Sleep overs

CapeCodMermaid, RN · May 17, 2009

I worked in a building which allowed visitors unrestricted access to the elevators and the stairwells. The new ED and I started within a few months of eachother. We instituted a sign in book in the lobby, locked the front doors at 6pm and made the stairwells off limits. You'd think families would appreciate the safety....nope. I was threatened by many family members. They thought it was their right to be in the building any time in any condition. I don't mean a spouse or a child...I mean some distant nephew who only came in when he wanted money and was either drunk or high. I'm glad my ED now sees things my way. We are not a motel.

oramar · May 17, 2009

I worked in a building which allowed visitors unrestricted access to the elevators and the stairwells. The new ED and I started within a few months of eachother. We instituted a sign in book in the lobby, locked the front doors at 6pm and made the stairwells off limits. You'd think families would appreciate the safety....nope. I was threatened by many family members. They thought it was their right to be in the building any time in any condition. I don't mean a spouse or a child...I mean some distant nephew who only came in when he wanted money and was either drunk or high. I'm glad my ED now sees things my way. We are not a motel.

The same visitor that gets nasty when asked to follow some rules about entering and exiting the building will sue when they get mugged in a stair well.

debRN0417 · May 18, 2009

There are such things as visiting hours....lots of folks don't respect them. A LTC facility is a person's home. I do not want someone visiting me after 8 or 9 p.m. at night after I have donned my sundries and crawled in to bed....Visits should be by invitation. Courtesy would be to call first and ask if one can come late...ugh....

Sleepovers- nah- don't think so- unless the person is on their way out or has a private room and then I think that there should be an understanding about it. Loke oramar said there are crazies out there...what if the person staying with momma or grandma is an offender and abuses momma or grandma, then we have to deal with that???? again-ugh! And I'm sorry- I'm all about the resident and being kind and courteous to their family, but I am not there to wait on the family- I am there for the resident....

NotFlo · May 19, 2009

I used to work in a facility that allowed visitors any time of the night or day for any length of time. They were trying for "culture change"...since this was the person's home, they can have anyone over any time they want. Not many abused this policy but, as always, there were a few that did and they were awful and caused numerous problems.

My current facility has posted and enforced visitation hours and I think that's just so much better. There are exceptions made sometimes, of course, like for a dying patient, but it's so nice not to have family members wandering around, barging into the mini-kitchen demanding food and drinks, all hours of the night. Visiting hours don't begin until 10 am, and it's really nice to be able to get the AM meds and care done without tons of family around too. If someone shows up before 10 the front desk will call up to the floor and ask if it's okay for that person to come up.

achot chavi · May 20, 2009

At an LTC facility I worked at, a woman was allowed to move a huge recliner into her husband's room. She stayed almost 24/7, only going home to shower sometimes and check on their house. This went on for about EIGHT MONTHS! He usually had a room mate.

The roommate never complained? even so, it is wrong to the roommate. Our SW would be setting limits, would she have liked it if the roommate had brought his family to sleep next to him...

We also dont allow other people even family members to eat from the pts tray- even if the pt allows it.

The dietitian is very strict that all the food on the tray goes to the pt and if the pt only eats jello, than we should throw away the leftovers, and work with the pt to see what he will eat and not allow families to eat from it, if the family wants to eat, they can pay for a tray, (reasonable cost)

we once had a woman obsessed with feeding her son and would steal food from other trays to give to her son when he came each day, the son was embarrassed and didn;t want the food but didn't want to hurt his mother either,so he would eat the cold, poorly wrapped offerings. We worked with him to keep his mother from doing this, but this just made her depressed. In the end he paid for a tray, she got two trays, marveled at her good fortune, and would save a tray for her son, putting her leftovers and choice portions on his tray as well...

This is why we have Mother's Day

southernbeegirl, BSN, RN · May 20, 2009

our facility allows this. it seems like every other room at our place has a family member staying 24/7. it is so commonplace at our facility that until i read the responses on this thread i had forgotten that in all the other places i've worked people didn't stay like they do in the one i work at now.

our facility is private pay or insurance for SNF, including medicare, only. we don't accept medicaid. i think that is a big factor in how our patients and families believe we should treat them like they are in a spa.

while i was giving a tour one weekend, had a lady ask "where's the pool?" and recently we had a lady ask where our "helipad" was because her husband would need a helicopter if he had to go back to the hospital. i swear it's true, lol.

our policy is that if they have a private room then whoever wants to stay can stay as long as it's ok with the patient. mostly it's just husbands and wives that stay though. we get a lot of people that will stay with their parent for the first night or two but then once they get used to us they learn to trust us and leave at night. thats real common at our place. a private room cost $15/day extra than the semiprivate if the pt is skilled. private LTC rooms are another matter. and we rarely have anyone stay with LTC patients unless they are dying.

but if a pt is in a semi private room then the rule is that only the same sex can stay. that way a son cant stay with his mom overnight if she has a roomate. that is to protect the roomate. and most are ok with this rule.

i think that we are just so used to people spending the night that we've forgot how nice it was when people didnt stay. *sigh* LTC sure has changed.

but i do have to say that most people are very nice. oh sure we get the anal ones but who doesnt i guess.

i admitted a 60y/o f last weekend s/p TKA. she was very apprehensive about coming for rehab. her husband stayed with her in the room. the next night before i left the husband came to talk to me. he told me that he had worked in LTC for 10yrs prior to retiring and moving to our state. he was supervisor of housekeeping/laundry. they didnt tell us that on admit. he told me that he wanted me to know how wonderful our place was. he said there hadnt been a person come in the room without a smile and that his wife was so comfortable that he was going home for the night. he told me he was going to talk to the administrator about us too and tell him how great we'd been to them.

you dont hear that enough,do you. it sure put a pep in MY step that night.

CapeCodMermaid, RN · May 20, 2009

I'm wondering how you manage to not allow medicaid residents. We've been told we can't discriminate on the basis of payer source.

Nascar nurse, ASN, RN · May 22, 2009

I'm wondering how you manage to not allow medicaid residents. We've been told we can't discriminate on the basis of payer source.

In my state, you can be a SNF certified medicare building without being a SNF certified medicaid building. If you don't have the medicaid certification you can not take a medicaid person.

This could sound like a good thing financially, but you run the risk of a very unstable census. Once skilled needs are complete, the resident is required to pay privately or discharge from the facility. Makes for wild ride with census, budgets, staffing, etc.

If the facility is certified by both, then we can not discriminate based on payor source either.

FooFootheSnoo · May 23, 2009

I don't see the problem. If my husband was in a nursing home, I'd want to be able to stay with him. Of course, I'd not bother staff or other residents.

achot chavi · May 24, 2009

I don't see the problem. If my husband was in a nursing home, I'd want to be able to stay with him. Of course, I'd not bother staff or other residents.

Your husband should never need a nursing home, you both should live long and healthy lives...BUT.....What if he were in a room with 2 other pts? would that be fair to the others?,...WOuld you want their wives or families sleeping in the room with your husband (thereby crowding it, increasing risks of infection, bothering the nurses etc.

southernbeegirl, BSN, RN · May 27, 2009

In my state, you can be a SNF certified medicare building without being a SNF certified medicaid building. If you don't have the medicaid certification you can not take a medicaid person.
This could sound like a good thing financially, but you run the risk of a very unstable census. Once skilled needs are complete, the resident is required to pay privately or discharge from the facility. Makes for wild ride with census, budgets, staffing, etc.
If the facility is certified by both, then we can not discriminate based on payor source either.

we arent certified for medicaid.

they've batted back and forth about reapplying for that certification but we are more profitable as a short stay rehab so, for now anyway, we are not getting that certification. we make a lot of money for the company.

but you are right about the census. it's a roller coaster ride sometimes! and when we get low, we take ANYTHING. lucky for us, our census stays up there where it should be. we stay at about 95% full all the time.

it's the first non-medicaid facility i have ever worked for. i like it though. but dang! it sure is fast paced! it's nothing to get 6-8 admits with5-6 discharges a day! not to mention constant md orders, labs, etc.

we have a doc in facility 4 days a week or else it couldnt be done.

people now a days do not understand that a doc is supposed to only see them once a month in SNF. they expect the md to round on them like they do in the hospital *sigh*

we are a good team...all of us in nursing. it takes us all to get it all done every shift. as the RN, even on the weekends, i am constantly on the phone with the docs, doing IVs,etc. i try to do everything that has to be done because it takes the nurses on thefloor their whole shift just to get the meds out, families talked to constantly and charting done. we've all worked together for years so we are a pretty good team and i wouldnt trade that for the world.