In your experience have you seen this happen?

[Smith-Lee]

I am not a nurse but a Radiologic Technologist for 39 years. Medicine has been my life many modalities. My mother is in a nursing home unable to verbalize because of a CVA. She has ogelvies syndrome caused by over medication with narcotics in this same home. She gets frequent UTIs. I was in checking on her last week and when we put her on the toilet via hoyer lift. I noticed a contusion at the pubic area. Looked live it had been pinched (fingers). She also had a large tear on her arm, not uncommon because of her thin skin. Although I told the nurse on duty when I went to remind her that her clonidine patch was 6 days over due for change, she didn't even look at the area of injury. The next day when I went in it was BLACK BLUE and as big as a baseball. I inquired again as how it happened. Got many different stories, was also told that she vomited that morning when I had observed the contusion. I think it was because it hurt so bad when they damaged her. The final story that administration gave me was that it was done when they did the cath for UA. I have done many caths for VCUGs etc and never heard of that happening. The report that they had given the Dr. as I inquired was there was a bruse about the size of a thumb. I don't want to cause any trouble but there has been ssooo many problems. In a routine cath placement could this happen?

[indiansfan]

Never in 25 yrs have I seen this happen. I would get her out of there fast then file a complaint with the state dept of health & the ombudsman. I have seen quite a bit & it is aweful what facilities get away with.

I agree, the facility needs to have some problems...that is neglect & abuse.

[morte, LPN, LVN]

My facility does NOT ever reek of urine...ever.

lol, i KNEW you would be around on that comment.......

[achot chavi]

My facility does NOT ever reek of urine...ever.

I beleive that,

no facility should "reek of urine"

but if you stand right outside a room where a pt is being cleaned of diarhea- you dont smell anything ? of course you deal with it and it passes fairly quickly, but come on, sometimes during diaper changes there are transient odors.

[CapeCodMermaid, RN]

lol, i KNEW you would be around on that comment.......

:loveya: It appears as if I have a reputation!!!

[morte, LPN, LVN]

:loveya: It appears as if I have a reputation!!!

i remember a thread where you were talking about that was a deciding factor if you would work at a NH or not.....so i knew you would get to this thread sooner.....or later, lol

[CoffeeRTC, BSN, RN]

Hey...even at my house we have "odors" at diaper change. To me, when someone says "reek" they mean all the time, every day.

One place I worked at could have been clasified as reeking (or maybe it was my hypersensitive sense of smell when I was pregnant). The residents were cared for, but there was no form of ventilation in this old building. A lot of windows didn't open, no exhaust vents...they eventually remodeled after I left.

Getting back to the OP....Good luck on getting better care for mom.

[debRN0417]

Reeking is when you walk in and it takes your breath and you don't understand why no one else seems to notice. Reeking is when it stays, and it is everywhere. Reeking is when your eyes water and your nose burns. Reeking is a sure sign of neglect.

I have only experienced reeking once.

As I said, there are some transient odors at times that can't be helped.

Most places do not reek...most places love their residents and care about them.

[expltcrn]

A string of awful actions:

Actual patient harm? Yes - bruise and skin tear

Failure to Notify the responsible party? Yes - you found the concerns during your visit, not calls initiated by the facility to you

Bruises and skin tears of unknown origin should always be investigated to rule out potential abuse (by the facility and their Abuse Prevention Coordinator)

Facility was negligent in its notification process

Did they even report it to the physician?

Failure to change the patch is also abuse/neglect

A surveyor would definitely find many many tags to attach to this event.

As for your mom, God gave her a wonderful daughter (or son?) like you to look out for her. I do hope you find a suitable alternative for her needs. It must be hard, but pulling her out of that facility was the right thing to do.

[Smith-Lee]

For all of you and your wonderful support. I have some follow up for all of you. I am waiting for a final report as it has been investigated. The Dr. is very involved and wonderful. There have been 4 discharged so far: Head nurse, assistant Head Nurse, Social worker inhouse, and another night nurse. Thanks to all of you and the support you offered. You all gave me the confirmation for what I already knew in my heart.

Thanks, for all of your professional advice and concern for the patient eventhough not directly in your care.

[achot chavi]

Hope your Mom is ok, thats whats important!!

[BoopetteRN]

I agree that your mom should be moved out of there. There should be a hotline number posted for public health in the facility. I would call that number and they will investigate that complaint. The facility would be in more trouble if they took any adverse actions toward your mom. Nursing homes like that are what give the ones that work hard to make residents happy and well taken care of bad names. I have worked in my facility for almost 37 years, and I have never seen a bruise like you described from putting in a foley.

[CapeCodMermaid, RN]

EXPLTCRN-What exactly is an "Abuse Prevention Coordinator"??? I've worked in 8 places and we never had anyone with that job title. At the end of the day it's up to all of us to prevent abuse and at the very end it's on the DNS and the ED.