Alert!

P_RN, ADN, RN · Jan 2, 2002

Wild, I usually follow what you post with admiration. This time, however, I think you are off base. My Mom is 83 and living at home alone (my sister is across the street ), but my MIL is in an ECF.

You see after 3 PEs and 2 CVA's she became unable to walk or turn or even think rationally. She lived with her unmarried son, 67 y/o with Shy Drager's.

Have you ever seen someone who cannot even stand up without vertigo or syncope try to turn or assist someone up? He has fallen several time trying to do it.

Then there was the constant 23.9 hours a day screaming......HELP ME, HELP ME......get up, get to bed, get up , get to bed, get up, get to bed................!!!

I can't lift but I can watch her, I can give her insulin and check her blood sugar. There is no money to hire private attendants. Home health was coming as long as PT was justified, but since she had no rehab potential they were no longer allowed under Medicare. I can't stay there all the time either, I have my own home and family. My daughter and I would go over every day and bathe and dress her. She had the BSC, the Hoyer, a wheel chair and a lift chair.

She bites, she scratches and she screams all the time. The problem is she has lived for 85 years....... This past March after her third ER visit in as many days, her doctor said.....this is enough....you (her son, and my husband and I) can't go on like this.

After MANY long hours of soul searching the ECF was the only solution we could find. But you see, he still drives the 16 miles each way to see her and to feed her her lunch every day. We go over about 3x a week. All the grandchildren except my two and another live out of state. They go either after work or on the weekends.

Those people in the ECF are lifesavers. I love every one of them. I have been around nursing long enough not to have any illusions, but to me, people who care for our elderly deserve more respect than this legislation provided. $14 an hour for a NURSE?

Ridiculous!!

wildtime88 · Jan 2, 2002

OK, I will fan the flames a bit more here.

In most of the cases, where these family members were not supportive, they all had good jobs and treated us like servants to their whims. These were healthy people more than capable of taking on the physical and financial obligation. I always ask questions, before I put anyone on the spot in a case like this. Actually what I have seen more often than not is that the best off are the worse offenders.

I also get a chance a lot of times to see these people again when the patient makes a return trip due to the effects of depression. Many times these are the most demanding family members. You see it is no longer there problem, it is yours.

This is the same way that many of these legislators look at it too. They just want to pass the buck or the problem. Who is the last one in line? The nurse is. Now they can sit back and blame greedy nurses for not stepping up. They in fact now have a scape goat. Now all the blame as usual can be pinned on the nurses. Nurses are uncaring. Nurses are unsympathetic. Nurses are not being professional. Nurses are failing in their calling to humanity. They will use these remarks and a whole lot more in an attempt to shame nurses. In many cases, it will actually work. This has worked for centuries against the nursing profession. We even hear nurses repeating the same things.

This legislation is another slap in the face. It was passed to put nurses in their place. I wonder how many nurses will again just turn the other cheek waiting for the next slap. Nurses literally feel alone because there is a lack of leadership. Many nurses at the bedside feel like they are the red headed stepchild. The nurses who choose to work in LTCs feel this way even more.

P_RN, I did say that sometimes it is unavoidable. But there are times that it is not. I have seen too many elderly people admitted to the hospital to await nursing home placement simply because the family refused to take them home with them. These were patients who could walk of stand on their own. These were people who were rational. These were people who had all kinds of healthy family members crawling out of the wood work. This is the tragety of it all. I am sure that they will get theirs though in the end by setting the example to follow.

Katnip, RN · Jan 2, 2002

We had to put my in-laws into an assissted living facility the week before Christmas. They lived out of state, and hadn't taken their meds in a month. They tried to drive (wrecked three custom Harleys and two garage doors). Grandpa wandered around outside in his underwear at night. They refused to let the home health nurse into the house. They were starving themselves to death, literally. They didn't eat even when there was food in the house.

We brought them to our house, which caused no end of fits on their part, and they kept trying to walk home (350 miles). When we got them settled into their facility, they started eating better,, and are beginning to get more talkative. During break I visited them several times a day, as did my husband, and now once a day. I talk to them everyday on the phone, even though they still have no clue who I am, and sometimes not my husband. They're improving more everyday, and are really becoming a bit more social. We're hoping they'l soon start participating in activities. Our kids love to visit with them. We get to see them much more often now that they live down the street.

But Wild is right. I have never seen a lonlier bunch of people. Every time I've been there, I'm followed around by other residents. My kids are dragged to the TV areas just to sit with them and chat, though conversations can get a little surreal. The staff mentioned that rarely do many of these folks get visits or phone calls from families. When the families do show up, it's usually to complain about something that the staff isn't doing right.

We truly can't take care of the folks at home. The facility is beautiful, and the staff is great, but it doesn't make up for lack of visits from family.

sajaha · Jan 2, 2002

Along the same lines.....where I live and worked, the administration is trying to deal with the nursing shortage be bringing in EMT's and paramedics to work in our ICU!! Can you believe that?? Talk about scarey. This ahs been in the works for about 2 years now and so far the RN's have won out. But with the situation becoming critical now it's being considered again seriously.

wildtime88 · Jan 3, 2002

sajaha,

I have worked in a few ERs where paramedics have replaced nursing staff. The RN is of course responsible for them.

Not that the paramedics are not good, let's just say that they are paramedics and come with that knowledge and skill level. As far as what they are allowed to do, well depends on the state and the hospitals self written policies and procedures, and protocals.

They origianlly came in to supplement staffing because hospitals would not hire new nurses. Cheaper labor more money in the ol CEO's pocket and of course more work for the nurse.

This is another battle that was chosen not to faught against and something that we can count as a defeat. There were many, many nurses apposed to this though.

semstr · Jan 3, 2002

Hi mr. Wildtime,

just wondering, I seem to remember you are not married, so you don't have any old inlaws. Don't know about the rest of your family, parents, old aunts, uncles etc. Neither do I know about siblings or nephews and nieces. Well, however

So, do I get it right and interpret your post here the way you mean it, you would take care of all those old folks in your house and you would stay up the nights, even after a hard days work.

(say didn't I read somewhere on this BB, that you are a traveling nurse?)

Ah well, good jobs aren't hard to get now a days:cool:

I hope you know what you are talking about, by writing the things you do. Hey, sure you see a lot of these old people in the ER, but I've seen even more of them in homecare and I see even more of them in LTC, whenever I go there with my students.

The LTC here in Austira are very good, one of the reasons for this is that a lot of RN's work there, since it is part of the training at school. All the students have to work at least 600 hours in a LTC and a lot of them go to work there when they have finished their training.

So the standard of nursing and care is very high here, plus the government pays for most of them.

Don't get me wrong now, I am not saying your LTC are not good or nursingquality is not good.

But I think it very important to have also higher trained nurses working in LTC, not just for the image (which is very important though) but also for the planning of the nursing.

Sorry, if this is offending to you mr. Wildtime, but what I've read from you till now, you're a tough guy, who always has a lot of good advice for others.

Take care, Renee

:D

wildtime88 · Jan 3, 2002

You did not offend me.

As I said sometimes there is no avoiding LTC placement.

Yes I am single and for all practical purposes an only child. My older brother has already proven that he would not help my father in times of need.

My father is 80 years old and for the most part very healthy both physically and mentally.

This last spring I had to take a break from my traveling for 3 months in order to take care of him after a knee replacement surgery. If I had not been here for him, then he would have also been placed in an LTC on a temporary basis. I can only guess at the emotional and spiritual toll this would have costed him.

I have often wondered what I am going to do if he has an event that leaves him unable to function for a the rest of his life. I can say that I would make whatever personal arraignments are needed to keep him at home if at all possible. This includes hiring someone just to be there while I was at work.

But I am realistic too. If he became mentally or physically uncontrollable or if my own health was too bad, then I would have to have him placed. If I become so physically exhausted that I could no longer see after him appropriately, then I would have no choice but to have him placed.

I have made other sacrifices in the past when it came to my parents. My mother died a few years back from cancer and my Dad went through a cancer scare before then. In both cases I was living out of state and gave up my job and my personal life to return to help out.

If I were to get married tomorrow, it would be with the understanding that if either of our parents needed help that our home would be open to them.

The funny thing about the whole thing is that my dad and I do not even get along that well. But I remember seeing him bust his butt in order to provide for the family. If anything he was dedicated to us.

Here in the US the LTCs are very much different than yours. There are some that are very nice and there are some that are not. This has nothing to do with the nursing care. It has more to do with the private/corporate management of them. The nicer LTCs have a waiting list.

There is no disgrace in using a LTC if there is a need. The disgrace comes when there are multiple family members that refuse to take in an otherwise healthy elderly relative who simply needs to live with someone else for their own safety.

Taking care of someone whom is unable to walk and help care for themselves is a hard burden on one or even two members of a family 24 hours a day, 7days a week. When ever one of these people bring in a family member to an ER that I am working at, then I give them the royal treatment. I will offer them anything that is available. Coffee, food, a chance to go to the cafeteria or anything else that is in my power. I try to give them information on adult day care or a put them in touch with services where they can get someone to step in for an evening so they can get out for a while. I always ask how are they doing and warn them to watch out after their own health.

In this country, it is not uncommon to see a recent elderly widow or widower pushed down the road to LTC placement. Together they were able to help out one another but as a single there is no one to support their shortcomings. This is starting to change with more and more assistant living apartments popping up. But these can be very expensive and out of reach for many.

Now lets get back to this legislation. The only reason I even went down this road is to clarify what Governor Ventura actually said. And he did have some very valid points. It is too bad that the ramifications of this legislation were not thought out. I wonder just how quickly someone will choose to either work in an LTC at a much lower wage rather than look for another place to work. This legislation could actually make the nursing shortage in LTCs much worse.

semstr · Jan 4, 2002

OK, Wildtime you've made your points and hey I admire the way you care for your father. As we say here in good old French: chapeau)

Take care, Renee