Geriatrics in ED

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Specializes in ICU/ED.

A lion's share of our patient's are 65 or older, especially those that get admitted. NICHE is gaining speed on other units and the ENA has launched GENE. My ED is trying to get the ball rolling on improving care for this population and I would love to know what other EDs do or wish they did.

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Specializes in Geriatrics and Quality Improvement,.

I sent my Geri patients to the ER, and I am aware from them of issues they have had, and can make one or two suggestions.

There is a hearing amplifier that looks like a CD player, headphones and all, which would enable them to hear you when you are talking. We dont like to send the "little things" like hearing aides when they go over, because here at the LTC place, we have a system and routine where they go in and come out, there with you, they get lost when the system fails.

Geriatric people in LTC live by a routine they can count on. Sending them to you disrupts that. Having a series of steps presented to them, first this then this will occour, then we will make a decision & tell you. (If this is possible) I know as an adult in the ER, sometimes the decision to make or change a test is made behind the desk, not with the patient. Knowing what is happening is so important. The what next fear is overwhelming and causes people to start refusing or acting in ways unfamiliar to you and them.

Dont ask if they are comforatble on the stretcher, they need NEED to be turned even in the ER, every 2 hours. Wrap a tourniquet on your arm for 2 hours, snug, not tight. See what that feels like. Thats what is happening to their butt, asnd they HAVE to spend time on it, seated or in bed.

Go to them and say, you need to lay on your left/right side for a little while. Alleviating the pressure is monumentous! Im not asking you to massage their butt, incontinence care is so important. Do this in the same way the phlebotomist says I need to draw blood, and the Nurse comes with medication. It is important and necessary part of the 'wholistic' approach. I have received patients back with underlying 5 cm stage II, from a 3 -5 hour ER visit. It only takes 2 hours to create a pressure ulcer.

Skin care, making sure they have devices by which they can hear/understand you, and communication of plan. These three things are the top of my list.

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Specializes in ER, education, mgmt.

Sitcom- As an ED nurse please allow me to say thank you for the above information. We completely let these things slide and it SHOULD NOT BE SO. Seeing the visit from the perspective of the elderly LTC patient has been beneficial to me and I will share it with my colleagues. God bless you for your work with the geriatric population, not just any nurse could do that!

Cookienay

PS- I have no idea what NICHE or GENE is.

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Specializes in ICU/ED.

NICHE- Nurses Improving Care for Health system Elders

http://www.nicheprogram.org/

GENE- Geriatric Emergency Nursing Education

http://www.ena.org/coursesandeducation/education/GENE/Pages/GENELanding.aspx

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Specializes in Geriatrics and Quality Improvement,.

I am more than happy to help the elderly.

I hope my information is helpful to coordinating an effort at your facility.

As well as the NICHE and GENE! lol.. Good Luck!!

:jester::nurse:

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After UTI's, pneumonia's and falls, mental status changes, never forget impactions. Yes, gurney's suck, had to lie on one 12 hours myself before they gave me a bed. Incontinence pads? Friendly known face? No, all strangers.

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