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!
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.
Yep. Too much intereference. They won't even adhere to the same regs that they expect their "licensed" facilities to follow.
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.
So am I. My sister is still riddled with guilt over what our father went through. We had no choice but to put him in this particular NH following his stroke, for she was recovering from a fractured ankle and I couldn't afford to take unpaid leave from work to take care of him under FMLA. I wanted to place him in another facility which was closer to us and had an excellent patient care record, but was told by their Admissions Department that there was already a two-month waiting period for a bed. In the meantime his Medicare days at the rehab facility he had been a resident at for the past five weeks were up, and they wanted him transferred ASAP. Three weeks later we were forced to remove him from that Hellhole we had put him in. He died peacefully at my sister's home 48 hours later.
Oh, and didn't family used to take care of its own? It's sad.
Oh, yes. I remember "waiting" on my great-grandmother when I was five years old. My grandmother and mother both took care of her at home before she died. The days of the Extended Family are but just a memory.
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.
We are dealing with that same issue at work right now. One of our Clients was just kicked out of a facility for flying into a fit of rage and assaulting another Resident. His family doesn't want him either, so they have appealed to the State to get his Termination from CCSP Medicaid overturned. He belongs in a Group Home, but funding cutbacks have nixed that. :typing
This country has big problems. Not enough folks either to take care of the overwhelming tsunami of baby boomers coming our way.
Yep...and my sister and I are two of many MILLIONS........
My experiences are not quite that bad, but I do remember washing a lady and squeezing muck out of her belly button like it was pus. What ever happened to basic hygiene.
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.
Nothin personal...or maybe it is...but why would you pass by the same resident smelling of poo, without changing them? No matter your title? or at the very least be sure that it was being taken care of? May I ask in what capacity you are working in now?
Nothin personal...or maybe it is...but why would you pass by the same resident smelling of poo, without changing them? No matter your title? or at the very least be sure that it was being taken care of? May I ask in what capacity you are working in now?
I am in the systems area now, as the informatics nurse. Were I to change a resident or call it to anyone's attention my boss would get a nasty email that I was interfering in the nursing home.
I am in the systems area now, as the informatics nurse. Were I to change a resident or call it to anyone's attention my boss would get a nasty email that I was interfering in the nursing home.
Situations like this are kind of touchy because changing the resident is the right thing to do. However, everyone has a job that they are responsible for and if you always stop to do someone else's job and then you cannot complete the work that YOU are responsible for then what happens?
Nothin personal...or maybe it is...but why would you pass by the same resident smelling of poo, without changing them? No matter your title? or at the very least be sure that it was being taken care of? May I ask in what capacity you are working in now?
Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
I am going to be rather blunt, and my reply might offend some people. At my workplace, caring nurses are viewed as a threat to the nursing home operation. The DON and management will do underhanded things to rid the facility of good nurses, because they are more likely to report wrongdoings. Since many LTCs suffer from bad management, the only people who can get along with bad managers tend to be uncaring nurses and rough CNAs. Like attracts like. Being a good nurse in a bad LTC is a drain to the soul, like a vacuum that sucks the joy out of you. I'd hate to sound pessimistic, but it is immensely difficult to bring about change in a vacuum.
Nursing homes tend to get the short end of the stick because of societal attitudes regarding the elderly. Elderly people in America are marginalized and often deemed no longer useful to society, so they are shoved to the background by lawmakers, administrators, and some family members.
Any nurse who works in LTC knows very well that a significant number of their elderly patients never receive any visits from family or friends. The ones who actually get visits typically receive them on a very infrequent basis. Only about 25 percent of my elderly patients are visited regularly by their loved ones. So, yes, many family members are using nursing homes to shove their elderly, unwanted relatives to the wayside. And, how can lawmakers, administrators, and the state care if countless family members no longer care? I call it the circle of uncaring...
:yeahthat: I agree 100% as cold as it is the truth is the truth.
Being a good nurse in a bad LTC is a drain to the soul, like a vacuum that sucks the joy out of you.
It's only been six months for me and I feel like I have got to get out of the NH or I will go crazy. It's not the hard work that gets to me it's the fact that what goes on at times just isn't right and there isn't much that I can do about it.
I am going to be rather blunt, and my reply might offend some people. At my workplace, caring nurses are viewed as a threat to the nursing home operation. The DON and management will do underhanded things to rid the facility of good nurses, because they are more likely to report wrongdoings. Since many LTCs suffer from bad management, the only people who can get along with bad managers tend to be uncaring nurses and rough CNAs. Like attracts like. Being a good nurse in a bad LTC is a drain to the soul, like a vacuum that sucks the joy out of you. I'd hate to sound pessimistic, but it is immensely difficult to bring about change in a vacuum.
Nursing homes tend to get the short end of the stick because of societal attitudes regarding the elderly. Elderly people in America are marginalized and often deemed no longer useful to society, so they are shoved to the background by lawmakers, administrators, and some family members.
Any nurse who works in LTC knows very well that a significant number of their elderly patients never receive any visits from family or friends. The ones who actually get visits typically receive them on a very infrequent basis. Only about 25 percent of my elderly patients are visited regularly by their loved ones. So, yes, many family members are using nursing homes to shove their elderly, unwanted relatives to the wayside. And, how can lawmakers, administrators, and the state care if countless family members no longer care? I call it the circle of uncaring...
CseMgr1, ASN, RN
1,287 Posts
Yep. Too much intereference. They won't even adhere to the same regs that they expect their "licensed" facilities to follow.
So am I. My sister is still riddled with guilt over what our father went through. We had no choice but to put him in this particular NH following his stroke, for she was recovering from a fractured ankle and I couldn't afford to take unpaid leave from work to take care of him under FMLA. I wanted to place him in another facility which was closer to us and had an excellent patient care record, but was told by their Admissions Department that there was already a two-month waiting period for a bed. In the meantime his Medicare days at the rehab facility he had been a resident at for the past five weeks were up, and they wanted him transferred ASAP. Three weeks later we were forced to remove him from that Hellhole we had put him in. He died peacefully at my sister's home 48 hours later.
Oh, yes. I remember "waiting" on my great-grandmother when I was five years old.
My grandmother and mother both took care of her at home before she died. The days of the Extended Family are but just a memory. 
We are dealing with that same issue at work right now. One of our Clients was just kicked out of a facility for flying into a fit of rage and assaulting another Resident. His family doesn't want him either, so they have appealed to the State to get his Termination from CCSP Medicaid overturned. He belongs in a Group Home, but funding cutbacks have nixed that. :typing
Yep...and my sister and I are two of many MILLIONS........