Yikes! Another bad observation at an LTC facility

Specialties Geriatric

Published

YIKES!!!!! That's about the only word I can express about this one.

Got off a weekend night shift (through my agency) at a nursing home I have never been to previously. I prefer to stick to hospital work when I can just because of what I am about to say.

Came on to the shift at 2200. As seems the usual, I had to sit and wait for report until 2245, already putting me behind for the night. I had to scramble to get caught up, but that's nothing new. Since we were running short 2 CNA's I was also putting in double duty answering lights and doing other aide work. No biggie as I always do this anyway, just usually as a helping hand not out of complete need. Still no suprise (been there done that). However, about 0200 I floated over to the other unit to cover a nurse who went home due to "female problems". She told me that she was having a "heavy flow", and so I left it at that. Now, I am covering my original unit as well as this lady's as well. No biggie, except I knew everything wasn't going to get done. A call light came up on this new unit as I was passing by, and I didn't see a CNA on the entire unit, so I went to help out. I got to the residents room and asked what I could help with. The gentleman promptly said, "my back is itch'in". I told him I get that all the time myself with a smile, and I asked him if it was okay to help him sit up. He pleasantly agreed that it would be fine. He also said "you sure are nice compared to most of the folks here." When he sat up I discovered the most terrible DC I've seen in a long long long time. It was so deep a 3 1/2 inch swab could be inserted all the way in and barely touch tissue. But that's not really the issue. It was full, and I mean FULL of the biggest maggots I have ever seen. When he sat up, they fell out all over his bed. I was shocked (not in a "gross! look at that!" way, but a "how the h*ll could this go unnoticed!?!" way). I cleaned the wound and got all the maggots (I think). Then, took another look inside. What I believe I saw was the back of his right lung. I quickly took a look at his chart (which took me about 30 minutes to even find as it was tucked away at the unit nursing station under an old notebook, NOT where it is supposed to be). This man was on a rotation to prevent bed sores!!!!! I called the DON, who said she would "call it in" with a yawn of disconcern. I also asked if she was aware that the LPN from the other unit left. She said that she was aware, and I would have to cover. I told her I would do my best, but we were pretty short all around. I asked her if she considered calling the agency for a nurse. She said NO WAY! We're not paying for a full eight hour shift if the person is only going to be there for 5 or so hours! Inside, all I could think was how rediculous she just sounded not caring an ounce for her residents care and well-being. I then charted what I discovered and the Doc arrived shortly after, VERY angry. He said (QUOTE), "They oughta shut this d*mn place down. Too cheap to pay for staff, and too cheap to use a d*mn agency." I replied with "I'm actually agency through ********." He then said, "That suprises the h*ll out of me! I have been on them for months now to get some help in here. In fact, I told them I would quit as the primary here if they didn't. Looks like they are trying to do just enough to get by. humph! Typical!"

Shortly after this conversation and about a 30 second exam of the resident, the Doc called for a transport. He said, "don't worry about messing with this. I'll take care of it. You have 40 other people to worry about. That's when I realized I actually DID have 40 other people to worry about!

I knew only the MOST BASIC requirements were going to be taken care of for these poor people tonight, but I hunkered down and started to try to accomplish the impossible. Meds got passed, the Doc stayed and did a couple foley's then did dressings on about a dozen residents!!!! Wow, what a cool guy!!! But of course, just about nothing else was done. I also discovered two other residents that were on scheduled turns were NOT being turned. Jeeeez!!!! And where in the world are the aides?!? I had only seen one aide (on my original unit) since I had been there (the aide issue is another story in itself).

Needless to say, when the DON came in an hour late (grrrrr!) I gave a report from h*ll to her. I told her that she needed to get some more CNA's in here and a nurse that cares more about patient care than a mild discomfort. She said something like, let's not talk about THAT and talk about all the things that you left undone. I was about to explode!!! I told her that unless I would have been able to split into 6 people last night, there was NO WAY that these people were going to be cared for properly. I also expressed to her the lack of attentive care the residents were getting. They were lucky to get a water refill in a 12 hour span, some clearly hadn't been bathed for weeks, and on and on and on. She rebuttled with something to the effect of, we aren't made of money and walked off! Seriously, she walked off!!!

I have never done this before, but for the first time ever I reported a facility to the state. God help those poor folks at that h*ll whole.

I know that agency won't cure the shortage of qualified nurses and nurse aides in this country, but in my opinion, if you need help and people are suffering as a result of such short staffing, it's time to call them in and in droves!

Sorry for the book... I had to get this off my chest.

As a LTC nurse for many years, I say, "HURRAY" to you for reporting this facility to the state and please follow up and make sure they listened. I work my tail off to render top rated care and people like this make me want to go postal!!! That DON should not only be terminated but in my book, she should loose her license because she allowed this to go on. I am very proud of the facility I work at, as a matter of fact we got a perfect rating from state last year, but people like this is why so many folks look down on LTC. Thank you for caring enough to get involved!!! God bless you!

Thank God that the facility I work at puts patient care before everything else, and we canstill make money doing it!! We all have the patient's well-being as first priority and everything else comes second to that. From DON to Admissions to rehab..we all feel very resposible for those residents and feel like they re part of our families Though I know that not ALL staff feels this way but I like to think that the majority do. I have been there for 7 years and I left to do med-surg for awhile but missed "my residents" and came back. I am the MDS coordinator and have an active part in their care and assist in directing that care, we know families by name and are always getting calls even in off assessment times with questions and suggestions. It horrifies me to read about things such a these listed and those poor residents who are at the mercy of a group of people who have no moals or consciece. Not only should they worry about what the State finds and cites, but I want to know how they sleep at night, knowing the poor conditions these HUMAN BEINGS are forced to endure. These are our elderly and they need our help, our kindness and our humanity. They did not ask to be put in "a home" but nonetheless they are there and need the expertise of our nursing experience and the love and care some of them do not receive from their families. These people are mothers and fathers and brothers and sisters and friends, etc. not the "big decubitus in room 214, or the "pain in the *** in room 213 who keeps pooping the bed". What happened to dignitY and common respect from one human being to another, most of us wouldn't treat our animals that way!! It really sets me off...good for you calling the State and whomever else will help!!!! Kudos!!!

EDY, what you did took courage I havre been there too in my 22 yrs of nursing,and I never regretted it, even when it came down to appearing in court. I carry my own even as a LPN . Remember, its conscious that makes the very best nurse in any capacity .jetlpn

Thank you everyone for the support and kind words. I guess I should update you all on the progress...

I have been contacted by several people over the course of the last month. The facility indeed tried to mess with my license as expected. The board put a quick stop to that. In fact, I spoke with the legal dept at the board and they said they will not be doing anything (off the record of course... hehe) and that they found the revenge tactics to be quite obvious and even said this leads them to question several other diversions/suspensions that have resulted from this facility in the past. They assured me I had absolutely nothing to worry about. There is a major investigation going on, and from what I have been told (the lawyers can't reveal too much yet), the facility owners may be held CRIMINALLY responsible!

More updates as they come in.... depending on what I am allowed to say.... :)

-eddy

:roll Like ive said before "its always something " !!!! and "what goes around comes around "MMMEEEowwwww!!!!!!!!

When I started nursing school, our first clinicals were at a place that is on the list for Ohio. I knew that I would see things like you see on tv. The very first patient I was assigned to was a 300lb female who was a total care. She could not even wipe her own nose. The Nurses called the Students in to observe a dressing change. As I prepared my self for what I was about to see, the stench of this decub almost made me vomit. I stepped back behind the curtain, and could feel myself losing it. Two nurses were holding her over onto her right side, while the nurse doing the dressing change, pulled out approx. 3 feet of gauze. The decub on her coccyx was so deep that i could have put my fist up to my wrist into it and not touched any of the surrounding tissue. I immediately burst into tears and turned away. My mind thought "This is the most horrible case of neglect I have ever seen. If the family could see this..." And the nurse said, "oh my, it certainly looks a lot better. (than what, I thought).

At any given time during our week there, at least two people could be found in their "butt hutt". Yet all day, we saw neglect after neglect.

Is it understaffing at most facilities that causes this type of neglect?

Or is it that the person assigned to them, didn't take the time to comfort and NURSE them back to good health?

I wish you worked for the agency that our facility uses. Those people are only there for the pay. Thank you for restoring my faith in "pool people".

Specializes in jack of all trades, master of none.

Eddy, your experience has just given me the kick in the rear I have been needing.

I was hired by a large LTC to be the treatment nurse. OOOOPS, BIG mistake on my part. Something was telling me don't do it, but I did it anyway, thinking I would be the one to help these residents. After constant short staffing, and constantly being pulled from my assignment as treatment nurse, I was getting verbally reprimanded for "not completing treatments in a timely manner" I asked how I could possibly complete some pretty major treatments for 30 plus residents when I was pulled to the floor to do med pass at least half of my scheduled tx nurse days. I was told to just get it done. HOW?!?! So, I am basically responsible for skin checks for 83 people, dressing changes for about half of them, and get to be pulled 2-4 times a week. On the rare occasion that I get to do treatments 3 days in a row, I am questioned when I report the new Stage II's, "why didn't you discover this sooner?" To add insult to injury, I get to deal with some idiot family members telling me how to do my job!!!! God forbid, that "mom" doesn't have neosporin on her head, I am trying to do a 4 hour med pass now, thank you very much, but am told by these family members that they will not hesitate to call state, because I am an 5 minutes late giving mom that neosporin. Fortunately for me, I have kissed butt very well with that family & others, & they KNOW that I will always take care of their mom before I go home. They actually thanked me & told me that I am the ONLY nurse that actually does her treatment. Hmmmpphhh.

It is a sad time for the elderly.

Thank you for reporting this. I hope the place gets what they deserve. This has to be one of the worst things I have ever heard. Keep us posted.

Originally posted by TracyB,RN

I have kissed butt very well with that family & others, & they KNOW that I will always take care of their mom before I go home. They actually thanked me & told me that I am the ONLY nurse that actually does her treatment. Hmmmpphhh.

It is a sad time for the elderly.

I think kissing butt actually allowed me to survive a long time in LTC. Better that than a call to the state !!?? I used to do what I called TLC rounds on my residents. It usually involved a kiss, a hug, or just a smile or reassurance from me. It was just a good way to start off the shift and get the crazy ones where you want them. Families got a GOOD earful about me when they came to visit and a few words with them was time well spent for me !!!

We had a family write a scathing letter to mgt about the care that mom received and how her dressing wasnt done. Nothing ever came of it and the nurses excuse was fully accepted. She claimed that when she did the tx the resident was asleep thats why she never remembered her in there ?

I was picking up orders one day and accidentally happened upon this: It seemed funny how a guy got coverage almost QD except when the same nurse above was on. Guess she didnt know that the glucometer had a memory !!?? She was making up FTG's under the coverage amount and not giving this poor guy insulin. nothing came of this either, she is still employed and I got labeled a RAT. :crying2: how do they sleep at night ????

I had just seen enough and now Im out of LTC but....

KUDO's to those who have the balls to report these H*LLHOLES and the staff that work there.

ditto this: It is a sad time for the elderly. :imbar

deb

The county DA brought criminal charges against a large chain hereabouts and won the case. Made national news a few yrs back. If you want to, you could "clue in" the media. That usually gets the ball rolling. You could also "clue in" the state, but somebody I know who did once, told me, she got caught off guard and gave her name when asked. You can guess what happened to her.

Stat minimums for staffing in LTC have not been updated in 15 years. what do you expect? Our LTC facility stays above the minimum and still does not have enough staff and of course, company won't pay for more. They recently decreased a few of the "extra" employee positions. Nurses should demand Nursing Boards update the stafing ratios for nurses and CNAs. Of course this would close some facilities but what is the alternative? Dead or injured pts.

If a nurse is endangering pts and you have the proof (glucometer) you can notify your state board They will investigate themselves.

+ Add a Comment