Alright, so I need to vent (I seem to need to do this a lot, maybe I shouldn't work every day). EMS brings me a 93 year old man from a nursing home who fell from his chair and hit his head. Non-urgent, head lac, no biggie. Until, of course, I get him undressed.
This poor old guy was totally AAO and coherent. He had been moved to the nursing home because his wife couldn't take care of him alone any longer and they have no family. He's just old and fragile. I get his pants off just to assess his skin to see how well he's being taken care of and... he has cellulitis all up his right leg and he's red in his groin and backside. The doc is with me when I do this. He semi freaks out because there was no mention of the leg in his NH papers and the pt himself didn't really know he had cellulitis.
The patient starts to tell us how he's neglected at the NH. He is put in his room early he says, around 7 or 8, alone and without being checked on. He says he can't get anyone to help him get up to go to the bathroom or bring a urinal and is consistently wetting himself and laying in it until morning because no one checks in on him.
I call the NH and they tell me he's being treated for a wart on the bottom of his foot and they soak it in warm water. And he's not on any medications. Despite his being on medications per his paperwork. So at this point, I'm ******. I call his wife who was the POA and was very knowledgable when I spoke with her. She explained to me how he had been complaining to her about the care at the NH. When I asked her about the cellulitis, she said every day when she came to see him, they had socks and shoes on him so she never saw his leg. So, I hotlined the NH for neglect.
Throughout his entire stay in the ED, he just went on and on about how grateful he was for us just being there for him, taking care of him, paying attention to him. Even when I was bandaging his head, he went on about how gentle I was and that I never need to become like the people at the NH. I teared up when I had to go tell him we were sending him back to the NH. He just had the saddest look I've ever seen when I said that. All he wanted, he said, was to go back home, where he could be with his wife and not have people neglect him every day.
I just do NOT understand how anyone, whether it's a nurse, an aide, or a clerk could even witness neglect and let it go. When do people lose their ability to care about another human being? They might be old, but they are still humans with very real emotions and not all of them have dementia. The only thing this poor little old man wanted in the world was to be cared about. He wasn't needy or mean or anything less than kind. It's a tragic thing how far some people deviate from the line of caring.
My dad was in skilled nursing for exactly 3 weeks. It took me 2 weeks to find better. And this was considered an excellent facility but finding my dad in his clothes and heavy shoes taking a nap, finding him in filthy clothes, finger nails filthy, infection in his mouth because they did not remove his partial was enough to make me crazy. Moved him to a board and care where he got excellent care, loving skin care, etc. I pray I never end up in skilled nursing.
I doubt you'll see a difference in care between profit and non-profit...seriously...Oh, and BTW, some of the worst places I've been in have been owned by physicians. Sad but true.
I worked in a SNF when I was a CNA, for a brief time. It just was not humanly possible to provide the care those people needed, no matter how hard I worked. That's why I quit. I just couldn't live with myself.
As an RN in the ED, I have accepted patients from SNFs that I just couldn't believe the condition of. I found myself feeling angry, wanting to blame the staff, but then reflecting on my own experience, I realized that the staff were probably doing the best they could with not enough resources, and that my anger was more appropriately directed at the corporations that run those facilities.
I have thought about what it might be like to make a phone call, but then realizing that the people truly responsible, the people making the staffing decisions, would never be held accountable but instead the RN or LPN would take the heat, I have held back.
I worked in a SNF when I was a CNA, for a brief time. It just was not humanly possible to provide the care those people needed, no matter how hard I worked. That's why I quit. I just couldn't live with ....
I think this is brainkandys point. Why are these nurses not playing hardball? Taking pics and anonymously forwarding them. Marching on the state capital, etc?If they say nothing and don't leave at all as a sign of protest, what does that say about them?In this way, brainkandy and I think alike. Silence is acquiescence.
Oh, I know. I've had the same thoughts when I've read about the conditions at some facilities here on AN. For that matter, why aren't *all* nurses doing these things? We all know what LTC facilities are like, we all know what hospitals are like, why aren't we all marching on our capitols holding protest signs?
As said earlier I have taken pics and sent to county health dept. With name of facility. I plan on continuing. I bet it is against hospital policy. Oh well. My patients come first.
I work in an ED in the Hampton Roads, VA area, and I see it all the time. There are good SNF's and bad ones. Every time I get a patient from certain SNFs, I know I can expect a "hot mess", not just the chief complaint. I hate seeing these poor people like this. I try to take extra time with them and be kind even if they are not so pleasant sometimes. I will feed them and make sure they are comfortable. Lots of times, they don't even have a family member with them in the ER, so I will try to sit for a little while with them if I have time. The other problem with the SNF's is that the nurses there are overloaded, and they do not have the freedom that we ED nurses do to use their critical thinking (i.e. a SOB asthma patient comes in, I can start stacked nebs without an MD order since we have protocols in place) so the policy at the SNF is to transport for anything abnormal rather than try to treat there because an MD has to see the patient before any new treatments. It sucks all the way around. I have an advance directive already to NEVER put me in a nursing home.
Guest372004
425 Posts
My dad was in skilled nursing for exactly 3 weeks. It took me 2 weeks to find better. And this was considered an excellent facility but finding my dad in his clothes and heavy shoes taking a nap, finding him in filthy clothes, finger nails filthy, infection in his mouth because they did not remove his partial was enough to make me crazy. Moved him to a board and care where he got excellent care, loving skin care, etc. I pray I never end up in skilled nursing.