I work in ICU. Time and time again I have gotten an admission from a NH were the patient looks as though they've been left to rot in a corner until someone finds them in such an awful state that they call EMS.
Now please dont think I'm saying ALL nursing homes are like this. I'm sure they aren't. I simply need to vent a little.
90% of the NH pts I get need a complete bath at the time of admission. This includes scraping off old stool and providing oral care for 10 minutes because there is so much gunk in their mouths, among other things.
What topped it off was Wednesday, when I admitted a patient who had been in our ICU for months with multiple problems, VRE, MRSA, and had finally gotten out of the hospital just recently. She had been placed in a local NH. I admitted her, intubated...foley in "place"... lactate 7.5 and in septic shock. No urine in foley tubing or bag. Not a CRF patient. We turn her to do the usual complete bedbath for NH pts and we see urine coming out. Ok no biggie, we figure the foley is leaking. Well turns out it's not even in the right spot. We inserted a new foley in the CORRECT orifice and out came about A LITER of PURULENT OPAQUE "URINE".
Now I'm not going to point fingers, but isn't it a common nursing practice to check for URINE when inserting a foley??? I wonder where her septic shock came from!
Not all nursing homes are bad, but the ones that are need to be reported to the state. Maybe they got that bad because they weren't reported, and that's a shame. As for the owners that let this happen for the profits-----may they end up in the Devil's nursing home.
I've worked in some that get reported over and over. The state comes, nothing happens. Inspection comes, they get maybe 1 or 2 tags.
It's ridiculous. The state is practically worthless.
It's ridiculous. The state is practically worthless.
Amen to that^^^ The only thing that happened after the state came to our facility was another form for the nurses to fill out!!!!
I used to also bring my own supplies; lotion, deodarant, etc...because the ones with no family (and that was many of them) did not have the custom supplies that the nursing home is supposed to provide. Most of the nurses were appreciative, but then, one nurse stated that we should be careful doing that, because the outside supplies may cause allergies.
I also have advised the CNAs I work with to not bring supplies from the outside for that reason. We have adequate supplies for ADLs but the quality is horrendous so the aides like to buy something a little better for the residents.
Thanks for all the replies. Can you believe they had a foley in the wrong place though!!? The CT showed bladder distention and slight hydro... I wonder if thats part of the reason??!!
God bless you all, who work to take care of our elderly.
We will be in the same boat some day. It's the way our western world is structured.
The problem, as stated above, is the lack of meaningful government regulation enforcement. If that doesn't change, then criminals will continue to break the law running holding cells that torture our elderly.
You know, the meat packing industry used to be very, very bad. But then Upton Sinclair wrote "The Jungle", which woke up America to the filth that they were eating. The public outcry led to changes in legislation, which cleaned up our meat packers.
Maybe it's time for someone to write a new "The Jungle" focusing on the nursing homes that are ran by criminals.
God bless you all, who work to take care of our elderly.
We will be in the same boat some day. It's the way our western world is structured.
The problem, as stated above, is the lack of meaningful government regulation enforcement. If that doesn't change, then criminals will continue to break the law running holding cells that torture our elderly.
You know, the meat packing industry used to be very, very bad. But then Upton Sinclair wrote "The Jungle", which woke up America to the filth that they were eating. The public outcry led to changes in legislation, which cleaned up our meat packers.
Maybe it's time for someone to write a new "The Jungle" focusing on the nursing homes that are ran by criminals.
Good idea. Except our meat industry is still filthy...
Specializes in med-surg 5 years geriatrics 12 years.
No not all nursing homes are bad; I work in a GOOD one now but have worked in the bowels of hell in the past. At first couldn't leave cuz I knew they would get good care on my shift; after a while I realized that they would never change as long as people like me enabled them. But it comes down to no regulation of staffing ratios. Have worked where CNAs had 15-16 people apiece and 1 nurse for them all. no matter how hard you try, with those numbers good care is impossible. We talk about taking care of our elderly but we don't follow through well .
It's the staffing. I worked in a great place but the CNAs who were there for 10+ years would talk about how in the past staffing levels were better. They could spend a lot more time with the residents.
BTW I did have some problems with a few residents who REFUSED to bathe and were combative. It was very difficult to take care of them. Sometimes family had to come in to do it but I made sure it was documented and DON, social worker & family knew about the problem and worked on a solution.
Specializes in LTC, Disease Management, smoking Cessati.
I work in ICU. Time and time again I have gotten an admission from a NH were the patient looks as though they've been left to rot in a corner until someone finds them in such an awful state that they call EMS.
Now please dont think I'm saying ALL nursing homes are like this. I'm sure they aren't. I simply need to vent a little.
90% of the NH pts I get need a complete bath at the time of admission. This includes scraping off old stool and providing oral care for 10 minutes because there is so much gunk in their mouths, among other things.
What topped it off was Wednesday, when I admitted a patient who had been in our ICU for months with multiple problems, VRE, MRSA, and had finally gotten out of the hospital just recently. She had been placed in a local NH. I admitted her, intubated...foley in "place"... lactate 7.5 and in septic shock. No urine in foley tubing or bag. Not a CRF patient. We turn her to do the usual complete bedbath for NH pts and we see urine coming out. Ok no biggie, we figure the foley is leaking. Well turns out it's not even in the right spot. We inserted a new foley in the CORRECT orifice and out came about A LITER of PURULENT OPAQUE "URINE".
Now I'm not going to point fingers, but isn't it a common nursing practice to check for URINE when inserting a foley??? I wonder where her septic shock came from!
Such a shame.
It's about staffing, most NH's use the least staff possible, get one call in and poof you're even shorter. I've worked in LTC and I know that 90% of the time we worked short staffed. Now what you describe is negligent, but it also comes from not having enough staff to cover the care residents need. Not all are so bad, and it is sad to see it happen.
As long as the almighty dollar is more important to the owner's of the home, than people who reside there, the problem will remain.
I've worked in some that get reported over and over. The state comes, nothing happens. Inspection comes, they get maybe 1 or 2 tags.
It's ridiculous. The state is practically worthless.
After my late father died at the hands of a similar facility, my family and I reported them to our State's ORS. When they did NOTHING, the only recourse we had was to sue them. We settled out of court. While we realized that NO amount of money was going to undo the damage they had done to him or bring him back, all we wanted was for them to be held accountable. They made off like bandits (as did our attorneys), getting away with the claim that what happened to our Father "wasn't THEIR fault".
I wish I could tell you what they did (and didn't do) to him. It would make you SICK.
But I can't, because of the Privacy Agreement we signed as part of the settlement.
I too worked in LTC, I quit after they kept sending nurses home and CNA's early. After 9pm there was 1 nurse and 2 aids for 56+ patients. It wasn't safe and they did not get good care. Heaven forbid we should want to spend quality time with our patients. I now work for Hospice and go see pts in the LTC facilities. I can spend as much time as I want/need with them and it is the best choice I ever made.
Maybe the problems is that government is TOO involved, or is involved at all, in the regulation of these nursing homes. Seems the free market should be able to rgulate itself. Those that provide the best care get the most patients, etc.
I have no idea how it all works financially -- I'm just talking off the top of my head.
I know it speaks volumes on our society how we treat our elderly. I will be there myself in a shorter time than most -- and I'm sort of hoping for a quick, fall-down instantaneous death of some kind when the time comes, just so I dont have to end up in one of these places.
Oh, and didn't family used to take care of its own? It's sad.
I think overall, also, the breakdown of society has led to more indigent, psychiatric sort of patients as well, and just to patients whose families are broken through divorce, etc.
This country has big problems. Not enough folks either to take care of the overwhelming tsunami of baby boomers coming our way.
Anyone remember seeing movies where old people went to "rest homes"?
That was then. On the unit I used to work almost no one was ambulatory, all had some degree of cognitive dysfunction, many were combative, and I used to get into trouble for advocating.
It's all about not getting cited.
I'm back in the same facility in a different capacity and can't tell you how many times I've passed by the same resident still smelling of pooh hours later - but there is SO MUCH NONSENSE required by state.
WHY does every resident need to get up every day? WHY do they need to go to the dining toom for "quality of life" when they don't know if they're on Earth or Mars? WHY do they need to be fully dressed as if for company every day? And WHY are they getting thousand of dollars of EPO and B12 a month when we could take that money and HIRE MORE AIDES to care for them the way they should be?
We spend too much time jumping through hoops for survey regarding documentation and stuff and not enough on our people.
Atheos
2,098 Posts
I've worked in some that get reported over and over. The state comes, nothing happens. Inspection comes, they get maybe 1 or 2 tags.
It's ridiculous. The state is practically worthless.