Mother's hip fx in nrsg home - page 4

I would like some advice from LTC staff and others including any LNC's regarding an incident which happened to my mother. In January at change of shift from days to evenings a CNA put her on the... Read More

  1. by   pappyRN
    Hello all and thank you for your suggestions. The situation at present is better than what it was before.

    To make a very long story as short as possible, my sister and I have now spoken with 2 law firms who handle elder abuse cases. They have both declined to take the case due to Medicaid and the fact that it would have to be reimbursed for all care. They said they did the math and that it wouldn't be worth the little amount of money that would be left. I also did the math and my calculations come up - greed on the part of the attorneys. For now, we will not even consider legal action because it really upset my Mom and she is afraid of repercussions.

    I took the advice given and I contacted the state Ombudsman office. After explaining the entire situation the lady got me all fired up about the 'violations of your mother's rights'. This recent call came as a result of my Mom getting moved from her room which was a Medicaid/Medicare swing bed to a regular Medicaid bed with a nightmare roommate. I was told that she should have been asked if she wanted to move and if she said no it was a violation. Also, there were some CMT issues such as why was my Mom wearing THREE nitro patches at one time? This happened at a time when her doc had just ordered Duragesic patches for pain from her hip fx. Any surprises that her bp plummetted? I removed two of the patches and gave them to the evening supervisor. She promised to take care of it and SHE did. A few days after that I went to visit at 12:50pm and her patch was just then being applied for the day. It is a nitro patch scheduled for 8am application!

    So, to get to the crux of the whole story. The ombudsman lady agreed to talk to the admin. with my sister and I. I was prepared to do battle as she had told us of so many violations. Well, this was a bust. The entire time the ombudsman stood up for the ADMINISTRATOR even at times telling my sister and I to be quiet and to let the other lady talk. We never did get to discuss the entire matter because we were being silenced. I passed a note to my sister at that time and told her I was finished and was going to leave. She agreed.

    We have reached the point that we will put this in God's hands. We had the opportunity several weeks ago to discuss our concerns with the nurses on evenings. They have absolutely been wonderful to Mom and to us. I feel so much better that they are looking out for her. They even apologized for going along with the previous b_ _ _ _h who left the facility. They have done a complete turnaround. There is a new GN, correction RN, she just got word of passing her boards yesterday, that has been wonderful. She is compassionate and such an advocate. She puts my Mom to bed in the evening HERSELF instead of the CNA. They have made every attempt to correct and prevent the wrongs.

    As far as the Ombudsman is concerned- that was a complete waste of time. She was clearly biased in favor of the home. In fact, she did a complete turnaround from what she told me on the phone. My sister and I felt completely abandoned like sitting ducks. Sis was so p_ _ _ _ d about the Ombudsman that she told the Administrator EVERYTHING the woman had said to me on the phone. Including the words " I don't ususally do this but I am going to supply you with the names and numbers of threee really good elder abuse attorneys". We are in the process of writing a complaint to the director of the State ombudsman program. She was worthless and I will never call her or Ombudsman again- no matter what.

    It is clear to us that the legal route will not pan out. In fact, we have given up on it. As far as the state surveyors- what a joke. They always seem to know when they are coming. They just had their annual review. It was almost funny. I happened to be there when the surveyors walked in. You wouldn't believe the action that took place before the surveyors even put their things down in the conference room.

    To be honest, I have very little faith in the system from what I've seen. When I reported a previous nursing home for 37 allegations they were only cited for 3-4. Do you think that they sat around and talked openly about my Mom when the surveyors were there? Of course not. They aren't that stupid to do that with the surveyor sitting at the same nurses station. The point is that many of the allegations were things that they knew they were supposed to be doing but didn't bother to- UNTIL the surveyors were there. They knew immediately which patient the call was generated about. My Mom's bathroom and patient room were shining before they even got down the hall. They must have a secret 'red alert' when the state arrives!

    Getting back to the present situation. We have discussed this with my Mom and she just wants peace. We have installed a phone for her and programmed it to autodial her children. She now calls us when things aren't what they should be. There has been a remarkable turnover in staff. This too has made a difference. A CNA told us she was warned to watch out for us and to do everything right because as they told her the "one that's a nurse is mean and sh'e a b_ _ _ h'. At first that really bothered me. I wouldn't have to confront if they did their jobs. But now, I kind of like it. It keeps everyone on their toes and my Mom is getting very good care. There are still problems but they pale in comparison to what they were. My sister and I visit three times per week. My aunt takes another day, my brother(nerd) takes one day, and my children cover the other two days.
    Sis and I visit together because we never know which one will be in any shape to drive. It's a day to day thing regarding driving.

    My Mom suffers daily pain as a result of their stupidity but she has decided to forgive them. If she can then we can and should for now. It may be different after she passes. For now and for our health, peace is a better alternative. Chronic pain doesn't lend itself to tolerating conflict as both my sisters and I know.

    Each evening when her nurses have supper they wheel my Mom up to the table with them and share their dinners with her. When they order out they let her order out, too. We have given her a stash of money to pay for her food. The food at the home is disgusting and she was starting to skip meals rather than eat. This is a great alternative. We also try to bring in food from home and things she likes. She is a Sicilian Italian and can't get enough tomato sauced items to suit her. They say they have grown to love her and love to interact with her because she is so sassy and feisty. She is one of the few 'with it' patients that are on her division. They have also helped by trying to get her to implement the things that speech therapy has suggested to increase the volume of her voce. It is still hard to hear and understand her but you get used to it and it works out.

    The facility has ordered ONE voice amplification system for use by any pt in the facility, stressing it is NOT just for my Mom. It hasn't arrived yet. We'll have to see what they do when two people need it at once. Thie fact that the order for it was written on May 17, 2002 and that it had not yet been implemented was brought out in our mtg with admin and ombuds. The administrator knew we had her at that point- at least on that subject. She ordered the staff to make it a priority. I will say she tried her level best to get out of taking blame to the point of getting frantic because she couldn't reach the speech supervisor. She tried her best to make us look wrong but ti flew up in her face big time. You should have seen her when she couldn't get a response from speech. She actually SCREAMED " I order you to find her and even if she left I order her to return to the facility at once!". Wow,she really lost her cool. The funny thing is she was saying this to the DON. The DON is her DAUGHTER!!!

    We realize that we will have to kiss her butt and always make her look powerful and in control. She told us she wants us to come to her personally to handle each situation. So, we have. She's been as nice as pie lately.

    I thank each and every one of you who has shared comments and suggestions. In a perfect world this nursing home would have to answer for these things. In the real world at least in my state, it doesn't happen. It is obvious to me that the nursing home industry is one hell of a powerful lobbying group. They have to be or many of these things wouldn't be allowed to happen. It's a big business and my eyes have been opened wide. The system lends itself to so many flaws. Most employess know that the state surveyors are there as they hit the door. Unless they are totally stupid they are not going to engage in behaviour that gets them cited. So, when complaints are made they aren't substantiated in a lot of cases. In one instance in my Mom's case there are FORTY TWO days of nurses notes missing. The explanation I received from one of the day nurses was" well, maybe there wasn't anything to say".

    My state didn't even close down or really punish the nursing home that allowed 4-5 residents to roast to death without air conditioning. My complaints look petty in comparison to those poor souls. I am too sick and worn out physically and emotionally to take on something that is just too big to fight.

    Warm personal regards and again, many thanks,
  2. by   Youda
    PappyRN, you brought tears to my eyes and such a sick feeling in my heart. Having worked in Missouri homes for the last 8 years, I wish I could tell you that you are wrong. But, I can't. Everything you've said is true. I've spent the last 8 years of my life trying to fight this kind of thing. It can't be fixed from the inside, either. God bless you and your family. Especially your Mom. And God help us all if the nursing home industry doesn't get changed.
  3. by   renerian
    This is a good example of why I quit my job to care for my father. No one else can care for your family like you......

    Also you just cannot turn off the nurse in you. It is automatic.....

    Hugs to you and prayers to your mom,

  4. by   sandyth
    I am a CN at a long term care facility. We dont leave our toileters unattended for a moment! If they fall at all, all ROM are performed and even if I suspect head injury neuros are started immediately. If they complain of any kind of pain neck down, I call the MD and have them sent out for x-rays. The pfacility sounds very negligent!!!!!! I even had a confused ladty fall trying to get out of bed, bad head injury; called MD and sent to ER for CAT scan.

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