Someone's mother, grandmother sister...

Got to work yesterday afternoon and we had a new admission a dear old lady who'd arrived from a retirement village. She wasn't well.

She'd just come from hospital where they'd given her a double dose of laxative medication and then another different lot of meds for the same thing. They then shipped her back off to her retirement village, where apon she was given more meds for the same thing!!

Next she was passed on to us(all in the same day), a nursing home. She was so sick from both ends. She was continuely telling us she was frightened,in pain and later thought she was going to stop breathing - through anxiety.

We were so infuriated that this purging of her system was done to her with a cocktail of drugs(we weren't even given information on why she received this medication) and helpless to give her meds to counteract the effects of the laxative. This type of behavior can cause an old person to pass away if extreme enough.

Why were we helpless? Because she legally hadn't been admitted to the nursing home by a doctor and that doctor wouldn't be coming until tomorrow - when they got around to it! So we couldn't administer her any meds other than paracetamol.:banghead

Here is a minor situation in a very majorly disgraceful Australian Health System we have at the moment! There are many horror stories that far out way my shift last night happening all over Australia and it pisses me off!:guns

And as I looked down at my shirt 10 minutes before going home, I noticed it smeared with faecal matter. Normally I'd think, damn, I can't stop off anywhere on the way home but last night my thoughts were of sadness at the pain and suffering this poor woman was going through through no fault of her own. Someone's loved one.Someone's mother, grandmother sister...

 

It takes caring people to make any care system to work. Sadly, to many it is just a job.

Keep on caring.

 

Yes it does Bill and yes sadly to some people it is just a job, which is reflected in their work. Why don't they choose a job more suited to them?

I dread the day when I am elderly and need medical help - will they really take the time to find out what's wrong and treat me or will they have the attitude that I'm old, had a good life and am going to die anyway? Because I'm sure that's the attitude with the doctors who have treated some of the elderly here.

 

Takes me back to 23+ years ago, when I was involved in Nursing. The lack of consideration and care pf many so-called 'care professionals' never ceases to appal me. rolleyes They seem to loose track that they are dealing with human beings, and they wouldn't like to be treated accordingly.

Sad to say, things seem to have deteriorated even further since those times. Some do indeed care and do an exemplary job, but many just view patients as some kind of inconvenience. That's when I think that maybe some day, they might be in the same situation. If you're beyond caring, then you have no business in the care business, i.m.o.

 

I believe it's the same all over, here in the US for sure. I make an annual trip to the hosp which gets worse every time. Last year had 5 people in the ER while I was not breathing, standing there watching me. Finally a young men ( respiratory) said, she's crashing" At that I was handed a suction tube and told to do what I thought needed and push it down my airway. I expelled something, (lived) lol and have what I hope everything I need here at home to survive. More then half of the people in the nursing community have no business in at all. It's scary for sure. Another observation I made the people who get the attention are the ones who's family is there with them.
It's like, " I've needed to use the rest room for over an hour now - Nurse," wait till I get the patient over here (the one w/fam.) a newspaper rolleyes

 

I've worked in health care in one form or another for the last 16 years (17 this year) and have seen the same. I have worked in pre-hospital emergency care (Ambulance), Cardiac Tech in ICU, Phlebotomist (aka Vampire) and now at the answering service, and I have to admit, it is a sad state of affairs when the people who are supposed to but the 'care' in heath care just don't.

Don't get me wrong, I have been accused more than once of not caring, but believe me, I do. Sometimes, you do have to be a little clinical, or it can drag you down, but i like to think that i have managed over the years to find a balance between caring too much (yes, it is possible) and not caring at all. The problem is that too many of the MD's here in the US have the God complex. That gets passed on to the nurses who have to deal with the fall out from that, and the resultant fall out ends up dropped on the patients and family. Not fairly, albeit, but still, that is my observation.

Unfortunately, I have no idea what to do to make it all better, but I do what I can with the people I work with to make each of those encounters a little bit better.

~C

 

Certainly in the UK much of the problem stems from staff shortages. The nurses would dearly love to have the time to spend with individual patients, but they are so short staffed that it's simply not possible.

In the UK I think a good starting in point to sorting this out would be to cull the ranks of pen pushers, administrators, managers etc. who contribute little to the actual caregiving, but merely add to the workload of the already overloaded nursing and auxiliary staff!

Sack the dead wood, streamline the management and have people who actually understand the difficulties of medicine and caregiving run their own ship. With the money saved more staff could be brought on board and the nurses might have time to do their job properly, the way the vast, overwhelming majority would wish to!

We have a real problem at the moment with "superbugs" (c. deficile, MSRA and a few others). The fact is the nursing staff do not have the time to clean effectively, and so such bugs are able to flourish!

Give the NHS back to the caregivers, take it out of the hands of the accountants and managers, and it'll all work better!

 

Regretfully healthcare facilities are more concerned with making money than the quality of care given. I worked in an out-patient surgery center for yrs and you would not believe some of what goes on. There are some great people in healthcare (the majority of what i saw) but also some real morons too and when your dealing with peoples lives a few morons make a lot of difference.

 

We suffer from staff shortages too and every Thursday and Friday evenings we lose one nurse because the owner of the establishment wants to work and save money! Huh? She's a multi millionaire!!

 

Snotagain, Do you feel your staff shortages are r/t social medicine. and what is a paracetamo? (like immodium?) What do you think it would take to end the nursing shortage worldwide? Money? Private pay? Are you disillusioned with social medicine in general? We have our problems here too, bigtime. But not as bad as some make it soudn I think. I am an RN in the US and am kinda curious what it is like in Austrailia.

 

I certainly commend you on your caring attitude and acknowledge you as one of the select few who takes the profession seriously.

As you are probably aware, when it comes to Aged Care Facilities, (eg nursing homes, hostels for the aged), a contract exists between the resident (often signed by the primary carer representing resident such as P.O.A. and/or legal guardian who is often a family member) and the Facility. Residents with such a primary carer (the lucky ones) who have read and understood the contract can work well with the management and staff towards not only the care of their loved one but also as an "advocate" for the other residents (a "voice") to prevent situations as you describe.

There is a lot of power within those contracts that can be exercised to ensure better care not only for your loved one but for other residents. I know through experience and by "exercising" those contract clauses while keeping the balance by "working" with management and staff.

Sounds to me that the procedure and practices at your facility requires review for a mechanism for contact with a medical practitioner at all hours for consultation with the RN in relation to medication management. This becomes duty of care within your facility and a vital area that appears to require active review by management to avoid breaches.

 

No, paracetamol isn't like Immodium, it's just an over the counter pain killer. The well known brand name is Panadol.

I don't profess to know the answers to these problems(I'm not a RN only a AIN) but at the moment we have a nursing and doctor shortage and our government has failed to inject necessary funding into the health system for years(we're just about to have an election so things might change, hope so).

Here AINs are on pitiful wages! Some of us go to college to become AINs but our wages don't match our labour output. Some teenagers working cash registers get more, so a lot of nurses are disillusioned. Don't get me wrong I love my job but I also work at the opposite end of the scale as a Youthworker and my wages are far better.

So tell me, does our government think more of our youth or our elderly? - the wages give that answer.

I think money and working conditions are a big thing. Why would doctors and nurses want to work in the system we have now, when they don't have the funds to run the hospitals at an acceptable standard? I mean, why should family members have to transport their sick loved one from one hospital to another because there isn't an ambulance to take them for example!!??

And another thing, to fix up Nursing Home quality of care I staunchly agree that all AIN nurses here should have their level 3 AIN certificate from college before they step foot in the door! Employing 'walk-ins' is bad practice - they have no idea on manual handling, infection control, catheter care etc and some don't even have a clue about the human body and it's functions.

 

I know that in my area, most of the facilities do have a contract with a PCP (primary Care Provider) in the area to cover after hours. The thing is, getting the on call to return their call is sometimes arduous. Can't say a lot more than that, but that is enough I think.

~C

 

Resent cases of Care improprieties have bought media attention in Australia, and consequently, some official investigations have resulted.

This is one study, based in Queensland, and published by the International Nursing Review. The overview and link listed below.

http://www.blackwell-synergy.com/doi/abs/10.1111/j.1466-7657.2005.00429.x?journalCode=inr

Original Article
Residents' rights and nurses' ethics in the Australian nursing home:-

And concluded by saying:-

Just one example of widespread concerns in the areas of Nursing Home Care.

Personally. amongst running a household and several companies, etc., one of my main functions is to provide home care for a family member with disabilities, precisely to avoid some of the issues outlined above. Nursing careers may come and go, but being a caring individual, on many levels doesn't. For some of us, providing care for others isn't just a job, but a part of daily life.

 

CallTaker makes a solid and valid comment: "know that in my area, most of the facilities do have a contract with a PCP (primary Care Provider) in the area to cover after hours. The thing is, getting the on call to return their call is sometimes arduous. ".

I fully understand the situation re getting PCPs on calls. This is where the contract clauses between resident and facility can be effective in pressuring Facility management to ensure standards which includes "on call" matters. Such matters affect Accreditation for the Facility - bad scoring with accreditation affects funding and at worst, closure of a Facility. So it is in the management's best interests to ensure standards which encompasses PCP. It just takes one active family member who represents a resident to put a fire under management - anything positive done for one family member actually can have a good domino affect for other residents and facility in general.

New legislation coming out is also going to put further responsibilities on RNs that they need to be aware of re Aged Care Facilities, so in their best interests, RNs should be aware of their own contractual agreements contents to ensure just what/how much management is laying on RNs (Nursing Board Associations can be a good point of contact here re RN contracts with Facility).

 

Phantom, re your comment: "Personally. amongst running a household and several companies, etc., one of my main functions is to provide home care for a family member with disabilities, precisely to avoid some of the issues outlined above.", there is assistance for persons in your type of situation - some government funded, other types voluntary.

Doing it alone is commendable. However, there will come a time where you will have to consider a Facility for the benefit of your loved one as well as yourself. There are some excellent ones out there (takes some research/networking/footwork to find the one that best suits). Not sure where you're located - if in NSW Down Under, I know of some excellent ones that also takes into consideration financial status.

 

My nursing home isn't bad as the standards go - they have always received 3 year accreditation every time, the highest level you can get I've been told. I also agree with Calltaker.

That's the trouble with some doctors, getting them to call back or come quickly. The RNs get extremely frustrated as well. Maybe the doctors are under a heavy workload, I don't know? Maybe most of us are just trying to do a great job in a shit system?:cry

Sadly Legalsuit, some of the services for families of the disabled have been closed in the Sutherland Shire where I'm from, which have left them in a terrible situation of no respite.

It's been really great with all you guys giving feedback. Thanks Phantom for the link as well.

 

Well, I've had a look at what I'm entitled to, which apparently isn't a lot, since I'm considered too 'wealthy' to need much help rolleyes . I get a (very) small allowance from the Govt., and some concessions. I'm not really complaining, as my only concern is for the quality of life of the Caree involved. I used to do a lot more for a few people, but Departmental bungling and improprieties have restricted that.

I'm in W.A... Really, I just do whatever it takes to ensure that others can experience life in the manner that they should be, i.m.o. It's not always an easy ask, but that's been my choices in life, I guess. I can't change the world, even if I wanted to, but I can change for the better at least some of the lives I'm in contact with.

 

Phantom, rather than looking at your own financial status, what of that of the Caree? Not sure of WA...have you checked out these links:
http://www.liswa.wa.gov.au/disability.html
http://www.health.wa.gov.au/services/
http://www.carersaustralia.com.au/

Even as a Carer, you should be able to get some sort of assistance/service (Centrelink?) for the Caree. Assistance/service for them actually can assist you. Rather than seeking assistance/service for yourself, turn it around as assistance/service for the Caree. If your Caree is an elderly person, then the Aged Care Team can also be particularly helpful in organising something for you/provide info & direction.

Don't give up looking/networking for some form of assistance/service which can be obtained without consideration of your own financial situation. The person is the Caree who needs the help and that's the way you need to approach it. Your own mental/health is very much important, so don't forget about yourself....you can only go alone for so long.

There is a way, just a way of finding it and you can do it.

 

Some good advice there. I'm pretty much up on what's around, I used to work for state Mental Health Services, and Disabilities Services back in my nursing days, and still have contacts there.

I'm not concerned with my own welfare, I can take care of myself, as I always have. The person concerned does receive considerable benefits and employment from a number of areas which I've helped set up in the past. My concern is for the caree to have a normal and happy life as possible, which he does.

I may have extra stresses and workload/expenses etc., but like I said, that is a choice I have taken. It's not about me, it's about doing my best for others, which I do to best of my ability. I'm quite aware of various options, the appropriate ones which have been explored/implemented in the past.

Without going into a lot of details, I'll just leave it at that.

 

But it is about you too. It's obvious you care very much for your family member and they are lucky to have such a caring person standing by them the way you do; it also must be really hard for you.

I probably don't need to tell you this because of your background with the MHS, DS and nursing but your health is important and doing the best for you too. You're just as important if you want to be able to continue care of your family member, which obviously is without question.

I hope you are entitled to respite, for 'you' time, so you don't burn out - you deserve it after all the work you do with caring for your loved one, running your home and several companies.

I wish you all the very best for you and your family.

 

Sorry it's taken a while to get back to this. Thank you for the kind words. I just do the best I can, for as long as I can.

Last Sept, resulted in two near-death experiences and hospitalization within four days of each other. Turned out my B.P. was 270/240, or something silly like that, and a blood clot had shifted (a legacy of previous army incident a few decades earlier), just before the second admission. That combined with a combination of other health issues and factors, was when I was told by the Doc., that something needed to be done immediately if I wanted to live much longer.

That was when I realized I was walking on the edge way too much for way too long. Three lots of B.P. medication, and six months later, things are nowhere near as precarious, and I'm becoming a lot more functional in some areas. Respite is not really an option, but a somewhat reduced pace is in order.

Now, I thank God every day I wake up for the fact I am alive and CAN wake up. At the risk of sounding a little pedantic, I guess life is as good as you let it be.

I guess the original point of my post was that Nursing care is somewhat of 24/7 situation for more people, and I know I’m far from alone in that.

 

Good grief Phantom, thats some blood pressure. Glad you got that squared away.

 

Phantom that is so scary! I'm so glad you're on top of your blood pressure. Thank God that blood clot didn't kill you!!

Like you said "reduced pace is in order" - please look after yourself.

 

My blood pressure was high, got one of those wrist gages. Worried about it so much I stopped taking it. :foolish

 

Yep, I bought one the wrist Blood Pressure/heart rate meters, too. Seems I'm a lot higher in the morning, soon after I rise than later on. So it's higher after I've slept, I still don't know why that is.

@ Snotagain:- Yes, when what turned to be a blood clot moved, my left leg and arm went all tingly, and I couldn’t move it properly, which was more than a little disturbing for someone that had just got out of hospital four days earlier.http://i59.photobucket.com/albums/g309/Zobor/bigeek2.gif Sometimes life has a way dealing us little 'wakeup calls'.

The Doc. eventually prescribed Avropro, Coversyl and Zanidip. Seems to be doing the job now. If B.P. continues to be good, I'll look at easing back on some of these dosages.

At least I've finally paid off the ambulance bills. rolleyes

 

So you discovered the clot after you had been in the hospital for something else? Has anyone explained why you BP is higher in the morning? Maybe by being up and moving around helps for they say exercise helps bring it down. I believe mine goes up due to the breathing medications I take.Medication freaks me out, I have never been one to use over the counter meds. I must have past this on to my children for I have noticed they are seeking more natural forms. One even was fighting the state she lived in over refusing to immunize one of her children. Not that they would refuse life saving treatments or medications.
Ambulances I believe charge by the inch rather mile. I must have accumulated thousands of dollars, thankfully I had insurance. It took years to get a handle, like I discovered the flu shot would start the process (for me anyway) late fall all the way through winter of being sick. Getting closer to my lung reduction surgery also. Well just saying that probably made my BP go up. - Take Care

 

I believe the clot showed up on a M.R.I., since they were a lot more thorough the second time around. I think they finally figured it was more than first thought, after finally checking my medical records completely.

I just woke up with an I.V. drip with Diazepam (Valium) in one arm, and some form of Warfarin in the other, and wires hanging everywhere. Glad it's over, anyway. I can now concentrate on my said duties of care.