Cecilea

Thanks dthfytr.....family very good to me, have an abundance of siblings most very supportive.Brother has agreed to support me in chatting issues through with the home and to tackle sticky situations together rather than me alone.

It was not a rhetorical question requesting medical advice.I know what dad needs.It just needs to be done . Personal support and stories of nurses in similar situations would be good.I will get whats required but it is like getting blood from a stone at times! Very frustrating.I hate complaining and want to maintain good relations.

My dad has dementia is in a care home and is well cared for pretty much of the time and I am impressed with the care standards but there are issues when he is sick .The family tend to notice more quickly when something is wrong and ask for the GP to visit but he is always called ONLY when the person in charge feels it is appropriate.On more than one occasion this has resulted in emergency admission once with serious complications. Three weeks ago my dad was diagnosed with a chest infection and my mother discussed his swallowing problems with me and I suggested that she might discuss this with the GP and the staff and ask for a swallowing assessment and ask them to use thickener for his fluids .She agreed to do this but could not get to see the GPand could not find the appropriate staff member.I visited dad on the following day(Saturday) and he looked unwell and carers reported coughing on swallowing fluids.I asked to see the person in charge and explained that he had some swallowing issues and that a product to thicken his fluids would help until he improved.I was met with the age old response "We cannot call the GP until Monday".I explained that we had purchased the product over the counter as it is not on prescription but they said could not use it with out the GP writing it up.I asked for a GP call out but it was refused so I said I will call him myself .I explained the issue and the on-call GP visit was arranged and he agreed to write up the product on a PRN basis.It was 4pm.Later that evening at 10. 30 pm my mother phoned to say that on arrival at the care home the GP was turned away by the person I has spoken to saying the visit was unnecessary. I was devastated and furious! My father has swallowing issues which are plain and clear to the trained eye.He has been assessed by the speech and language team in the past and the home know this . Three weeks later he is better after antibiotics and is waiting for the speech and language team to assess him again but still no thickener product is available for his fluids.Two days ago he went off his feet and was admitted to hospital where they noted the swallowing problem again and used the thickener product as on previous occasions. My mother says that the product is still not available for use by the home even now that he is home again.The nurse at the hospital agreed to inform the home of their use of the product suggesting that they continue it PRN. I have had to negotiate so many things for dads care and some staff seem to want to make a fight out of it every time !I work in a nursing dementia care home myself and have always prided myself on listening to family and being as open as possible about taking their concerns on board .Most of the time family are right and they carry a knowledge and love of their relative that we will never fully comprehend and we must respect this. Why should dad have to wait three weeks for such a simple thing? Why are families treated like criminals?They have least support when the family member is at home being cared for 24hrs a day in many cases and are blamed for being stressed by it.We did this for as long as we could until we were exhausted. Why cant health professionals be listened to when they recognize problems with a relatives care ? I cant do this anymore my energy is running out and I cannot face the staff there any more. I finally understand the reason why families stop coming to visit their loved ones .They just cant take it anymore.You either succumb to what the staff decide or you complain or you just stay away. What am I going to do ?

What a great post . You say everything that needs to be said . God send us more team players please .Where I work patients needs come last and our Nursing Manager is listening to her assistant care staff not the nurses.I hate it when she is around she is rude and takes nothing on board that we report to her. I will be completing a task and she will tell me to do something else while she sits around chatting to another nurse who is doing nothing. The male nurses dont go near patients except to give drugs but the female nurses help out on the floor if it is needed but the guys wont help even if the patient is male and needs care. Its appalling behaviour and she does nothing about it .I am looking desperately for something else and am sick of nursing homes where mediocre care is seen as acceptable. By the way they say I am not a team player if I assist a pt or answer a bell when all the staff are at coffee break. The other day a handle came off a door and I was locked in a room with two guys who have assaulted staff in the past. The manager said I was making a fuss and that the door wouild open I just didnt do it properly.(I rang the emergency bell ) She gave an explanation as to how I should open the door so the handle would not come off. I had opened the door normally and the handle came off in my hand . I am afraid I walked out in disgust and left her talking to the wall.The other day we were in need of legal advice over an incident which hit the news and she told me it was not neccessary again , We needed a syringe driver we were told it was unneccesary. WE KNOW NOTHING IT SEEMS ! I GOTTA GET OUT OF HERE before i lose all sense of worth.Please dont say chatting and getting to know colleagues is important . I know it is but never ever at the patients expense.HEEELLLLP Down hearted Cecilea:confused:

My father is in a dementia unit in the UK. He has reacted badly when at home to Cipramil..stomach bleed. Quetiapine ..in two weeks off feet not swallowing . Trazadone upset his heart.. etc. He had a gastectomy at 15 yrs old so I guess his b12 intake has been compromised all his life as he did not supplement.He was at home with us and prostatism disturbed his nights and the confusion from the drugs combined with dementia made nights very tiring for us but we maintained his continence. We refused to continue drugs that didnt suit him even though gp wanted us too saying it was the process of the disease not the drugs making dad ill . We stopped the drugs dad began to walk talk and swallow safely but continued to be up alot at night in an agitated state. We asked for night care but were told nothing was available . So after many tears and the start of lorazepam to which he reacted with paradoxical agitation our social worker eventually found us a place in a care home (no nurses)close by.After two days i think he fell down and was in a lot of back pain plus he had another bleed from his ulcer .( I could smell meleana on his breath but he did not vomit any blood) they treated him again with omeparazole successfully and then began to teat the back pain with paracetomol but changed to co co damol. After this he has slept nearly all day with some periods of being agitated which i think is still paradoxical agitation from the lorazepam 1mg bd.I think that the coccodamol is potentiating the effects of the lorazepam and making him so sleepy. While this gives him respite from his anxiety due to his skill loss from the dementia and sadness from missing us I am concerned that the staff insist dad is still in pain from his back but he "aint its bettter" we got in a massuse who did a great job on his back and he is upright instead of bent over following the fall .The gp says the codiene content of the cocodamol is too small to do this to him but i disagree having seen him at home six months ago without drugs.While I can see that this sleepy state is better than an agitated one i wish they would just say he aint in pain and they are using the meds to sedate him. THE MANAGER SAYS DAD WOULD HAVE TO LEAVE THE HOME IF THE COCODAMOL IS STOPPED!!!! This is a dementia unit! I DONT WANNA STOP IT BUT THINK THEY SHOULD GIVE HIM SOME SPACE WHEN HE CAN BE HIMSELF AND NOT SLEEP. hIS DAY NIGHT IS REVERSED NOW. HE IS INCONTINENT . wE KEPT HIM CONTINENT AT HOME . wHAT DO YOU GUYS THINK. DO RECKON THAT THE COCCODAMOL AND LORAZ TOGETHER ARE DOING THIS .. I AM A GENERAL AND PSYCHE NURSE AND WORK IN A DEMENTIA UNIT .IF FOR ANY REASON THEY HAVE TO STOP THE COCODAMOL IE ANOTHER BLEED DAD WILL GET "GRANNY DUMPED " and have to be sedated til he is better in a hospital ward or psyche unit. ( HE MUST BE ADDICTED TO THE LORAZEPAM NOW) Or just be treated at the home............Any thoughts out there. I miss my dad he is still a great dad and i wanna care for him so bad i hate other people doing it. Every time i visit he manages to let me know he wants to come home and says he hates it. But i am grateful for the good basic care its the other end of the scale i,m no sure of and i am getting tired of advocating for the rest of the family. I am the baddie who has to ask the awkward questions and it is getting too much now . TEARS IN BUCKETS . Cecilea.

The comment by the nurse tutor who said psyche nurses are not real nurses shows her age I guess,her prejudice and how little knowledge she has of the skills involved. How much time did she spend in her training in psychiatric studies? Did she ever teach psychiatric nurses? She probably never went near a psyche unit and therefore has no right to speak with any authority on the subject. We all take real listening and caring so much for granted that we can easily miss its value and accept its glaring lack in general nursing at times to our patients huge disadvantage. Hence the phrase "only talking to pts and doing nothing". The seperation of psyche nursing and general nursing in training has to change.Both need each other. Here in the UK Project 2000 has done something towards acheiving that and I recognise differences in the nurses coming through who have been taught the value of listening skills etc . A trained as a general nurse and enjoyed it but I grew up when I went into psyche nursing .

Hi NH Mummy Thanks for your post. I found it very moving and will remember what you have said for ever. Im so sorry about your experiences they should never have happened and you must not feel bad that you didnt ask. The nurses should have been asking you and doing this stuff for you . You had already done so much and gone through so much. My heart goes out to you. Bless you for passing on this information. Cecilea.

Oh boy not again! When will nurses stop trying to put themselves up just a bit higher than someone else by sidelining a smelly job as one that anyone can do. Yup you do need education for the job its one of humilility and willingness to help another in distress and a knowledge of infection control and promotion of dignity. My first ward....pt returns to ward mid physiotherapy post stroke because he needed the toilet!! Were there no toilets on the physio dept ,perhaps no one had any hands to help him there. Were there no people with brains on the physio dept able to work out how to wipe his bum. By the time the pt came half way across the hospital to go to the toilet he...you guessed it he had been in his pants! He found it scary to go to physio again. Surely the physio had a role in teaching him how to get on the loo safely and before he had an accident. Pray God theres enough Cna.s around if nurses reach the dizzy heights of "no bum wipes physio and other paramedics" Mad Cecilea If no ones around you gotta do it even if you are a doctor. :angryfire

First Post. Hi every one I am a psych nurse (not in US) with general nursing qualification that is still active . I have been looking for something like this for a while now and it seems great. Thanks to all. Psych nurse not real nurse? A typical response from the hoards of nurses who have never had the glorious opportunity to witness the power and value of real listening, care empathy and the importance of empowering other people in distress. One of the reasons I went into psych nursing. It was a chance to give time to patients that was impossible on task oriented wards with task oriented managers and petty colleagues whose main aim in life was to get the tasks done to impress the night staff manager. Never mind that seven patients had just been given diagnosis of Ca and were left high and dry with no support! Yep there are poor nurses everywhere but " nurses who have learned to be busy" need to see that sitting and listening to a patient is vital to his sense of being involved in his recovery and so often this is what the psych pt has never had. Come on when was the last time someone gave you real active listening. Great isnt it. EXAMPLE in 2004 Caring for a pt in terminal cardiac failure."I Know Everthing Manager" insists on sub cut treatments pt not keen. Pt decides no and pulls it out.Manager insists we replace. Several times . All the time we minions are saying all this lady needs is someone to sit and hold her hand as she is scared. By passed manager who would not listen. Area director listens for once and lets me put in a nurse to sit and hold hand. Bingo . Problem solved ! Lady relaxes no more sub cuts needed. First Post Groan Over. Cecilea.