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LTC: Directors Nursing and Assistant (DON/ADON) /

" I dont have to be better than the others"



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Feb 05, 2009 11:25 AM

" I dont have to be better than the others"


Unbeleivable!!
Yesterday we get a faxed report for a potential client. Basic info missing so I called to ask: what level ADL's. PT care, any decubiti, rashes etc.
Doc reassures me- light asst in ADL, no decubiti, no rashes, wonderful patient and family . So I say we accept him, Lo and Behold= Decubiti on the buttocks, has Scabies, totaly disoriented, full time care in all ADL, out of it, etc.

So I call the hospital and speak to the Doc who says "Come On, everyone here does it ,.I dont need to be better than the average!"
I told him that I hope he learns to strive for better than the average!!
He then tried saying I yelled at him and he will report me!!!!!
Can't win (don't worry my staff knows enuf not to believe him!!!

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17 Comments
No. 1
from Nascar nurse
Old Feb 05, 2009, 04:50 PM

Default Re: " I dont have to be better than the others"
What a creep. And, I am sure enough others know it too.
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No. 2
from debRN0417
Old Feb 06, 2009, 06:36 PM

Default Re: " I dont have to be better than the others"
I worked at a facility where the ambulance would drive up and bring in a resident and say that they were here for admission. We had no info, never heard of them, never had a referral from the hospital about them and the ambulance wouldn't take them back. The person would be usually someone that they could not place, so they would bring them to us. This happened more than once. Our administration had to have a meeting with the hospital who threated to cut off our referrals if we did not accept their "difficult placements" or whatever they wanted to send us....ugh.....
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No. 3
from achot chavi
Old Feb 07, 2009, 11:39 PM

Default Re: " I dont have to be better than the others"
What nerve!!~! How do they know if you are equipped to handle that situation, obviously we all want to fill the beds, but not every pt can be treated properly on every unit- depends on the staffing, equipment, available doctors etc.
And to threaten you is against the law!!!
I hope you passed it on to your administrator to handle!!!
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No. 4
from CapeCodMermaid
Old Feb 08, 2009, 07:59 AM

Default Re: " I dont have to be better than the others"
I've had the hospital threaten to call the DPH if I wouldn't take a patient. I had to have patience and explain to them that there are no regulations in Massachusetts which would force me to take a patient and it would be MY license if I admitted a patient I knew we couldn't care for.
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No. 5
from kermitlady
Old Feb 08, 2009, 02:59 PM

Default Re: " I dont have to be better than the others"
Originally Posted by achot chavi View Post
Unbeleivable!!
Yesterday we get a faxed report for a potential client. Basic info missing so I called to ask: what level ADL's. PT care, any decubiti, rashes etc.
Doc reassures me- light asst in ADL, no decubiti, no rashes, wonderful patient and family . So I say we accept him, Lo and Behold= Decubiti on the buttocks, has Scabies, totaly disoriented, full time care in all ADL, out of it, etc.

So I call the hospital and speak to the Doc who says "Come On, everyone here does it ,.I dont need to be better than the average!"
I told him that I hope he learns to strive for better than the average!!
He then tried saying I yelled at him and he will report me!!!!!
Can't win (don't worry my staff knows enuf not to believe him!!!
If I'm reading your post correctly, no one from your facility went and assessed the patient? I don't know of any facility in my area that would take a patient w/out someone going and physically assessing the patient and going through the chart.
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No. 6
from CapeCodMermaid
Old Feb 08, 2009, 05:10 PM

Default Re: " I dont have to be better than the others"
We don't have a screener who goes to the hospital to look at the patients before we admit them. If they are looking for admission from another SNF or from home, I go look at them. The hospital is 90 minutes from the facility...would have to have someone stationed there all day on the off chance we got a referral.
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No. 7
from debRN0417
Old Feb 08, 2009, 07:10 PM

Default Re: " I dont have to be better than the others"
It is hard to go to the hospital for every referrral. I tried to go for some of the most "questionable" ones, but I agree, someone would have to be stationed there! In my area, there are several homes and the competetion is great...there is also pressure from many of the corporate folks to keep the census up and get those skilled medicare residents for the $$. Sometimes we had to take whatever,(not meaning to sound mean about anyones circumstances) but we had some challenges. Even if I protested about the care, it mattered not, because if they were medicare then that was more $$ for the facility for those 100 skilled days...one of the reasons I am no longer a DON.....
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No. 8
from achot chavi
Old Feb 08, 2009, 11:32 PM

Default Re: " I dont have to be better than the others"
we used to go except for those really far away- more than an hour. But with cutbacks recently, we have only been going for really questionable ones. This came in in the evening with a request to immediately send him- always a red flag- so I called to get all the rest of the info and relied on their supposed professionalism and honesty- LOL
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No. 9
from debRN0417
Old Feb 09, 2009, 05:50 PM

Default Re: " I dont have to be better than the others"
That's right..."Oh yes the patient is alert and oriented...yes, they have had all their medications for the day...yes, they are continent, and they have no bedsores...oh no, they are not on any kind of precautions...."

What you get: extermely confused, combative, no meds given, can't get them (meds) either because you have omnicare (haha), soiled from head to foot, peeing all over room (if male), covered in bedsores, some unstageable, and consumed with MRSA, ORSA, and VRE....

been there...done that....
sad.....
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