Suicide Pacts - A Vent

Nurses General Nursing

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This week has been "national nursing home dump in the ER week". Happened over mother's day too. Kids go see their parents/grandparents that they havent seen since christmas and all of a sudden realize that *GASP* they dont look too good! So what do they do? Bring gram and gramps to the emergency room. Along with 25 family members that are "oh so concerned" about that particular family member that they only care to visit twice a year. Grampa has had a UTI for 3 months... but TODAY it is an emergency. GRRRR! We are short 4 full time RNs, down two techs, and we dont use LPNs in the ER per hospital policy, people keep calling in sick even when we KNOW they are not sick because they know that when they come to work they are going to get triple patient loads because we have no staff.

This has made me decide two different things... Im going to start working as a part time recruiter for the hospital at Missouri Universities to get new grads into our facility...

If I have children, I am going to be really really nice to them so they pick a nursing home that actually ASSESSES before they send me out half naked in an ambulance for a CHRONIC UTI. If I DONT have children... im making a suicide pact with someone, so that they shoot me the day I can't make it on my own.

Ok, I rarely rant anymore... but this felt GOOD!

Specializes in Corrections, Psych, Med-Surg.

Don't you just love these family holidays?

What about the suicide pacts. That is pretty shocking. You mean like heavens gate or jim jones? Why do you associate this ER/elderly thing with a title of suicide pact. Lol!

before they send me out half naked in an ambulance for a CHRONIC UTI.

:chuckle

Im going to start working as a part time recruiter for the hospital at Missouri Universities to get new grads into our facility...

Good idea Brandy:)

Specializes in Geriatrics/Oncology/Psych/College Health.

I hear you, Brandy. I understand that people have guilt issues associated with putting their loved ones in a nursing home, but try calling more often, maybe get someone in the area to look in on the person more often if you live far away - or move your loved one closer.

I also greatly enjoy the people who drop off their loved ones for whom they are caring at home in the ED on the family's way to going on vacation. I admire anyone who tries to care for their elderly at home, but it's called respite care - get some! The hospital is not there to babysit your relative while you're out of town.

What kills me worse is when the psych doc on call actually admits people with Alzheimers who otherwise are actually physically healthy because they got "combative." Turns out they swung at a staff member who surprised them. All they're doing is increasing the risk of a broken hip by sticking these folks in a strange setting where they're more likely to fall.

I imagine as I grow older that my greatest fear will be having something suddenly incapacitate me enough that I can't off myself before I get stuck somewhere. Nobody had better peg tube me either.

Specializes in NICU.

Let's remember, too, though, that not every family can visit their loved ones every weekend; some people live awfully far away from each other and it may be impossible for them to visit frequently. If your grandfather had been suffering from even a chronic UTI for three months, wouldn't you at least try to do something more aggressive (like going to the ER, rather than depend on the doctors at the facility) at some point, instead of just sit by and tell him there's nothing or not much that can be done?

Watching your parent or grandparent grow old and get sick is painful, and many family members begin to feel helpless. Can we really blame them for trying to take matters by the reins at some point, even if it is a bit misdirected?

My own grandmother died in January; she was living in a facility that had doctors on staff, and they misdiagnosed her with pneumonia more than once when what she really had was invasive lung cancer. It was impossible for me to visit her like I'd have wanted to- she lived six states away. My main point is that maybe we should reconsider damning statements like "oh-so-concerned" and "only care to visit" and instead realize that every family is different, and while some of them truly do neglect their elder family members, others do not. Rarely are we in a position to tell the difference unless we actually work in that long term facility.

Sounds like your ER needs to get some staff. ;>) Good luck with the recruiting.

Specializes in LTC,Hospice/palliative care,acute care.

Good post,Kristi....I admit I too sometimes tend to be judgmental where the families of my resident's are concerned and that's not fair to them........But when I am having an awful day and someone pops up for their yearly guilt visit and starts "The ME show" trying to monopolize my time with numerous ridiculous demands I get a bit upset...

I think I know this patient! I cared for her but from the other side. I was the nurse in the nursing home working on Mother's Day. This lady had a chronic UTI ever since her last hospitalization (hospitalized 4 days after a fall even though she didn't have any injuries) when they put a urinary cath in her for no reason (she was continent of urine and didn't have any urinary retention). Actually, I did a complete head to toe assessment and assured the family that she was not actutely ill and could be manged in the nursing home, but they insisted on taking her to the ED. I tried to talk them out of it because I knew she would be in worse shape when she returned . The family just wouldn't listen to me. After she was discharged from the hospital and came back to the nursing home she was covered in skin tears and bruises, could no longer ambulate, and it took us 4 months to heal that stage 3 pressure ulcer that she aquired while lying on a stretcher in the ED for 18 hours. I have to agree, family members can be so frustrating! :(

Specializes in ICU.
Originally posted by Nurse Ratched

I imagine as I grow older that my greatest fear will be having something suddenly incapacitate me enough that I can't off myself before I get stuck somewhere. Nobody had better peg tube me either.

Just had a mental image of a 90 year old Zena the Warrior Woman hanging onto an IV pole with enteral feed going. Shuffling around the ward in her hospital night gown and fluffy slippers a pair of pale pink granny undies around her ankles:roll

It is interesting to see both sides of a picture here and the truth is there is not enough respite care anywhere in the world. The problem isn't new either I can remember when I was training ( back in the dim dark days) we used to get "social admissions" for "backache" just before every school holiday.

Specializes in LTC,Hospice/palliative care,acute care.

I have not seen many nursing home patients transferred out under these circumstances myself-what is more common in this area in acute care is families dropping their loved ones off at the ED and suddenly when it comes time for discharge you just can't get ahold of anyone.The whole family is away on vacation..In my opinion in most of the cases I have seen the loved one really belonged in LTC but the family kept them at home...They usually have good intentions but the loved one's condition often proved that the care they were receiving was sub-standard...Another pet peeve of mine-why do these people think their loved one's care should be given gratis?Even with the regs families still try to hide assets when putting Mom and Dad in the LTC....The folks that pop in once a yr want no expense spared as long as they are not footing the bill....

Specializes in Hemodialysis, Home Health.
Originally posted by gwenith

It is interesting to see both sides of a picture here and the truth is there is not enough respite care anywhere in the world. The problem isn't new, either.

True. And I agree with Nurse Ratched... "I imagine as I grow older that my greatest fear will be having something suddenly incapacitate me enough that I can't off myself before I get stuck somewhere. Nobody had better peg tube me either."

Me too.

I can remember years ago, in the late '70's and early 80's when I worked as a CNA we had several regulars that came in right before the holidays. The family wanted to go on vacation and brought grandma or grandpa in and took off and left them after they were admitted. We were like a babysitting service to the family I guess.

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