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This is a discussion on Is Jevity considered "medicine"? in Patient Education, part of General Nursing ... Hello all from the confused daughter of a patient. My mom has been on Jevity for 8 years now, fed...by tracyIngalls Aug 14, '10Hello all from the confused daughter of a patient. My mom has been on Jevity for 8 years now, fed through a drip all night long, peg site. For years she hooked herself up at night at bedtime etc etc.
Now she is in a nursing home. She likes them to start her feeding at 9pm so that she can be finished at about 8am. But sometimes the nurses don't get to her until 11pm or midnight so the feeding time throws off her whole morning.
Since my mom and I are experienced with her feeding machine etc (we had to show the nurses how it works)....if I'm at the hospital I was turning on her machine for her at night. (She can't reach it herself). Now the nurses tell me that Jevity is considered medicine and I am not allowed to do this for her.
I don't want to be Miss Unco-operative Patient but I don't know the reasoning behind this. If Mavis next door can feed her husband his applesauce, I don't know why I can't get my mom her Jevity. And I'm wondering, if my mom could reach the on switch herself, would they allow HER to turn on her machine at night? She can't wait until 11pm for them to feed her, that's way too late. She rings her call button around 9:15pm if they haven't hooked her up but they don't answer until 10pm....the CNA who answers doesn't know how to turn on the machine and gets a nurse...it takes way too long.
Any words of wisdom are appreciated.
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- Aug 14, '10 by ohmeowzer RNWe cannot give out medical advice ! Jevity is a nutritional supplement I don't know what the nurses are thinking but I wouldn't want you
playing with a pump , that I am assigned to use ! I don't know why they can't turn on your mom's pump when doing meds ? I don't know how many patients that nurse has , if it's a nursing home than maybe 30 patients !! You don't want
to turn on the pump yourself or have your mom
do it , you are not an employee there and if your mom
got fluid overload from that tube feeding that you turned on , the nurse would be held responsible !! I always tell ny patients and family don't touch my
pumps !! That will get me angry , I am responsible for the fluid going in my patients and fluid going out !
I'm using my son's I pod
so please excuse my bad typing !! Maybe you could meet with the Director of Nursing and tell her your concerns rather than turning on the pump
yourself !! I don't recommend your mom turning on her own tube feeding !!
Just see if you can work something out !! I have no idea how kids type on these things !! Good luck to you and your mom !!
- Aug 14, '10 by ohmeowzer RNSorry about my poorly written reply !! My son laughed when he saw it !!
- Aug 15, '10 by tracyIngallsThanks for the quick Ipod reply. I understand what you are saying about "don't touch my pump" but actually it's MY pump. LOL. We had to lug it from home because the nurses didn't know how to use the one in the room. Well, a couple of nurses did but most just spend an hour trying to figure it out and then left. Some nights she didn't get fed at all. So they actually agreed that we should bring our own pump from home. Oh, and we had to bring our own jugs of Jevity as well. Usually they didn't have the right size and gave her less than what the doctor ordered by about 30%. Other nights they just plum had none AT ALL. I had to chuckle when you said to talk to the director of nursing, her reply about the nurses who couldn't work the pump was "OH, that was not one of our nurses!" Right, it's a temp nurse from an agency, but you know what, she might not be one of "your nurses" but SHE IS ONE OF MY MOTHER'S NURSES! FEED MY DAMN MOTHER! I WROTE THE INSTRUCTIONS OUT FOR YOU and taped them to the wall, WHAT THE HELL IS THE PROBLEM HERE?????
Sorry to vent but you have no idea......yesterday she got somebody elses meds. Last week she woke up in a big puccle of Jevity, none of the food had gone in all night. I could go on and on....it's gotten so that my sister or I have to be there around the clock, but my sister is almost 2 hours away. God bless her she comes often.
Believe me I watch the nurses and the assistants and I would not want to / could not do their jobs. I understand....overworked, understaffed....the whole nine yards. And you are probably saying "girl...you have no idea!...." , but like I said, it's my MOTHER! I'm going to lose my job because i am so worn out and it's not fair. I don't mind spending 4 hours a day there, I don't mind paying someone to be there with her for as many hours as I can afford, but I cannot be there from 7am to 9am, then go to work, go there at lunchtime and have her begging me to stay longer, then go back at 5:30pm until 9:30pm and all weekend. Plus all the medicare paperwork and the insurance forms, I'm at the end of my rope. I've done it for weeks. WHY CAN'T THEY JUST LEARN HOW TO FEED HER????
So, I thought we could make it easy for them. I'd turn on her machine, like we did for six years, and sleep easy knowing that she was going to be okay that night, not wake up in a panic because she's getting dehydrated again. You're probably thinking "You need to find another place for her". Well the closest one is 22 miles and how am I going to make it back and forth 14 miles to work then 22 miles in the other direction to this supposedly-better facility?
Anyway, just wanted to make it a little clearer why I wanted to give my mom her Jevity. It's not that I'm what you probably call a meddler. I am going to try to hire a private nurse to come in just for 90 minutes on as many nights as possible or that I can afford, and make sure that she is well versed in everything my mom needs. I am assuming they would allow this, even though she is not a nurse on staff? I'll have to check further.
I have taken good care of her for 8 years since her stroke and I thought that now the nursing staff could take over some of the burden. But apparently the regular staff is not around much at night and its all temps. And the reason I can't care for her at home is mobility and transfer issues as well as other things I won't get into here. Thanks for listening I just needed to vent before I can sleep!
- Hi, I am sorry to say also that Jevity is a medication, but your problems can be gotten around. The director of nursing should have an inservice with all the nurses, including the agency nurses to go over the use of the pump. If a new agency nurse comes in, that person should be individually taught how to use the pump and sign off that they have learned how to use the pump. You need ask for a careplan meeting with the MDS nurse and director of nursing to go over your multiple concerns. At that meeting specific problems need to be addressed: specific times for your mother's tubefeeding, medication errors, why don't they supply a pump instead of you (which they should be doing), what ever else concerns you have. I would have all of these things written down. During the meeting write down what they say, what they say they are going to do and how the problems are going to be resolved. Let them know that you are expecting this to be resolved within a specific time frame a week, 2 weeks. In that set time frame you still are having problems, you come back to the DON and MDS nurse and request a meeting with the administrator. If you get no satisfactory results from them, you can call the state and report neglect. You will need to explain to the state complaint person exactly what you have done, meetings, what they said they would do, your frequent checking (I mean write everything down.) and your results. You know that if this happening to your mother, what is happening to other residents who don't have someone to check on them frequently. You shouldn't have to feel bad about leaving your mother at the facility. That facility is suppose to be her home and not a house of horrors. If you do want to take her home, Medicare will pay for home health and equipment necessary for her care.
My sister took my grandmother home for her last 2 years of her life. It was hard, but my sister had a lift, shower seat and if needed extra support from home health. There are 4 sisters so we helped my sister as much as possible.
Good luck and I understand your frustration.
- Aug 15, '10 by grandmawrinkleHi there. I'm a hospital nurse, but I have a few opinions on this. I, too, would be irate if this was my mother.
1. I don't see why your mom wouldn't be able to hook up her own feeds if she is still able to do so. I disagree with the previous poster that said that Jevity is a medication. It's not -- it's a tube feeding formula. I have had hospital patients come in that live with PEGs on tube feeds at home and they give themselves their own bolus feedings 3-4x/day by syringe (instead of a pump). If you had to bring in her own pump and everything and no one else knows how to use it (it seems), it seems reasonable to me to just allow her to do it herself. If you can't get the DON to get her nurses to do their job, I would continue to push for this.
2. I don't think it is so awesome that the NH hasn't gotten up to speed on how to use your mom's pump. Ahead of that though, I don't know why the nurses didn't know how to use their own feeding pump! They should have been appropriately inserviced on how to operate their own equipment.
3. I think you should stop bringing in Jevity from home. It's the NH's job to provide your mom with her ordered feeds in the ordered amounts. You shouldn't have to pay for the feeds on top of what is being paid to the nursing home.
If you can't get this resolved through the appropriate channels at the NH and you don't want to move her, I would consider reporting the facility to the state for neglect. Write down everything including what came out of your meetings with the DON/administrator and report it off.
I can see why you are mad. Good luck.
- Jevity is a nutrional supplement, but we must have a physician's order for the supplement. A careplan with a doctors order can be done for the resident and her daughter to do the tubefeedings. It just sounds like the facility doesn't have their act together. The facility should provide the pump, tubefeeding and any other supplies. Your mother was admitted from the hospital and should get 100 Medicare days. There are exceptions but hopefully she will be able to use her whole 100 days. She should also get therapy. You need to monitor her skin closely, because with her missing several tubefeedings her general health will deteriorate and will show up as dehydration and with skin breakdown.
- Aug 15, '10 by tracyIngallsThanks to all for taking the time to advise me.
Yes, my mom needs her therapies and works hard, I think that the therapists here are very good. It just adds to my frustration, however, because when they bring these temp nurses on and they can't figure out how to feed her until almost 11pm, she isn't ready in the morning for her therapy. And the therapists just seem to move onto the next patient whenever that happens, so she has missed maybe 6 out of 18 days of her therapy.
You have made me think and I have come up with a great idea however. My sister's husband is not good with my mom and not good with hospital rooms/visitation in general, but I know he wishes he were more help. I think he would be great at meeting with the heads of staff and following up and filing complaints if it comes to that. He probably is better at making demands than I am and would be a good advocate and could make things happen. I think my sister will ask him to step in here as I would prefer to spend all my free time helping my mom and not waiting for a meeting or writing letters to the conglomeration that owns this place and to medicare. This joint gets one-star out of four ratings on most points from Medicare and I'm sure they want to improve that but they're not doing a very good job of it. I feel badly for the therapists who want to help but enter the room and encounter patients who are fed-up with the place and ornery. I have seen my mom take out her frustrations on the wrong person more than once and we are working on that but it is difficult and after 8 years of living with tube feedings I can see how she has a short fuse nowadays.
Hopefully we can get the doctor's order for me to be able to hook-up my mom whenever needed , we'll see.
Thanks again I hope you all are having a better weekend than I am, you have really helped me to simmer down.
- I know you want to be with your Mom and your brother in law may be better at the meeting set, but the management at the facility need to see YOU ALL standing together and upset. They should set a meeting up this week. If they will not set a meeting time, call the complaint survey in your state. I don't normally recommend calling the state, but there are so many errors going on at this facility. I would feel it very necessary to call. If you don't know who to call, look under your state for your medicare board or the ombudsman. Oh, you can call the ombudsman. The ombudsman can really get things a rolling sometimes and at least they can give you the number to your state survey agency.
- Aug 15, '10 by janfrnMaybe becaue I work in peds I'm seeing this from a completely different perspective. I have NO issue with family members who have been providing care for someone with special needs at home for years doing so when their child comes to hospital, as long as we agree that there are certain things that I must do myself. That has always worked well for me. Parents of children with chronic health care needs are often more skilled at many things than nurses with 20 years of experience are... because the parents do it EVERY day. I would think that in this case the OP would be in the same boat.