It's just a ******* straight cath!!!

%D#2 · Feb 10, 2016

Lupie,
I see lately stuff sorta stinks at this employer and you were contemplating leaving lately (or at least looking for another position). I wonder if any colleagues found out and are being jerks more so than normal, if this is a known fact or around the gossip cooler, or water cooler, where gossip occurs, whatever that saying is!!)
If this is normal yeah, sounds like you're more than ready to be looking, I know I'd be. Sorry to hear you're co-workers are so, uh, unprofessional and lack critical thinking skills (trying to be nice). good luck & I think you should feel free to vent. Sounds like you could certainly use it!!!

I don't see how they'd find out cause I didn't tell them or anyone there and I don't live in the area. Unless they're reading my posts (hi!)

but who knows. I just am so unhappy and I was at my last job as a PCA for 6 and 1/2 years. Did I complain sometimes? Of course. Our field is stressful.. But I felt I enjoyed my job and was proud of it. I thought going into assisted living would be good cause I love the elderly and God bless those residents of mine they are why I haven't had a major break down- and being able to vent here.

I've just never seen so much drama and high school stuff. He said she said BLAH blah blah! Lol

It's too much to be around it all the

Time I just can't.

ProgressiveActivist, BSN, RN · Feb 10, 2016

Since you're leaving this clownshow anyway just get another order and be done with it. Keep the family in the loop so they can advocate for her too.

ProgressiveActivist, BSN, RN · Feb 10, 2016

So you can do heparin drips but not a straight cath?

Since you're leaving this clownshow anyway just get another order and be done with it. Keep the family in the loop so they can advocate for her too.

%D#2 · Feb 10, 2016

So you can do heparin drips but not a straight cath?
Since you're leaving this clownshow anyway just get another order and be done with it. Keep the family in the loop so they can advocate for her too.

I know! It's so *** backwards!!! Can I just escape already? Someone hire me. Idc I'll go work in retail!!!

Nurse Leigh · Feb 10, 2016

*insert huge eye roll*

LupieNurse, some of the posts I have read from you and others really make me think the whole concept of Assisted Living needs an overhaul, or at least some regulations.

I recall you advocating for another resident who wasn't appropriate for AL and I wonder if you think this resident needs a higher level of care, at least until the UTI clears.

I've never worked in AL but the fact that she's confused and combative doesn't sound all that appropriate for AL to me.

Sorry you are dealing with this stuff and for the residents who are clearly less important than $$$ to mgmt.

**NickiLaughs, ADN, BSN, RN** · Feb 10, 2016

I worked in ALF and a group home . We did a foley catch change monthly for one pt. The nurses were qualified and trained and they doctor gave the order. It sounds like this nurse wasn't comfortable with the procedure and that's on her. I would snd her to the ER at this point if you are unable to do it yourself and get the order reinitiated.

jadelpn, LPN, EMT-B · Feb 10, 2016

This place does not let me advocate for my patients. I'm a caring nurse and I fight for them every day and get crap for it, and in the end every thing I do doesn't matter cause someone else just goes and undoes everything I do

But this resident is AL, and not sub acute, correct? So this is a resident and not a patient.

In AL there are very specific guidelines that need to be followed, and straight cathing is not one of them, at least in my state. This would warrant an MD visit or to urgent care for a straight cath,

YES, it is "just a straight cath" but NOT part of AL. And there is a huge "thing" about acquired infections, and there could be some bru-ha-ha regarding "did she have a UTI, or was it poor cath procedure?"

I would advocate for this resident to be put in an alternate level of care (moved to sub acute until her UTI is cleared) then to re-assess to be where she should be. Sounds to me as if she is on the cusp of needing more care than AL.

And the Executive Office of Elder Affairs, at least in my state, frowns on doing skill in AL. Unless the resident is on Limited Medication Administration.

Just because a nurse knows how to do it, it is not within the scope of AL to do it. Sub acute maybe, but this is not that.

Critical thinking would be to get her to her MD/urgent care and could have been done days ago. Even to have VNA come in and manage her until she is clear of her UTI could be a choice.

When AL starts mimicking a nursing home, there can and will be issues with your licensing entity.

And just so I am clear, and in reading your other posts, the stuff you are involved in (ie: heparin drips) is way way WAY beyond AL. I would go online and get a set of your state regulations. As an LPN who worked acute for multiple years, it was a process and took more than just me to be sure this stuff was done correctly.

It was eye opening to me when I started as a nursing supervisor at AL, how specific AL is on what one can and can not do in house.

And it opens you up to liability if in fact this stuff is happening in an AL setting under your direction, your delegation, and your license (get malpractice insurance if you don't have it!)

Different drips and the like take policy and procedure, and specific to other stuff that requires constant monitoring. A straight cath on a combative resident could do more harm than good. Lots of red flags, and you could be left holding the bag.

Just because a co-worker says this stuff can be done, doesn't mean it can or should. Get those regulations and look for yourself. Sometimes the almighty dollar of AL fees outweigh common sense.

Hoosier_RN, MSN · Feb 10, 2016

But this resident is AL, and not sub acute, correct? So this is a resident and not a patient.
In AL there are very specific guidelines that need to be followed, and straight cathing is not one of them, at least in my state. This would warrant an MD visit or to urgent care for a straight cath,
YES, it is "just a straight cath" but NOT part of AL. And there is a huge "thing" about acquired infections, and there could be some bru-ha-ha regarding "did she have a UTI, or was it poor cath procedure?"
I would advocate for this resident to be put in an alternate level of care (moved to sub acute until her UTI is cleared) then to re-assess to be where she should be. Sounds to me as if she is on the cusp of needing more care than AL.
And the Executive Office of Elder Affairs, at least in my state, frowns on doing skill in AL. Unless the resident is on Limited Medication Administration.
Just because a nurse knows how to do it, it is not within the scope of AL to do it. Sub acute maybe, but this is not that.
Critical thinking would be to get her to her MD/urgent care and could have been done days ago. Even to have VNA come in and manage her until she is clear of her UTI could be a choice.
When AL starts mimicking a nursing home, there can and will be issues with your licensing entity.
It was eye opening to me when I started as a nursing supervisor at AL, how specific AL is on what one can and can not do in house.
And it opens you up to liability if in fact this stuff is happening in an AL setting under your direction, your delegation, and your license (get malpractice insurance if you don't have it!)
Just because a co-worker says this stuff can be done, doesn't mean it can or should. Get those regulations and look for yourself. Sometimes the almighty dollar of AL fees outweigh common sense.

Same thing in IN

Been there,done that, ASN, RN · Feb 10, 2016

While everybody is arguing over what can and cannot be done for her in the AL setting, the raging UTI continues.

Waiting for her to go into septic shock?

bluegeegoo2, LPN · Feb 10, 2016

I would call the family and have them request a send out to the ER then call the MD and get the order so that she can be treated ASAP. She shouldn't have to die d/t a squabble over policy.

Libby1987 · Feb 10, 2016

After reading Jadelyn's post it all makes sense. Being in assisted living where these procedures are not within your regulatory scope, (I know straight cath is a layman' procedure but still beyond your scope in this type of facility) she should have been sent out for the sudden change in mental status.

**Elektra6, ASN, BSN, RN** · Feb 10, 2016

Agree with NickiLaughs and others. Get an order to transport to ER. Change in mental status, whatever you have to do. The goal should be to keep people in their facility but if they won't allow a simple straight cath you really have no choice.