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I'm at my wits end today. First of all, why does the hospital d/c patients who apparently are not stable enough to go home, much less send them home with these outrageously complicated orders on a Friday evening?????
Yesterday, got a patient sent home who had orders for gentamycin every 12 hrs with a dose of fortaz to be run through his PICC line afterward. Labs must be drawn every morning for gentamycin trough. Since this patient lives in a very rural area this means his labs have to be driven on a 100 mile round trip daily by the home health nurse, on top of the nurse having to stay with the patient in his home for more than two hours while the antibiotics are run through the PICC line, twice a day.
Well, then apparently he had the order changed to every 8 hrs. and this new order was faxed to the wrong home health agency and we didn't get the new orders until after we had started the old ones...so this has messed the schedule up.
But now I am on call this weekend and I'm expected to travel to the patient's home every 8 hrs. around the clock for the next ten days and stay with him at least 2 hrs. each time. With the patient being in such a rural area it would be mroe sensible to have someone stay with the patient around the clock, especially considering I have about 100 other patients I need to be available for in case there is a problem (I'm on call all the time, BTW).
Is it just me, or does anyone think this set up is not very reasonable?
I mean, home health is supposed to be for the convenience of the patient and family, but really, home health can only do so much.
Sometimes, the hospital is the only sensible option.
Jo Dirt
3,270 Posts
I checked. Nurses only are supposed to change the PICC line. But today sister complained to the agency and said she wanted another RN to come out because I caused her brother's PICC line to clog up so no one could get blood out and then when I drew his blood in the forearm I had to stick him twice and one time I had the needle "upside down."
The DON told her there was not another RN available to come out there but she had the option to refuse the service all she had to do was say so. For some reason or another the sister chose to have me come back out and to be honest I really resent the hell out of this because I'm the type that if someone hints they don't want me around I will be as far away as I can as fast as I can and I won't look back. But the DON hung up with the sister and begged me to go "just one more time, it's the last day, please?"
So what else could I say?
This sister is not the brightest candle on the cake (she is dedicated to taking care of her brother and that is good but she is somewhat intellectually challenged) but that still doesn't mean I am okay having her scrutinizing every move I make and giving me a hard time.
I already know I am not doing the dressing change. It is due weekly and she says she is going to bring the old agency back to start caring for his PICC line so I'll just take that as refusal of care and that is that much less I have to do.
I'm to the point I don't care. I've worried with this all week and with the guy being Tenncare this means the company will not be reimbursed for having me be tied up with this crap the last seven days. The DON is tired of it, too. It is just strange that when something doesn't go right it always has to be someone else's fault. Always has to be someone else to blame. People don't want to accept that sometimes things happen (clogged PICC lines.)
Furthermore, I have run out of butterfly needles and the only thing I have left is one of those vacutainer things, which I have never used. If the private duty LPN can't use a vacutainer either then I don't guess there will be any blood drawn tomorrow from me. I'll tell sis to go call her other agency.
I'm more than tired of it.