much do what we want.

Specializes in School Nursing.
Of course we accept Medicaid. It's the philosophy of the company that everyone deserves the best care and the best life regardless of the payer source. We are a very small, family owned corporation so we can pretty much do what we want.

I wish there were more like that out there, I'd work for you, or a place with your philosophy in a heartbeat.

I wouldn't really mind living where I work right now, but only if I had a private room. We have a dining room where you get two options (but can order other stuff if you're not feeling the choices). An aide helps the dining servers take drink orders and monitor everyone. We have a smaller dining room as well for people who need more supervision/help. Residents can also eat in their rooms. We usually always have 5-6 activities a day and some outings. Each week we have a "pub" night. The aides and nurses genuinely like what they do and love the residents. I could definitely be living in far worse places.

+ Add a Comment