Yikes! Another bad observation at an LTC facility - page 5

YIKES!!!!! That's about the only word I can express about this one. Got off a weekend night shift (through my agency) at a nursing home I have never been to previously. I prefer to stick to... Read More

  1. by   JetLPN
    :roll Like ive said before "its always something " !!!! and "what goes around comes around "MMMEEEowwwww!!!!!!!!
  2. by   lateblumer
    When I started nursing school, our first clinicals were at a place that is on the list for Ohio. I knew that I would see things like you see on tv. The very first patient I was assigned to was a 300lb female who was a total care. She could not even wipe her own nose. The Nurses called the Students in to observe a dressing change. As I prepared my self for what I was about to see, the stench of this decub almost made me vomit. I stepped back behind the curtain, and could feel myself losing it. Two nurses were holding her over onto her right side, while the nurse doing the dressing change, pulled out approx. 3 feet of gauze. The decub on her coccyx was so deep that i could have put my fist up to my wrist into it and not touched any of the surrounding tissue. I immediately burst into tears and turned away. My mind thought "This is the most horrible case of neglect I have ever seen. If the family could see this..." And the nurse said, "oh my, it certainly looks a lot better. (than what, I thought).

    At any given time during our week there, at least two people could be found in their "butt hutt". Yet all day, we saw neglect after neglect.

    Is it understaffing at most facilities that causes this type of neglect?

    Or is it that the person assigned to them, didn't take the time to comfort and NURSE them back to good health?

    I wish you worked for the agency that our facility uses. Those people are only there for the pay. Thank you for restoring my faith in "pool people".
  3. by   TracyB,RN
    Eddy, your experience has just given me the kick in the rear I have been needing.
    I was hired by a large LTC to be the treatment nurse. OOOOPS, BIG mistake on my part. Something was telling me don't do it, but I did it anyway, thinking I would be the one to help these residents. After constant short staffing, and constantly being pulled from my assignment as treatment nurse, I was getting verbally reprimanded for "not completing treatments in a timely manner" I asked how I could possibly complete some pretty major treatments for 30 plus residents when I was pulled to the floor to do med pass at least half of my scheduled tx nurse days. I was told to just get it done. HOW?!?! So, I am basically responsible for skin checks for 83 people, dressing changes for about half of them, and get to be pulled 2-4 times a week. On the rare occasion that I get to do treatments 3 days in a row, I am questioned when I report the new Stage II's, "why didn't you discover this sooner?" To add insult to injury, I get to deal with some idiot family members telling me how to do my job!!!! God forbid, that "mom" doesn't have neosporin on her head, I am trying to do a 4 hour med pass now, thank you very much, but am told by these family members that they will not hesitate to call state, because I am an 5 minutes late giving mom that neosporin. Fortunately for me, I have kissed butt very well with that family & others, & they KNOW that I will always take care of their mom before I go home. They actually thanked me & told me that I am the ONLY nurse that actually does her treatment. Hmmmpphhh.
    It is a sad time for the elderly.
  4. by   sassynurse78
    Thank you for reporting this. I hope the place gets what they deserve. This has to be one of the worst things I have ever heard. Keep us posted.
  5. by   debRNo1
    Originally posted by TracyB,RN
    I have kissed butt very well with that family & others, & they KNOW that I will always take care of their mom before I go home. They actually thanked me & told me that I am the ONLY nurse that actually does her treatment. Hmmmpphhh.
    It is a sad time for the elderly.

    I think kissing butt actually allowed me to survive a long time in LTC. Better that than a call to the state !!?? I used to do what I called TLC rounds on my residents. It usually involved a kiss, a hug, or just a smile or reassurance from me. It was just a good way to start off the shift and get the crazy ones where you want them. Families got a GOOD earful about me when they came to visit and a few words with them was time well spent for me !!!

    We had a family write a scathing letter to mgt about the care that mom received and how her dressing wasnt done. Nothing ever came of it and the nurses excuse was fully accepted. She claimed that when she did the tx the resident was asleep thats why she never remembered her in there ?

    I was picking up orders one day and accidentally happened upon this: It seemed funny how a guy got coverage almost QD except when the same nurse above was on. Guess she didnt know that the glucometer had a memory !!?? She was making up FTG's under the coverage amount and not giving this poor guy insulin. nothing came of this either, she is still employed and I got labeled a RAT. how do they sleep at night ????

    I had just seen enough and now Im out of LTC but....
    KUDO's to those who have the balls to report these H*LLHOLES and the staff that work there.

    ditto this: It is a sad time for the elderly. :imbar

  6. by   caliotter3
    The county DA brought criminal charges against a large chain hereabouts and won the case. Made national news a few yrs back. If you want to, you could "clue in" the media. That usually gets the ball rolling. You could also "clue in" the state, but somebody I know who did once, told me, she got caught off guard and gave her name when asked. You can guess what happened to her.
  7. by   Betty Smith
    Stat minimums for staffing in LTC have not been updated in 15 years. what do you expect? Our LTC facility stays above the minimum and still does not have enough staff and of course, company won't pay for more. They recently decreased a few of the "extra" employee positions. Nurses should demand Nursing Boards update the stafing ratios for nurses and CNAs. Of course this would close some facilities but what is the alternative? Dead or injured pts.
  8. by   Betty Smith
    If a nurse is endangering pts and you have the proof (glucometer) you can notify your state board They will investigate themselves.
  9. by   RN2B2005
    Wow, I checked out my state (WA) on that Member of the Family link, and it seems like every single nursing home I've ever heard of is on the complaint list. Even Bailey-Boushay House, a nationally recognised hospice for HIV patients, is on the list.

    So, is neglect or outright abuse endemic in nursing homes? Or is it something about the reporting process that skews the figures? I sincerely hope it's the latter.

    Anyhow, kudos to Eddy for reporting that facility. If something like that happened to a relative of mine, I'd be kicking a*s and taking names (and licenses!).

  10. by   Catsrule16
    Unless you know the specific "F" tags cited at a facility, I would not be too quick to judge a facility based just on what you see on websites. While the websites give you an idea of a facility's past performance, the actual details in the deficiency statements of the survey results give specifics. I have seen F 309 Quality of Care and Services cited because a Nurse forgot to pre-medicate for pain prior to performing pressure sore treatment. The resident flinched and grimaced in pain during the treatment. Because the staff member inflicted pain..... this was cited at the "G" (HARM) level. One observation. One human mistake. There are specific tags that speak to Abuse and Neglect. They fall under Resident Behavior and Facility Practices F 221 - F 226. Just because something is cited at a Harm level, doesn't mean the facility is abusing and/or neglecting a resident.

    Many of the complaints I have investigated, have been unsubstantiated. I have only been able to substantiate 2 cases; one neglect (a Nurse) and one verbal/mental abuse (a CNA). I haven't made it to the State Board of Nursing yet to testify and verify my findings. The CNA is apealling her case. All our reports are reviewed by the state's attorney's office for possible legal proceedings and criminal charges.

    I commend Eaddy for having the guts to report his/her findings. :hatparty: We all need to be more pro-active and remember we got in to nursing because we care!
  11. by   Hellllllo Nurse
    I tried speaking up against poor conditions at nursing homes for years.
    I worked in LTC for years, but I will never do it again.

    The deck is stacked against the pts and the nurses. You just can't win.

    God help us all.
  12. by   realmean1
    I work at a LTC fac as a supervisor and also cover 12hr shifts in an LPN slot: meds, tx, etc. I sympathize with those who work in h#llholes. I certainly agree that the steps Eddy took were excellent. I guess I am a troublemaker at my fac., when I see something wrong, I usually bit#h about it, until something is done. My current targets are unnec. drugs and figersticks. Have yet for an RN to justify sticking someone's finger every day for months with no change in routine insulin or oral meds. Routine tylenol every 6hrs for yrs. Megace for yrs, even when the pt is eating well. My all time fav. Ventolin treatments, 3 bronch dilators, nasalnex, give Tussex for cough. These are all v.o. by the nurses. The MD has no clue what all His pts are taking. 6am med pass takes as long as 9am. Can someone tell me why a geri pt needs lo-dose synthroid at 6 am????? with no hx of thyroid problems??????
  13. by   night owl
    We usually tell the doc who comes in every morning if we think he/she needs the nebulizer tx or not and the doc will review the order, examine the resident then draw his own conclusions from there, but at least we make the doc aware of it...Now if we could clear up the unnecessary FSBS. What would you consider unnecessary?