Having A Difficult Time

[sparkey]

I have worked in many nursing homes over a period of 10 yrs. and 15yrs. in a hospital. When I worked in a nursing home I could not believe half of what I saw on a day to day basis. It was a very sad place and the care was terrible meaning not the care that one would give to their own family member at home. Sometimes the staff was short and they would give one aid 10 patients to take care of in one 8 hour shift. I am not making excuses as I am totally agreeing that nursing home care is terrible and something needs to be done about it. Also there was cruelty I saw with how some would just leave patients in their feces sitting for hours etc. I finally could not take it anymore and got out of nurses aid work. When a woman I loved like she was my own grandmother passed on, I had to give it up. I was to attached to her.

I also have a daughter that was very ill starting at the age of 16. She would come home from school with loose stools and lay on the kitchen floor on her stomach as it soothed her tummy. I use to yell at her for laying on the floor and now that she is 27 she explained to me why she did. For almost 8 yrs during her early childhood I was taking her to a pediatrician for stomach and stool problems. They told me she was a hypocondriac and that she had a lactos problem and to stay away from dairy products. Her stools continued to get worse and she lost 40 lbs. I took her many times to the ER for dehydration only for them to send her home after giving her fluids.

Her stools got to be without exaggeration 20 times a day and bloody with no form to them at all. I took her to the ER again and they were sending her home. Thank god she had to go to the bathroom as I gave her a hat ( to catch on the toilet) and collect the stool. I then showed it to the nurse and REFUSED to go home. I demanded she was admitted that night. The next day they had me drive her to a hospital of my choice in her johnnie with the hep lock ( for IV) still in her hand about 40 miles to a good hospital of my husband and my choice. That evening they marked her stomach for an emergancy surgery to remove her WHOLE large intestine due to ulcerative colitis. She had a colostomy bag for 2 yrs.

The reason I am saying this is, this pediatrican for 8 yrs. told me my daughter was a hypocondriac and that she only had a lactos problem. Never had her tested. My daughter was 21 when she decided to take this doctor to court to fight it. She wanted this doctor out of practice. I will never forget the day she sat in court with just her lawyer and had on the other side at least 15 lawyers for the doctor, hospital etc. This fight went on for 5 yrs. and she ended up walking away with NOTHING. They dropped the case. I have no idea why. I think my daughter should of had a better lawyer to tell you the truth.

This lawyer made my daughter pay for every stamp, paper typed etc. This was a medical malpractice suit where she ended up with NOTHING. This doctor still practices today, and my daughter has a scar from under her breast, down past her belly button and a scar of memories of doctors not listening to her pain for 8 yrs. Sometimes you go through the pain of taking doctors, hospitals to court and ends up you get nowhere. Just make sure it is something you want to persue and fight for as it can get dragged out and only to find you do not get anywhere with help for neglect.

[capricorn]

Oh Red..you are an Angel as are all nurses in my eyes.


MJC...I am so sorry you are going through this. There is nothing for me to add that hasn't been said by the others. My prayers will be with you and know that your mom loks down on you and loves you for the wonderful daughter you are. Go with your gut.

The only time I had ever heard of C dif was through one of my husband's stays in the hospiatal this past year fighting cancer. He was very prone to pneumonia so admitted several times. After his Chemo and radiation were done he had suffered extreme radiation burns in this throat and esaphogus. WHile in the Hospital he vomited and had diarrhea for 12 days. If I heard one nurse I hear 10 a day tell him they were sorry about all the stool samples a day but they HAD to check for C dif. Now I understand the danger.

God bless you and keep you strong.

Hugs,
Cap

[red1030]

Good Morning all.... first I want to clarify a few points. I do not want to bash nursing homes. I personally would have no issues with living in a nursing home if it is ran correctly. I don't believe they are the best thing since sliced bread, but they are the only arrangement for our elderly. There is no money in long term care. We often were not able to make payroll or had to borrow to make payroll and I saw what came in and what goes out. I was one of the major payers in developing the budget for major sized nursing homes. My budget was the largerst since nursing covered not only the largest number of employees but also, all clinical needs such as the buying of bed, hoyer lifts, etc etc etc. The reason there is no money is that people believe that paying $5-6,000.00 each month is a lot and those that are on a medicaid which is usually greater than 50% of a home pays less. Consider the cost of care by nursing for 24 hours. What does it cost to bring in a private nurse? Have you ever tried to do it. Brandi rans a nursing agency and she will charge for a certified nursing assistant to come to help with a shower about $150.00 a hour wiht a minimum time there of 4 hours. That is $600.00 a day...now multiple that by 30... that would equal $18,000.00 per month. Now consider your rent of medical equipment, and your cost of housing, your cost for utilities, your cost of transportation to and here, etc etc etc... 5-6,000.00 a month does not even begin to allow for good care. Then the next consideration is what does the federal laws allow for in staffing patterns. For day shift it is less than 1 aide for every 10. The law actually allows 2.7 hours a day of care for your parent. THat is all they pay for. What can happen in 2.7 hours. Remember this includes cooking time, nursing care time, housekeeping time etc. I usually ran a 3.4-3.6 HPPD (hours per patient day). I was in heaven when I could budget a 4.0 due to money from other sources than payment, such as a dowry for the home etc. A 3.4-6 equals staffing patterns as such... 7-3= 1 licensed nurse for every 30 patients on a non skilled unit, 1 CNA for every 6-8 patients, then one supervisor for no more than 180 patients. On a skilled unit (sub acute) the hours would run closer to 5.0 HPPD...but mostly because this is paid for by medicare and that is more money especially if they are in rehab which is the highest paying section of the RUGGS grouping or MDS assessment period. On a subacute, I would run 2-3 licensed nurse for 30 patients on days with 1 aide for every 5-6 patients. 3-11 pm... non skilled would recieve 1 cna for 10 and 1 licensed nurse for 30 etc...night 11- 7 non skilled ... 1 cna for 20.

Sparkey I have seen a lot of cruelty, and it is a mandate to be reported to the department of health in each state. There is a complete protocol that must be followed from how to do the investigation to time limits in reporting it etc. Abuse is not tolerated by the federal statues and should not be tolerated by a Director of NUrsing or a ADministrator. I hope that you reported this abuse that you saw and that it was taken care of. People who don't care, do not belong in Long Term Care with our elderly population. In my last home, I walked in and the day I got there, the home went in to immediate jeopardy. This was my 5th time I took a home knowing that it was going to have to be cleaned up or it would be closed. These homes are not easy because a DON a lone can't do it. It takes an entire staff who wants to do it, to make it happen. I was successful all 5 times in a home from 30 beds to a home with 530 beds. The day the 530 bed went in to jeopardy, I went directly from the meeting and planned a clean up phase in about 8 hours... went directly from that to educating over 200 staff during the 11- 7 shift..then anothere 400 from the 7 - 3 shift...yes I didn't go home...I didn't go home for an entire week following this one. Cleaning a nursing home is about the residents. Did you know that statistic tell us that any resident who has lived in a home for more than 1 year and is forced to move may not survive past the 6 month margin. This is related to a lot of issues. New room mates, nurse, changes in routine, distance from support, and so forth however, the point is that to close a home has a greater impact on the residents than on the organization or the staff. It was my job to assure that my residents could feel safe that their home was not in jeopardy.

C diff runs rampant in nursing homes. It started however, in the hospital. I will talk about this later after MJC comes back. MJC... I have a lot more to discuss with you to help you when you pull records...you need to kn ow what you are looking at..what is the norm and what should be expected versus what you can't expect to happen... love you all REd

[MJC]

First, thanks to all of you that responded and care about this situation.

Red,
I just read your post and I have plenty of work to do for you. I will get this done as I will print out your post so I can better answer the questions you need answered. You are such a sweetheart to take your time to help me with all this mess. I can tell you one thing. Just by reading some of the questions, I think this nursing home will be in deep trouble. There is so much you asked me to answer that I know the answers to them will be no, the nursing home had none of these plans in place. I will take my time to thoroughly review your questions and I will get back with you. I just got the death certificates so now I am able to proceed in getting Mother's medical records. I will be starting to work on this tomorrow. Just give me some time to get back with the answers you need. I can't thank you enough and I will also call you. I believe I still have your telephone number in one of my emails you sent me when you had new contact numbers. Jayne was so right and I thank her for her advice telling me to get in touch with you......so thank you Jayne.

God Bless all of you and my love to all.

Cajun Hugsssssssssssss,
MJC

[red1030]

MJC...why don't you call me when you want or have a question. Also, lets communicate through our phones and our email systems... I will send you a pm with updated information. When you get your mothers medical record I may be able to help you with this..it is my pleasure. Love you Red

[jayne]

ahhhhhhhhhhhh I love it sisters helping sisters that my ladies is what family is all about......

[sweet tooth]

one for all and all for one !!!

[red1030]

amen....love Red

[Tuffy]

MJC,
Iam so glad you called Red, If there is anyone that can advise you it is her!. This Lady is a wonder and so full of knowledge. I would want her in my corner any day.
Good luck and here's wishing you the best. With Red's help all will be well......

[red1030]

Tuffy...thank you. That means a lot to me, coming from you as another nurse. I respect your knowledge as well. You as a nurse is what I had hoped to grow up to be as a nurse..thank you love Red