Question about skilled nursing and g-tubes - page 2

Is it common for a skilled nursing facility to refuse to accept a resident with a g-tube? We are searching for a placement for my dad who is expected to be DC'd from the hospital by the end of the... Read More

  1. by   txspadequeenRN
    in all my years of geri nursing and of all the facilities i have worked at ,i have never seen any resident turned away.. if they were dead and wanted a bed, the nursing facility would be more than happy to take a dead man's money.. most facilities could care less about staffing or the load the floor nurse has so don't count on that for that being the reason. never heard of a geri facility not being able to handle a g tube..strange but if i were you i would be looking more into the financial part.. did his insurance approve his stay ,does he have enough medicare days or do they have a medicaid bed..then the next thing i would consider is his last stay and his behavior but even if he beat up all the staff (minus admin of course) i just cant imagine admissions caring enough to deny him....
  2. by   marjoriemac
    I've never heard of folk being refused admission due to feeding tubes. Not familiar with the american term g-tube (is it what we in the UK would call a PEG tube or a nasogastric tube). PEG's are common in LTC facilities over here, nasogastric tubes are less common and probably would require refresher training for staff.
  3. by   CapeCodMermaid
    Gtube and PEG tubes are pretty synonymous. I've NEVER worked in a skilled facility that used or accepted patients with NG (nasogastric) tubes because of the high chance of migration and aspiration.
  4. by   hecete
    i work in ltc. we never refuse anyone. we have trachs, pegs, piccs,
    various drains, ij's. there are several ltc's in the area that are very selective in the type of resident they take. pegs are very basic. good luck.
  5. by   not now
    Another LTC nurse who works in a facility that accepts G-tube/PEG patients. We even got the facility certified for IV's by our pharmacy just so we could flush the port a cath of one resident once a month (the DON and assessment RN did it). Now we have an IV emergency kit that just sits in both med rooms.
  6. by   LPNJessi
    We have several feeding tube patients at my work. At the moment we have 2 trach patients as well. There was a time when we had 5 trach patients. We also get a lot of behavior patients and hospice and cancer patients. I don't see why it would be so hard to have a feeding tube patient. Even if the patient had behaviors. I thought that is what SNFs and LTCs were for. I could see how an assited living facility would not take them but not a SNF/LTC.
  7. by   nurseangel47
    That's weird. I guess I just assumed that all SNU facilities did accept them. It isn't like it's a vent, or a very complicated nursing skill to perform! I've always had them in my assignment in every nursing home LTC, SNU facility I've ever worked.
  8. by   CapeCodMermaid
    Quote from not now
    Another LTC nurse who works in a facility that accepts G-tube/PEG patients. We even got the facility certified for IV's by our pharmacy just so we could flush the port a cath of one resident once a month (the DON and assessment RN did it). Now we have an IV emergency kit that just sits in both med rooms.
    NotNow, Aren't all the nurses in your facility IV certified? Every facility around here assumes nurses can do IVs and everyone has to take the pharmacy class to be able to do IVs on the units. We have them on every unit including on occasion the dementia unit.
    Could you please tell me what an "assessment RN" is?
  9. by   brendamyheart
    We have so many G Tubes that it flags our QI'S.The only patients we do not take is trach's.
  10. by   not now
    Quote from CapeCodMermaid
    NotNow, Aren't all the nurses in your facility IV certified? Every facility around here assumes nurses can do IVs and everyone has to take the pharmacy class to be able to do IVs on the units. We have them on every unit including on occasion the dementia unit.
    Could you please tell me what an "assessment RN" is?
    Nope. None of the LVN's have to be IV certified because we don't do IV's here. I didn't get IV certified until I started working part time in a hospital setting (they required it). We are a 99 bed facility (not associated with any hospital) which in CA means we only need an RN on one shift instead of all three. Even if we were all IV certified we (the LVN's) would be able to start an IV and hang fluids but no meds. It does not make any sense to require us all to be IV certified.

    The administration made the choice to accept a patient with a port a cath. For the first month the MD actually came in to flush it since we didn't have the supplies nor was the facility IV certified by the pharmacy. He then requested that we do it (he is the medical director) and administration took the steps necessary. Our pharmacy is an hour away so the IV emergency kit is stocked for any order that may come our way (pointless, but it's required). We have a PO/IM/SQ/NEB emergency kit used when, say, an order for an antibiotic is placed. The facility is required to start the antibiotic within four hours so we break open the E-kit to get the med and notify pharmacy so they can send the remaining doses.

    The Assessment RN is the one who does the actual admission assessments since an LVN can not do an admission. We can do assessments after her, just not the initial assessment. She is also in charge of monitoring RNA (restorative nursing assistant) therapy, dietary changes, weekly(Medicare)/monthly(everyone else) weight monitors, quarterly range of motion/gait assessments, med audits, I'm sure I'm forgetting something...she contacts the MD's for any questions/recommendations regarding the previously mentioned areas, she is our go to reference and she's in charge when the DON is out of the building or out of town.
  11. by   CapeCodMermaid
    Isn't is odd how regs differ from state to state. In Massachusetts, the LPNs do admissions, IVs everything but death pronouncements.
  12. by   bshaw96
    As an agency nurse, I've worked dozens of LTC facilities. Never seen even one without g tubes. They're no big deal. I know assisted living and rest home level won't take them. But SNF's always do. On any given day, I have 5-6 g tubes. Kinda like them, don't have to worry they'll throw their medicine back at ya Good luck finding placement, take your time and you'll know when you've found a fit!
  13. by   KYGrace
    There isn't a SNF here that doesn't accept a patient with G-tubes. The floor I work on has 63 residents, 14 of which are g-tubes. We have g-tube patients on all 3 floors, plus vent patients, trachs, PICC lines, IV's etc. Fortunately, for 63 residents, on day shift (12 hours), we have 2 charge nurses, myself and my partner, and 2 med-techs. And still, on most days, it is a race to get everything done!

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