Yikes! Another bad observation at an LTC facility - page 6

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... Read More

  1. by   CapeCodMermaid
    I used to think we were short staffed here. Compared to all y'all we are OK. We give excellent care despite being short. What really makes me angry is sending our patients to the hospital with intact skin and having them come back with horrid stage 3's on their heels or huge stage 2's on their coccyx with a little note from the hospital nurse. Bad care is bad care no matter what facility it occurs in.
  2. by   CseMgr1
    Originally posted by BrianWhitfield
    While your story is horrible, it really doesn't surprise me. Not putting down the honorable profession of nursing, but there are some bad apples out there and the state agencies and NH administrators don't pay enough attention. My mother was killed in a NH about a year ago by a RN who had a long history of medication errors, paitent assaults, etc. All the state people did was write up violations against the NH. The state attorney general brought homicide charges to a grand jury but they didn't prosecute. The RN told the grand jury she was having a "bad stress" day and they took sympathy on her.

    The bottom line is that NH administrators and owners treat these elderly people like farm animals. When reported to state agencies, all they get is a simple slap on the wrist. I could have done better by having my mother boarded at a animal hospital. It's a lot cheaper, she would have gotten walked twice-a-day, bathed once-a-week, and fed twice daily......
    I know the feeling, Brian. My father died last year at the hands of a nursing facility, too. He was medically stable when he was transferred there from an inpatient facility, and three weeks later, he was dead. I'm not going to to go into the details, for my family and I have litigation pending against this place. I will tell you, however, that he was IGNORED to death.
  3. by   rnnurse2be
    Please keep us updated as to what is happening. Even though we would HOPE most nures would turn them into the state, there are some that dont.

    No matter what happens, you should feel PROUD of what you've done! We all are!
  4. by   2bPhD
    Eddy,
    This is the worst experience that I think I have ever heard. You did the right thing to report the facility, and I wouldn't worry about the DON's complaint to the BON. While this facility was terrible and nursing home residents often do not receive the quality of care that they deserve, there are many reputable facilities out there and many dedicated long-term care nurses. Long-term care needs more nurses who are just as dedicated as you are. I have worked in long-term care for the majority of my nursing career, even though I could have worked in many other environments with my BSN. I work in long-term care because that is where I am needed the most. I hope that your story doesn't discourage other nurses from working in long-term care. Although this was probably the most challenging 12 hours of your life, you made a major impact in the lives of many people. Your shift may have been the catalyst for change. It sounds like the doctor was at the breaking point and ready to see some heads roll. No doubt he confronted the DON and this is why she filed the complaint. Also, don't forget, you also have a case to file a complaint about her to the BON. She is ultimately responsible for the facility and she failed to repond promptly when you notified her that there was insufficient staffing.
  5. by   dwoodruff
    eddy,

    I want to thank you for doing the best you could do in that tough situation and for reporting that nursing home. I was always taught to consider: If it were my father in that home...

    Though your actions were tough, and may get tougher. You will be able to sleep at night knowing you did what was right.

    Keep up the good work. We need more nurses like you in the profession!

    Best wishes,

    David Woodruff, MSN, RN, CNS, CCRN
    Ed4Nurses, Inc.
    Nursing Continuing Education
  6. by   wif411
    I work in LTC to. I broke my foot four weeks or so. Worked on this foot, (I thought it was a bad sprain, bruise), for three of those weeks. I work nights. The good doc put me on my bottom for two weeks. I spent 1 wek doing paperwork, but no light duty for non-workman com issues, so I can't work for a week.
    To the point---the ADON called me yesterday wanted to know Can you come in and work, if I get yu a CNAII to do tube feedings and accuchecks in am??? You should be able to give what meds there are....I said Duh---I am on crutches and haven't put full weight on this foot for two weeks---like the doc said. I haven't even washed a load of clothes..I could just imagine a code. With just me and three aides to 50 pts I do not think so.
    Am I crazy???????
  7. by   wif411
    I work in LTC to. I broke my foot four weeks or so. Worked on this foot, (I thought it was a bad sprain, bruise), for three of those weeks. I work nights. The good doc put me on my bottom for two weeks. I spent 1 wek doing paperwork, but no light duty for non-workman com issues, so I can't work for a week.
    To the point---the ADON called me yesterday wanted to know Can you come in and work, if I get yu a CNAII to do tube feedings and accuchecks in am??? You should be able to give what meds there are....I said Duh---I am on crutches and haven't put full weight on this foot for two weeks---like the doc said. I haven't even washed a load of clothes..I could just imagine a code. With just me and three aides to 50 pts I do not think so.
    Am I crazy???????
  8. by   itsme
    Tina, you arent crazy, that ADON is!! I had to check what state you are from cuz she sounds like my ADON!!
  9. by   tonchitoRN
    one of the reasons these things happen is because staff and facilities hide behind those stupid pt. confidentiality rules. now with hippa and the threat of fines even fewer people are going to report any abuse. many times unless you can cite a specific example of an abuse then it does not exist. because of confidentialty rules you cannot take a patient's name home. if there was a way to anomously (sp) report abuse there would be more self policing. as it is now when nurses see problems they run the other way and don't look back. can't blame them. would you give up your livelihood to report neglect? in the eyes of the law you also neglected the residents if you were not able to adequately care for the 80 patients assigned to you. that is how the don intimidates the nurses for so long.
    you wonder how facilities look like gems during inspections? when i worked in ltc the way the facility looked so good in front of those inspectors is because when they showed up the admin. miraculously overstaffed the floors and gave double portions at meal time. you would have thought they were in a fancy hotel. as soon as the inspectors left they went back to the usual understaffing and half portions of food. very sad.
    i have seen pts. die at the hands of healthcare workers and the only thing the family is told is they died peacefully or it was their time. in other words many deaths are covered up.
  10. by   tonchitoRN
    forgot to say this about staffing. there is no excuse for understaffing when there are agency nurses willing to work. the facilities excuse is always we can't find anyone to work. bs. they just don't want to pay.
  11. by   Else567
    Hello Eddy
    I applaud you for your courage,and strength,yes inner strength,for reporting the NH,and phyicaly strength,
    I have neevr heard of such a horrible thing,and i have been a nurse for a long time,I have seen bad things,,but this,,never !
    I hope the place shuts down,and also,how about the Ombudsman,did they get involved.?
    ,how about an update,is the place still open,?
    I hope not
    ,what you did that night is nonthing short of a miracle!
    I myself work agency,,and for 50 residents,i have to be charge nurse,treatment nurse,and anything else nurse.
    all the while with residents families wanting everything 10 minutes ago,,residents families threatening to sue,because as they say,,their words,not mine''piss poor nursing''
    I do the best i can,with the 2 legs and 2 hands i have.
    I take no breaks,or lunch,
    Just a quick 2 minutes for a smoke break,thats it.
    It seems to me,every place I go to,its the same problem,not enough nurses or cna's.
    nurse to resident ratio is about ,from what i see every day is 40 residents to 1 nurse!
    thats so dangerous,its not funny.
    I swear,,,i keep saying im going to quit nursing,and go work at Burger King,less stress.
    In closing Eddy,,I'm very proud of you for the wonderful job you have done,and for the good nurse that you are
    Else567"))
  12. by   blueeyes827
    I have worked in LTC facility in management for over 15 years and have seen good and bad. No facility is perfect, there are some really poor facilities just like there are some really poor acute care settings. There are many good nurses in long term care who work hard at making things right for their residents and work on making changes to benefit their residents. Please do not let this experience sour you on long term care.
  13. by   Enabled
    Eddy, you should feel some satisfaction knowing that this facility will hopefully be shut down by the state, Medicare, or by the press as family members who are still available will hopefully have enough sense to take their relatives out. I know you posted some time ago so I have not looked back at your last posting.
    I worked in a hospital med/surg. Many times, far too many to count we would get patients from LTCs. Most had decubiti at least throgh the initial layers of skin and in time began to heal. I am only afraid the new skin wasn't going to last long as they were going back into the same situation. We have also had a few come in that were so deep you could see each individual vertebrae of the sacrum. They would be almost as large as a football. Many did not complain of pain as I think at that point too much neuro damage had been done to the skin.
    We did have a patient come in from home who had a leg wound and it did have maggots in it. The doctors took him directly to surgery for debridement but we had to remove the maggots as they were not aloud in the OR. Wish they were. The doctor said that the maggots were the only thing that saved the guys leg as they had removed most of the infection and in some areas new tissue was beginning.
    Another sad issue I have found is patients that come in from these facilities who have been obstipated for days. We end up getting them and have to do a manual disimpaction along with x-rays as we go along. I had to have had pounds out of a little old woman who didn't complain and the films still showed her completely filled. I had worked on her for more than an hour at that point. Regular laxatives or even enemas were going to help at that point. I think these are definite cases of abuse. The nurses are responsible for patients as to whether or not they are having bowel movements or constipated or worse. I have seen hospital patients charts not marked for days when a patient has been in only to ask the patient about the situation and find they did have a BM and had told someone but was never documented. We have serveral docs who are adamant about this documentation and if not noted they patients are subjected to unnecessary laxatives and such.

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