tewdles

But...my name really is Dr Dick, I'm new in town and I really am going to work with you!

in Michigan the pay at LTC is better than no pay...just sayin...

nuthin like having the buckwads hijack a Michigan thread...

I agree that this is abuse. This is not appropriate age specific nursing care. The nurse described is likely not uneducated about relevant nursing care, she is a bully. Report her in every way you are required by your workplace policies and by your license.

If it were my grandma I would have scooted her up in bed first and spoken to the staff later. Would it be possible for grandma to get into a chair for her feedings? If she routinely "burps" the feeding into her mouth I might question the volume of the feeding, or the time over which it is given. You are correct to wonder about this. Your grandma could aspirate and I would consider her to be at risk for that complication based upon the scenario you described.

depression would be a medical diagnosis, which most of us are not qualified to make...

wow...just wow.

I had plans once, for retirement, even had money. One foray into the health care system without insurance took care of all those plans.

The images from this area are heartbreaking...

Goslings often don't look or act much like geese...but they will soon enough, if they survive. New grad nurses also often don't look or act much like professional nurses...but they will soon enough, it they survive.

Twice I have changed jobs and taken a pay cut. Once was to take a job that was almost literally in my backyard. I walked to work, my kids walked to my office after school, I was VERY available to my children and to the schools. It was a lovely arrangement and the money I saved by 1) not commuting (60 + minutes/day) and 2) not paying afterschool supervision for my children was noticeable in the change. Not quite a wash but the piece of mind was priceless. The pay cut was more than $10k/year (worth it). I went from acute care/hospital work to community health. The second time was to work for a preferred agency. I gave up a good paying job with an abusive employer to take a lower paying job working with a top notch employer. I am much happier and much healthier now. The drop in pay was a couple bucks/hr (worth it). Both of these jobs were in hospice. I am a cancer survivor, mother of 2, wife to a man who has had a significant medical event that could have been life limiting...money is not the most important thing in my life so these type of changes are not too difficult for me.

The blow of the O2 from the NC is likely helping to dissipate her SOB (which in COPD pts is often unrelated to the O2 sat). She will likely benefit from a small fan to move the air around her head/face. Her sense of dyspnea and air hunger is probably more related to the work of breathing and her emotional status much of the time. These patients are frequently very anxious and benefit from a POC that actively treats this symptom. Ask the doc about her nebulized meds. She may benefit from nebulized morphine. Is she on a steroid? How is she sleeping at night? Is she eating ok? These folks often suffer in many other areas because of their ongoing respiratory distress and the work of simply breathing. Many of the techniques we use in hospice and palliative care are also helpful to patients who are not in the last year of life. Good luck.

I personally think meperidine is not the best pain reliever and would always prefer to give morphine...but then again, I am not the prescriber.

Indeed, medicare and medicaid are pretty efficient when compared to similar services provided by private companies...less % of the $ spent for "overhead" more of the $ spent on actual patient based service. Fraud is problematic...sure, but you cannot blame medicare or medicaid for the greed and misconduct of those (largely for profit) entities who are billing for services not rendered.

Beautiful solution. I doubt very seriously that our government will regulate what the big pharma companies are allowed to market to the general public, although that very concept of reducing the marketing could save the public some serious cash in the cost of their needed meds. If our politicians did decide to limit what and how big pharma could advertise, could I ask that they PULEEZE stop with the erectile dysfunction ads 24/7 ?!?!?