what can you say - page 2

Howdy yall from deep in the heat of texas I will never understand nursing homes or nursing home nurses. After another lovely weekend with sick people, trauma of all sorts. psych... Read More

  1. by   RainbowSkye
    I know. I wonder what the answer to this is. I know the nursing home staff are overworked and underpaid, but.... A couple of weeks ago I had a gentleman come to our ER from the local long term facility. I was told in report (these nurses always do call, well almost always) that he had cut his hand during a visit to the doc earlier that day. Come to find out this nurse call 911 for a wound she had never looked at (the folks who transported him to the doc's office bandaged him). The laceration turns out to be an itty-bitty skin tear. Now there's no way to get him back to "the home". Which is okay because the man is febrile, stinks to high heaven of nasty urine (which turns out to be solid green when I cath him). So he gets admitted for uroseptis. Makes us nurses look bad.
    Do any of you nurses who work in long term care have any suggestions?
  2. by   JE1RN
  3. by   Coldfoot
    ...they are just as helpful to the Medics when they pick'm up at the Home. Try to be understanding when the Medics can't answer those silly questions like "How long has he been like this?" or "If this is confussed then what is baseline?" Just gotta throw out a couple experiances.......IM D50.......Call for ALOC, arrive to find a HUGE PULSATING MASS IN THE ABD with bp of 80/60....... IV Start for dehydration sec. to overdose on Lasix..... Gotta drive you nuts sometimes
  4. by   flashpoint
    LOL...We see stuff like this all the time. I work ER and I'm a volunteer paramedic, so I tend to catch it from both ends. I just love it when we show up at the NH and the nurses yell at us for opening up the transfer packet..."That's confidential....that's for the ER, not for you!" Well, if you want this lady to get into my truck, you'd better give me a little history. We have one NH that sends us patients for enemas all the time. The best (worst) was when I was in paramedic school. Picked up a lady at the NH for "severe respiratory distress." We show up and the lady is there in bed, flat on her back, and mouth breathing - her tounge was STUCK (tight) to the roof of her mouth. Her sat was 76% and her resps soundsed like STRIDOR! My preceptor rolled up the HOB, I did a little oral care with those little pink sponges and got her tongue loose...and what do you know? Her sat came up to 99% on room air and her "stridor" went away.
  5. by   Indiana ED RN
    [QUOTE]Originally posted by traumarns
    BUT ALAS, no phone number, address, or name of the ltcf on the face sheet. just the pts information, diagnosis, religion, core status....

    Hello All

    I must agree with the above comment... but I find something even more amazing. The many times I have had a patient come in that is altered and the paperwork states he is DNR. Fine and Dandy if the patient could tell me his name....because there is not an armband to be seen. My newest trick for this is to have someone come from the nursing home to verify who the patient is and have them place an armband on their patient!

  6. by   Kayzee
    Been reading your posts, and hope you realize that there are good LTC facilities. I work at one, and these people get the best of care. I realize there are many bad ones out there, and I wish something could be done to close them. I'm shocked at some of the care and conditions of these facilities. When we send out a resident, info is definetly sent with. Too many of our fragile elderly are not monitored or given the care they desrve.
  7. by   tatianamik
    Originally posted by teeituptom
    I will never understand nursing homes or nursing home nurses.
    I had one refuse report on a patient that we were returning. NH stated mental status changes (told paramedics that they had arrainged a direct admit to the psych floor as she had a psych history, but that was not done). All our Doc could find was a UTI. They refused to accept the patient back. We went so far as to call the administrator of the nursing home at thier house at 3am. The administrator refused to accept the patient back. Licenseing board was getting a phone call the next morning...
  8. by   RNFROG3
    i like the one where the NH across the street from the hospital calls 911, calls report to the ER for resp distress or code in progress and then the paramedics call us back asking us to call the NH to let them in. They are LOCKED OUT!!!
  9. by   AngelGirl
    I worked in a Nursing Home briefly years ago. An aide came to find me to report that a patient had no pulse. I checked the DNR status report first. The patient was a 'No Code.' The aide accompanied me down the hall, explaining that the patient WAS still breathing, but had no pulse. Huh? I'd loved to have seen her CPR exam! Scary.
  10. by   Chiaramonte
    I am enjoying the scenerios here!! Amazing that there is a commonality of complaints. I also work in the ER at night and have never gotten report from any of the 3 Nursing Homes here before they send their patients in. But on the other hand, try to get these people transported back...takes many phone calls...should be their problem...not ours.
    I always feel so frustrated when they come in gurgling and need suctioning from the aspiration pneumonia they've recently acquired from being fed through their peg tube and laid flat afterwards.
    I know there are exceptions to the rule and there are good nurses working in most of the homes but it's just those few that ruin it for everyone...
  11. by   berry
    my fav is to ask the nurse calling you report on a pt the are sending over for resp distress and you ask for v/s you get the long pause then a hold ...........wtf i always ask 9/10 times they dont know course no big deal as you will get an ems report in route and actually find out what is going on with the pt. My biggest pet peeve is pt in arrest situations with no lines damn NH have RNs i am sure of it how can you send a pt with no line i know you had time between finding them and ems arriving, and howbout switching form 2lnc to a nrb for pts with sats in the 70's
  12. by   LilgirlRN
    The grossest is when the NH sends in a patient who codes and you pop their dentures out before they get tubed and you can tell they haven't been cleaned in several months. One of the only things that makes me wanna vomick.
  13. by   deespoohbear
    We got a male patient the other day from a nursing home in the ER. The NH reported the guy had peed after they anchored a foley the day before. Bring the guy in, the ER nurse deflates the bulb, advances the foley, and SHAZAM! urine. Go figure? Called them back and said guess what? You are getting this 90 y/o full of cancer, confused, full code back......