Oooh I could strangle the MD and NP!

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Specializes in Cardiac/Step-Down, MedSurg, LTC.

We've had a woman in our facility who was in end-stage Alzheimer's and quickly declining over the past couple of weeks. She was refusing to even swallow, let puree food just fall out of her mouth, etc. So, we nurses thought hospice was the next call. Apparently it wasn't that important to the MD and NP covering this woman. The NP was in Friday afternoon to see some residents, and, according to the 7-3 nurse's note did not want to start hospice "secondary to it being the weekend. MD will follow up on Monday." WHAT? So, the 3-11 nurse was B.S. about the decision, called the covering MD and got an order for Morphine Sulfate. At 3:20am this morning I pronounced her deceased.

I am so angry and frustrated for this resident. She has no family, her HCP/POA (an old HHA of hers) didn't know where to send the body, and the body was still in the room at 7:50am. UGH. Even when I called my ADON she had no idea what to do. The day nurse said she would F/U around 8am.

It just disgusted me that no one CARED for this woman at all. No one thought of HER. Thank god for the 3-11 nurse, who actually pulled through for her.

:banghead:

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Specializes in Med-Surg, Peds, Ortho, LTC and MORE.

I am so sorry this situation happened. Most long term care facilities during the "office" administration part (for the "face" sheet) list the mortuary of choice. Perhaps this issue should be addressed by the business office and administration as to what information is needed on/for administion. At least some kind of check list for the face sheet information is needed so that this doesn't occur again.

As for starting Hospice, perhaps the Hospice can give some sort of inservice to physicians and other mid level care providers to have more information about when Hospice can be called to have services started during off office business hours.

Thank you for being a great patient advocate! As well as your co-worker.

Reigen

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Something like this should have at least come up at the quarterly review. Or now maybe they can make it a policy to check this stuff out more often.

yrs ago, we had a problem with this and code status never being reviewed. Took an incident like this to change things......

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I hate when patients do not get the full benefit of Hospice for whatever reason. Either it was a weekend, family didn't agree, or the MD didn't agree. I cannot count the times that I have seen patients pass away before their alternating air mattress was even delivered! If they are that close to dying, Hospice was most likely needed much sooner. The 3-11pm nurse did a great job..

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Specializes in Maternal - Child Health.

It just disgusted me that no one CARED for this woman at all. No one thought of HER. Thank god for the 3-11 nurse, who actually pulled through for her.

:banghead:

You nurses did. You were her family, advocates and care givers. Bless you.

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Specializes in Gerontology, Med surg, Home Health.

If she were that late stage Alzheimer's no one should have waited that long to call hospice. There are many hospices, Beacon and the VNA hospice, with programs specifically made for end stage dementia patients.

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Specializes in Cardiac/Step-Down, MedSurg, LTC.
I am so sorry this situation happened. Most long term care facilities during the "office" administration part (for the "face" sheet) list the mortuary of choice. Perhaps this issue should be addressed by the business office and administration as to what information is needed on/for administion. At least some kind of check list for the face sheet information is needed so that this doesn't occur again.

As for starting Hospice, perhaps the Hospice can give some sort of inservice to physicians and other mid level care providers to have more information about when Hospice can be called to have services started during off office business hours.

Thank you for being a great patient advocate! As well as your co-worker.

Reigen

This is a great idea and I will definitely be expressing this to my ADON on Wed. morning. I've felt so insensitive sometimes about asking crying family members what arrangements are in place for their loved ones. It would be a lot easier to say "let me call Mr. Jones and Son Funeral Home" for you when you are ready."

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Specializes in Infusion Nursing, Home Health Infusion.

Agree with Jolie...you guys were the hospice...you guys were the patinet advocate...hats off to you for caring about someones last few days on earth and providing her a peaceful ending

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Specializes in mental health; hangover remedies.

Considering the woman died within 24 hours - I'm not sure why a hospice move was required?

I also agree with CapeCod - that if she were to go to hopice care then she should have been moved long time before then.

If she wasn't on morphine already then presumably she didn't have a co-morbid condition and she was simply dying of AD which is perhaps why she didn't appear to warrant hospice until too late.

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Specializes in Cardiac/Step-Down, MedSurg, LTC.

Well there was talk of her going on hospice for 1-2 weeks and it never came to fruition. In the last two days she was declining rapidly. I just felt for her.

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Specializes in Gerontology, Med surg, Home Health.

One doesn't need to 'move' to go to hospice. Around here we have 3 different hospices which send their staff into my facility. We try to get them involved sooner rather than later. They help the resident, the staff, and the families as well.

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Specializes in mental health; hangover remedies.
One doesn't need to 'move' to go to hospice. Around here we have 3 different hospices which send their staff into my facility. We try to get them involved sooner rather than later. They help the resident, the staff, and the families as well.

Ahh.. ok. Makes things clearer. I'm a long time being away from elderly care.

Sounds good.

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