Stable Vent Patients in LTC

Nurses General Nursing

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My workplace (an older nursing home) is thinking of admitting stable vent patients in order to raise the census and profits.

When I lived in California, the subacute facilities would be full of these stable vents. However, the nurses only cared for perhaps 10 or so patients due to the acuity level. My current place of employment staffs 1 nurse for every 30 residents. We already have residents with simple IV meds, PICCS, trachs, colostomies, etc.

I am willing to work with stable vents as long as nursing staff is increased, and as long as I am properly inserviced, oriented, and trained by the company to care for patients on ventilators. However, the company does not plan to increase staffing. The turnover rate for nurses is already profound.

I am praying that the admissions manager chooses not to admit the stable vent patients if they don't plan to include training and employee retention in their plans for the future of the facility.

I work full-time weekends (16 hour shifts on Sat and Sun) which enables me to attend school during the week. I need a weekend job for as long as possible, which is why I work at this place.

I hope someone tells me I'm overreacting.

We have vent patients where I work at an LTAC, but we are still 5-1 and the nurses don't touch the vent settings AT ALL! We record numbers and hit 100% oxygen before doing inline suctioning. I don't know how they expect you to have vents without RT to check the settings and wean them off. Sounds crazy.

Commuter, how did it work out with the vent patients?

Specializes in pulm/cardiology pcu, surgical onc.
We have vent patients where I work at an LTAC, but we are still 5-1 and the nurses don't touch the vent settings AT ALL! We record numbers and hit 100% oxygen before doing inline suctioning. I don't know how they expect you to have vents without RT to check the settings and wean them off. Sounds crazy.

If they're on long term vent therapy no settings should be changed, they won't be weaned off. But that could be really tough with having to suction and do neb tx's on top of what you already do. Realistically though you only have a few more months and it could take them that long to get a vent patient.

Oops didn't realize this was an older post.

Specializes in ICU, PICC Nurse, Nursing Supervisor.

to me this situation spells out trouble...i work for a ltc and i know how cheap they are...your turnover will increase and so will the lawsuits.....

to me this situation spells out trouble...i work for a ltc and i know how cheap they are...your turnover will increase and so will the lawsuits.....

as well as the incidence of vap's (vent-acquired pneumonia) will escalate, i'm sure.

i'm pretty confident staff would be inserviced...

but i'd be leery w/o rt present.

everything in life, is hunky dory, until something goes awry.

then the proverbial poop hits the fan.

i feel badly for these vent pts as well.

commuter, just think of all that experience you're accumulating.:cool:

leslie

Specializes in med-surg, psych, ER, school nurse-CRNP.

And what, may I ask, do they plan to do in the event of a power failure? Are there backup generators? Are there going to be enough staff to bag the vent patients if there are no backup generators?

This is just very wrong and very unsafe on more than one level.

Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
Commuter, how did it work out with the vent patients?
The facility got into trouble with state surveyors, so management decided to abandon their plans of admitting patients on ventilators. I did have one alert vent patient, and thank goodness that he knew what to do when his alarms sounded off. Thank goodness that the power never went out.

I resigned from this company nearly 7 months ago, and my stress level is lower.

Specializes in Med/Surg, ICU, educator.
Surely a patient's family will look at some guidelines before allowing even a stable vent to be treated at a facillity without a RT http://www.ardsusa.org/inpatientrehab.htm

some families want the cheapest facility that they can get away with. I worry about this....

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