Do you agree with Gov. Cuomo?

guest1143647 · Feb 23, 2021

She said nursing homes do not have to test before discharge because many people test positive even after they are symptom free and post 14 day quarantine/isolation period.

https://www.CDC.gov/coronavirus/2019-ncov/if-you-are-sick/isolation.html

Getting testing again for COVID-19

If you have recovered from your symptoms after testing positive for COVID-19, you may continue to test positive for three months or more without being contagious to others. For this reason, you should be tested only if you develop new symptoms of possible COVID-19. Getting tested again should be discussed with your healthcare provider, especially if you have been in close contact with another person who has tested positive for COVID-19 in the last 14 days.

guest1143647 · Feb 23, 2021

22 hours ago, Tweety said:

This seems odd and shady to me. Here we have to test all patients going to nursing homes and provide proof that they are negative before the transfer.

We have had one facility that was designated for covid nursing home patients but they closed and now patients have to remain hospitalized until they have 10 days of no symptoms.

CDC no longer recommends this.

Emergent, RN · Feb 23, 2021

15 hours ago, amoLucia said:

This is what I believe contributed to my elderly aunt's hosp>NH>hosp>NH, back & forths, but then she came up positive the last in & out. Somewhere in the course of transfers & short stays, she was exposed & converted+.

She was 98yo, AO, living alone at home with assist in place as she WAS frail.

I just got the news past hour - she died this morning.

I believe the early disease mismanagement by public officials did contribute to the worsening of the pandemic. JMHO.

My aunt has just joined the ranks of some 500,000.

Sorry for your loss.

98 is quite a long life! Do you think that it may have been a factor in her death?

CrunchRN, ADN, RN · Feb 23, 2021

I think , at least at my MIL's ALF it has been spread by staff. Over and over. However, without those staff who kept coming in there is no way she would have survived to this point. They do the best they can under the circumstances.

amoLucia · Feb 23, 2021

Crunch - God bless those staff who went in day to day, and continue to do so. They are the most under-appreciated and under-recognized staff in the crisis. TV does NOT really demonstrate the REALITY. Even though that staff won't know me saying this, I thank them for their dedication.

And the same to the facilities where my aunt admitted - 2 diff hosps and 1 rehab/NH and 1 NH.

Emergent - it was unrelated GI/abd issues that initially hospitalized my aunt. But with all the back & forths (in the span of 2 wks), she was being freq tested until that last time when she came up + with URI S&S that hit her hard. Yes, her age and other issues were SIGNIFICANT, but she struggled with the resp. I know she would really have not lingered very long, even if C19 hadn't occurred, but that tipped her over.

OrangeSlushie, RN · Mar 4, 2021

On 2/16/2021 at 6:53 PM, DesiDani said:

That the reason why COVID got into the nursing home is because staff brought it in while coming into work. It did not come from patients bringing it to the nursing homes.

The NH I worked at got hit by covid fairly early on in the pandemic madness, when the news was still saying people were falling over dead in the street with it (remember that?). Administration was sure it was a staff member that brought it in. However, myself and other nurses know it was the readmit we had to accept back from a sister facility, who, despite having had a negative test the day he got sent back to us, became bedridden and had to be fed by staff within the next 2 days and actually passed the day they were going to re-test him for covid. The facility that returned him to us was having an outbreak at the time. Since we was still mobile the day he re-admitted, he was around a lot of other patients on his unit all day (all of our residents were supposed to stay in their rooms per the pandemic protocol, but you try telling an alzheimers/dementia patient that). The next residents who became ill were other dementia patients who he had been around that first day. The first staff member who tested positive (the CNA that admin was so sure was the person who brought it in) had floated to his unit that day. The next set of residents to get ill were the patients on a different unit that the CNA worked the next night, followed by a bunch more staff. By the end of it, all but 4 residents and a small handful of staff tested positive.

Anyway, it doesn't really super matter ultimately how it got in. What mattered was that our PPE protocol at the time was embarrassing and completely ineffective for infection control. Since PPE was in very short supply (surprise, surprise, we had no stockpile going into covid and NHs didn't get priority for receiving any new supplies) administration's solution was to place one gown into each sick resident's bathroom. Every staff member who entered a room to wear to interact with that patient was expected to wear that same gown. Of course, we were also instructed to wear masks until they fell apart before we could get a new one.

TLDR: In my personal experience, a patient brought it into my nursing home. However, it was lack of PPE and poor administration choices that let it flourish.

Orca, ADN, ASN, RN · Mar 4, 2021

On 2/18/2021 at 5:21 PM, Hoosier_RN said:

I think he has/had aspirations of a presidential run. I'd say that's bit the dust at this point. But, I've seen crazier things in politics

Recently.

DesiDani · Mar 8, 2021

Before COVID I got a 2nd job at a nursing home part-time. My full-time job is at a hospital. I am used to having patients with infections or rule out in isolation or pairing them up and having some PPE supplies on the door or something makeshift.

Well at this part-time nursing home job, I had two of the residents were on isolation. One was kept in the same room as her roommate who was not infected. The infected resident had the window side, the PPE supply was kept in a "Walmart" like plastic 3 drawer chest on her side of the room. Yes you read that right "WAS KEPT IN THE SAME ROOM AS HER NONINFECTED ROOMMATE!". The other one had her own room, but she already had her own private room. Her Walmart PPE supply bin was kept WAY inside her room.

The nursing home did not have any gel things on the walls or near any door. In fact when I asked the charge nurse where is hand sanitizer was? There was none and suggested that I purchase some and keep it in my pocket and that there were sinks in the residents rooms. Other than that zero gel-in/gel-out stations in the entire place. Not to mention the short staff too.

Remember this was before COVID. I worked from October 2019 to January 2020. I think part of the problem, which is not an excuse is that they wanted to give the look of home and away from that hospital look. PPE stations and gel dispensers as you walk down the hall doesn't fit that look.

By the way, I was SOOOO glad to leave the place. The extra money wasn't worth it. I do wonder how many resident died there. The place looked nice from the inside and out. Nice garden, even a bunny loose in the hall way, beauty salon, art room, entertainment, and a ice parlor. With COVID all that crap isn't important.

DesiDani · Mar 8, 2021

Oh I forgot to mention. The place did have a lot of empty rooms. Maybe not a lot, but they had some. The thing is that no one was paying (private or Medicaid) for those rooms is my opinion why they weren't being used

amoLucia · Mar 8, 2021

Desi - sorry you experienced a 'rude awakening' re NH/LTC operations. It is sad, but very real that NH/LTC is like the locked away fair-haired Cinderella step-child in health care spending. It is NOT like acute care, as you found out.

Way back, it took forever for most facilities to install individual gloves dispensers in each room. And syringe boxes too. But I ask, where would you suggest that they put those isolation carts??? It's pretty typical that they were placed inside pt rooms. If in the halls, those carts could/would be tampered with by pts, families, other staff (for un-auth pt use).

Acute care gets most of the resources; NH/LTC struggles with what's allotted like measley handouts. IT IS NOT ACUTE CARE - bottom line.

And I'm curious re those empty beds - perhaps Medicaid 'mandatory day bed holds'?

DesiDani · Mar 8, 2021

4 hours ago, amoLucia said:

Desi - sorry you experienced a 'rude awakening' re NH/LTC operations

Oh I worked in them before, I just forgot. Just found it strange that isolated resident was kept in the same room as one not infected. Daybeds never heard of that in context of nursing homes.

amoLucia · Mar 8, 2021

NHs often just don't have the 'luxury' of moving around pts. Even though it may seem nec, all parties usually have to AGREE to moving. Like it has to be remembered that the NH is now the pt's HOME and the pt can't just be 'evicted'.