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LockportRN

LockportRN

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  1. LockportRN

    Ataxia s/p Brain Tumor

    Thanks for your response. My first instinct is to send to the ER. They have been there so many times and have had no hydrocephalus diagnosed but 'headache' that it becomes frustrating to know when to go to the ER for them. I have heard of new device made that is based on temperature of shunt placement equalling the temp down the path of the shunt. Do you know if it is use as of yet?
  2. LockportRN

    Ataxia s/p Brain Tumor

    First off, I will state that I am not a neuro nurse but could use your valueable input! I will be caring for a patient with a resected brain tumor that had a shunt placed which remains very unstable, with his last revision done about 3 1/2 weeks ago. At times he has too much fluid buildup and at others it drains too much to the point he will get severe headaches upon sitting. What are signs that I may need to send him to the ER for shunt failure? Does a shunt failure happen quickly, or slowly with symptoms worsening? Is it always an emergency or do the fluid shifts even out? Any advice you can give in regards to caring for a person with these types of problems would be greatly appreciated. Thanks in advance!
  3. Thanks for your response Libby. I will be moving there in a few weeks and agree with you 100% that he should see a marked improvement in nearly all areas just by getting one:one care. That being said, he has a GT, JT, stoma from trach hasn't yet healed, only gets ice chips per ST at present, F/C, Stage IV to coccyx, recieves Neb txs, O2 prn and suctioning prn as he occassionally aspirates if JT clogges. These things are all manageable by me. I would like therapy to continue in the home at least to help us to help him manage in the home environment. The issues with blood draws for coumadin, continual problems with low HGB and elevated K levels will need to be managed. Sooo, after all this is seems as though we won't want Hospice as the hope for a better recovery remains. But was unsure what exactly Palliative Care would help us do or better to just try to go with Home Health referral? I am thinking Home Health but from what the hospital explained, equipment-wise, they won't help much. There is so much to think about but it helps so much for me to just write it here. Thank you to any and all that reply...helps to calm me down and focus to think that there are others that have done this. That it can be done, even when it sounds overwhelming. Yes, I am a nurse, for a long time...but this is my dad. Will be treated at home without all the resources I am used to being able to just order up from maintanence and I really never gave much thought to patient payer sources but now I must. After being in ICU so many months, I am not sure where their finances stand.
  4. LockportRN

    Only Crusty Old Bats will remember..

    Ok, now I just feel old.lol
  5. Ok guys/girls. I do understand that no medical advice can be given here but I am looking for a clearer explanation of each of these areas as I have only a few weeks to help my dad decide what to do. The hospital Social Workers are not very helpful. The doctor came in the room, asked my dad what his wishes were if he again had trouble breathing. My dad told him that he didn't want the trach ever again. The doctor replied, "Well ok then. We'll discharge you home on hospice and give you Roxanol until you die." And with fear and trepidation in his eyes, my dad stated "Well, I think I have a few good weeks left in me.". Uggggg. Dad was in a rollover tractor accident in March. He has spent most of these past months in ICU with multiple bone fractures, and burns and all the complications involved. At this point, he is down to 137 pounds, with a GT, still with the hole from his trach healing, a GT to drainage, a JT for feeding, Stage IV decube to his coccyx and remains NPO. He does love his therapist at the Skilled Care Facility but the nurses are way overworked and cannot be in his room to suction him as needed (he is back in the hospital after one of the nurses/aides gave him a glass of water, he began coughing so hard that he vomited and aspirated GT feeding and reopened the stoma from his trach.) Anyhooooo, he wants to go home. It has been months. I want to help him do just that and will be quitting my job here in another state and moving to his state to help with his recovery. We are having ramps and rails put in and will ensure that all the equipment he needs will be available but I am not sure at this point which of the above would help him the most. He is now able to speak above a whisper and can have ice chips. He does get up to the w/c to wash his face, brush his teeth and shave. He needs assist to transfer to the w/c or commode. He does NOT want to die and has good cognition. The hospital obviously as noted above is pushing for him to go home with Hospice but I feel that once he gets back home with his wife, his dog, his chair, the lake and birds, he will finally begin to heal. Especially if he has someone right there to assist him and ahem, push him to go further. Plus, the only thing he doesn't want is to be intubated, but he does want to be given CPR if needed. That being said, I am a realist. He was very critically ill and is severly emaciated and weak (he used to work out 4-6 hours every day, after all these months, he still cannot stand by himself). He did get gastroparesis from the rapid IV infusion after the burns and his stomach is slow in responding. He has virtually only gained 0.6 ounces...due to???? Letting his GT run empty too many times? Shutting it off and forgetting it? Yes these things have happened, and is yet more reason to get him home. More reason to believe he can actually heal there, and yet? Still we don't know. But I'd like to give him that chance. If nothing else, to go home for Christmas and be surrounded by help and love. Sigh, I've run on. I do apologize. So, he has Medicaid with a supplemental insurance. I would appreciate anyone with general knowledge with the above 3 options to help out a fellow tired nurse :))) Any guidance to where I can begin would be most helpful!
  6. LockportRN

    Judge Sends Man to Prison Because He Can't Pay Hospital Bill

    Free medical care? Yeah, like that's going to happen.
  7. LockportRN

    Orlando

    Thank you (( ))).
  8. LockportRN

    Orlando

    Oh my hon, please know that we are 100% thinking, praying and sending you huge amounts of love. I am a mom of a child that has gone there. 3 of his friends were killed. He is struggling so much, but in spite of it all, he praised all the first responders. His heart is grieving for his friends. For the small community where he finally found safety for which he no longer feels safe. His heart is grieving for all the hateful comments by some of our elected officials, the community at large for hate speach against those that frequented this club, and the LGBT community when they talk about hating all Muslims. He wants to find a way to tell everyone that this is not the answer. You all did an amazing job on that horrible day. And from what I understand, there are still 6 in critical condition. I am sure that it will take much time to come to terms with this aweful action taken by one person...so much damage. Please be kind to one another and know that we are with you in thought. Come here if you need to. Thank you again. I for one am so glad that there were people right there to comfort, heal and save lives....it is so hard thinking about the terror for these people. And so hard to think of my boy, my sweat loving son being lost in such a senseless way.
  9. LockportRN

    "Your job is to make me happy"

    Arrg, after typing a response it all disappeared. This is not the first time that has happened to me here but I'll try again. I had to lol as I currently have a private duty case where the woman stays in her room with her door closed. If she wants something, she used the intercom to call me. I have to use all of my powers of persuasion to get her to turn, sit, get out of bed etc. As she is well-to-do, I am guessing this is what she is used to, but she may simply be reading the local papers. In this town, a hospital actually took out 8 full page ads reading "Patient satisfaction or get your money back'. Honestly. 8 FULL pages and the words in quotes were bolded. Now, from what I have seen when my private duty patients have to be hospitalized is that the same dismal nurse:patient ratios exist here as in most of the rest of the country. So I am wondering just what hardship this means for the nurse that also must act as CNA, housekeeper, dietary aid, transporter etc. One person cannot be all to everyone.
  10. LockportRN

    Hospitals Firing Seasoned Nurses: Nurses FIGHT Back!

    This doesn't just happen in hospitals. With the new healthcare system as it is, docs in general are being paid less. When/if you go to an Ergent Care Center or other type of 'walk-in' clinic, if the doctor orders a test for you, that is that much less money that they make. They therefor, don't order tests as they had in the past. It only means less money for them. I hear it said in the news how this or that agency thinks that docs order too many unnecessary tests and then try to tell the public how useless the tests are, but then turn around and blast docs for over-prescribing meds like, oh, antibiotics. Seems like a severe catch 22. In these cases, you have to INSIST on care. The scary part is, most wouldn't know where to begin to tell the docs what they need. That is why they go there in the first place. It's becoming scarier every day.
  11. LockportRN

    Negligent CNA?

    I am sorry that this happened both to you and to your resident. As others have said, it appears as though there is a facility-wide lack of communication. For this reason, it would appear as though you may be scape-goated. Like another poster said, do document all communication regarding this incident with management in an email to yourself. If there is a paper 'write-up', make sure that you ask for a copy. Now the report to the state should not be considered a punishment. This is what the facility is mandated to do. Well, at least in Illinois it is. All incident or accidents must be reported. If your manager and administrator are smart, they will start a POC (Plan of Action) immediately and that should include getting all Care Plans up-to-date, and instituting a better way for staff to know about pertinent changes promptly. Under most circumstances you will not loose your certificate unless the facility can prove that you were aware of the proper transfer technique but refused to comply. Even then, it would seem as though you would be given proper training. I wouldn't think that a one-time incident could get you punished by the state. From what you say about this, it sounds like an internal communication problem. If you are formally 'written-up' I would ask for guidance (in writing) what you should do on a daily bases PRIOR to shift start, to ensure that you are made aware of any changes (for nurses, we give each other a report). There are many many ways this could be done for you, but these are usually facility specific. Try to breath, take responsibility KNOWING that accidents do happen (many of our elders have tissue paper for skin...heck, I am getting close to that myself!), and often skin tears can't be helped. It was good that you immediately got her help. Hopefully, you can be a part of changing what sounds like a faulty communication system so that these things will happen less often. Best of luck to you.
  12. LockportRN

    You Never Know What's Beneath the Surface - I'm a Prison Mom

    I thought something was odd...saw this on several of the articles. Thanks for responding!
  13. LockportRN

    You Never Know What's Beneath the Surface - I'm a Prison Mom

    Since when does allnurses allow blantant advertising? Hate to see this.
  14. LockportRN

    You Never Know What's Beneath the Surface - I'm a Prison Mom

    Me too, I cried my way through! I can really feel her pain.
  15. LockportRN

    You Never Know What's Beneath the Surface - I'm a Prison Mom

    Farawyn, RN, So true...so very true.
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