Latest Comments by CoffeeRTC - page 5

CoffeeRTC, BSN 17,660 Views

Joined Jan 22, '03. CoffeeRTC is a RN LTC. Posts: 3,672 (24% Liked) Likes: 1,726

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  • 1
    Hopefulpsych likes this.

    Why can't the DON just rewrite it?

  • 0

    I realize that we would need my mother in law to proceed. She was POA and the next of kin. She is a very reasonable woman and has relied on her faith to get her through this period and I think, for the most part, we are all dealing with this. I think I will always have those moments where I wonder "what really happened?" and I understand that those questions will go unanswered. She did ask the doctor and he sugar coated a lot. He is her doctor too and my husband also went to him. My husband is switching from his practice. (he had to beg for an EKG when he was having chest pain, dizziness headaches, fatigue.)
    At this point, the questions to ask would be what benefit would it have to ask questions? What would it solve/ prove? We didn't have an autopsy done. We don't have a lawyer. I was just wondering what the process would have been.

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    As the title stated, I had a family member die in the hospital. Not recently, it was about 2 months ago. I still have so many questions. Questions the rest of the family do not want to ask. It was my father in law...and I'm just the daughter in law.

    FIL had been sick with a cold for about a week and a half. At 76 he was doing well, had his diabetes under control with diet and lantus insulin (good HGA1C #s), no issues with his cardiac status (he had a cabgx3 about 4 years ago), went to the gym 3 days a week and walked for over an hour, cut his grass...etc. MIL and FIL went to the dr for the cold and she got antibiotics, he got Mucinex..his chest xray was negative.

    1.5 days later, he was cranky, slightly confused and still was coughing. He made MIL take him to the ER in the evening...they admit with bronchitis for antibiotics, steroids, neb tx and o2. Spent 9 hrs in the ER on telemetry waiting for a bed. Gets to the floor and it took another 2.5 hrs until he was seen by a nurse.
    Next day husband visits (I was going to pop my head in the next day) until 9pm, dad was feeling better, mentally clear, feeling better. I would have never thought to come in or even stay overnight.
    We get a call in the AM from a friend (yeah, hippa break) to come in...dad is in the ICU. We get a brief report that he was belligerent and confused around 1am, nurse got an order for Ativan that was given around that time. Next time he was seen was 5:30 am and he was cold, blue, pulseless. Full code...cpr started. He was down waaaay to long.
    The only time I've ever seen him confused was when his blood sugar was super low. I would expect if he was admitted with bronchitis, hypoxia could have also caused this change. He's never taken sedatives before (aside from the surgeries he has had). After two days of the hypothermia treatment, we pulled life support when he had no brain function.

    So...yeah, I know I have issues dealing with a lot of this. Should we have really been told that "they are soo short staffed and the hospital is full" ? That just makes my head spin. This is way after the fact, but what would have been the proper way to ask questions? Who do you approach first? This is a community hospital and at the time, he was being followed by his family practice MD. Does your hospital have a way of helping families deal with this?

    I'm not asking for medical or legal advice, just wondering how situations like this are managed.

  • 1
    amoLucia likes this.

    What are you giving at 1 am?? I would kick someone if they woke me up for meds.

    We have 50. I might start at 5:30 am and be done at 7. This would be accu checks, synthroids, prilosec, iv meds and g tube feeds....probably for about 25 or so getting meds.

    12 am pass was very light, but I would also change tubing, g tube dressings, IV meds, neb treatments....and probably be done 1 am -130.

  • 0

    Yes, med error for you and the nurse taking off the order. if you don't know what a particular med is, then look it up.

    The nurses following made the error, but they wouldn't have know the med was dc'd unless they got it in report.

  • 0

    read the Terms of Service....we cannot give you medical advice.

  • 3
    Kitiger, poppycat, and Sour Lemon like this.

    For the most part, we do not wake the residents just to check them. Sometimes there is not need to wake them to check on them. Unless they are on vital signs q shift or more frequent, there is no need. If they have a treatment or iv med timed then that would be a good time for a mini assessment. I do visuals every 1-2 hours when I work 11-7. I'm normally down the hall helping the cnas or giving a prn anyway.

  • 2
    NFuser and PierreB like this.

    Your pharmacy should have a policy in place.

    I work LTC. We get meds delivered from an off site pharmacy. The case comes in and has an inventory sheet. We are supposed to verify that we get is on the sheet (blister packs etc) We get a copy, the delivery driver gets a copy. We also sign the hand held computer and a paper sheet for them.

  • 1
    amoLucia likes this.

    Quote from amoLucia
    To CoffeeRTC - are the facilities JACHO?

    No. Our company is unofficially pushing it too. Is it better for the QIs? They seem to think there will be better care. I've met my fair share of LPNs that can do circles around the RNs.

  • 1
    Tippyrn likes this.

    I never thought I would see the day, but many LTCs in my area are now pushing to have mostly RNs on staff with the CNAs.

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    I work in a LTC facility with 50 beds. Some days I'm supervisor and have two LPNs other days I'm on a cart and have the facility plus a 24-26 resident assignment depending on what hall I take.

    As far as stress....every day is different. We have a good turn over of residents. Some shifts are more stressful than others. Stress to me would be different than what it is to another nurse. After 20 years...I get kinda numb to it, LOL

  • 8
    KariT, Orion81, missdeevah, and 5 others like this.

    I had to call off once for "having a baby." She was a few days early

    My favorite of all time came from a CNA's husband "yeah, she won't be in tonight. She has a real bad yeast infection." He went on to describe all the issue she was having in full graphic detail.

  • 1
    lindseylpn likes this.

    While I never practiced as an EMT, I had taken the classes, did the ride alongs and got certified. I see EMS point of view. I've also been the only nurse on duty taking care of 50 residents with needs.

    When your local EMS has the same type of issue with the local LTC, has your director ever voiced their concerns with the administration of that facility? I strongly urge you to have a meeting or at least a call with the DON. Some nurses are just clueless on the life of an EMT or Paramedic. It doesn't need to be an us verse them. We have a great relationship with our local service (including the 911 services).
    Nurses....if you see EMS treating your nurses like crap...get to the bottom of it. Call them out. yeah, some folks just have a bad day.

    If we call EMS, we work as a team. CNAs know to get the room ready (clear out all the WC, chairs, bedside tables etc) and to get the resident ready (clean gown and brief) if we have more than one nurse on...we take turns getting the papers ready and taking care of the resident. Have someone greet the medics when they come in. yeah...all of this is thrown to the side in a true 911 emergency code.
    We just recently had a 911 code. CPR was started, defib uses EMS arrived on the scene and took over. While I wasn't around for this one, in the past, after it was done..we would reach out to the EMS team and ask for feed back. Sometimes it isn't nice to hear the negative critic, but it is good to learn from these situations.

  • 1
    AliNajaCat likes this.

    the blue dye in the roxinal...I'm just guessing since this is a hospice patient.

  • 2
    AnOldsterRN and canoehead like this.

    I'm not quick to say quit, but I can't see this being good. I've been in LTC for ever but I would never be able to work with that ratio. I have 50 where I am now. Most are skilled and about 10 or so are LTC with not that many needs. We staff with 2-3 on...never less that 2 on the 11-7.
    If they said there would be two on 11-7 and they are now staffing with one, I can't see this being good. I don't think explaining this in an interview would be bad.


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