Now I've seen everything.
Recently I took an ambulance call that went something like this:
"This is unit X and we are coming from the local nursing home with a 92 year-old female that is pulseless and apneic (code word for dead) CPR is NOT in progress as the patient has a DNR. Our ETA is 2 minutes and we will give you the rest of the report in house."
WTF?
Well it turns out the patient is not only a DNR, she is a hospice patient who is on comfort care. She should have never been transported to the hospital but the ambulance was called. When they arrived the patient was clearly almost dead and they tried to refuse to take her but the nursing home staff was insistent so to avoid an ordeal they transported the patient, who died just as they pulled out of the facility.
The medics did the best they could but now here we are with a corpse that we will have to make arrangements for. Someone who should have been allowed to pass in peace, in their own bed. What kind of idiot cannot understand 'comfort care only' orders?
Shortly after this, the patients son - an attorney - arrived and he was livid that his mother had been sent to the ER. I don't think I'd like to be in the nursing home administrator's shoes right now, or the nurse that made the decision to force the ambulance crew to transport the patient.
Friday, June 13, 2008
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9 comments:
I guess the nurse felt she would have less paperwork to fill out for an ambulance transfer than a death. Wonder how much paperwork she'll be dealing with now?
Wow--that has all my dumb NH transfer stories beat, including the stable patient with edema for years who had "more edema in her left forearm" one morning so they sent her to the ER.
If they're declared in the nursing home, reimbursement ends that day.
If they're in the hospital when they die, however, the nursing home can be reimbursed for the rest of the month.
Motive, perhaps?
AD,
You cynic.
Maybe what we need is for a few more family members of lawyers to be mistreated to get some changes in the bad nursing homes.
Ditto for EMS. :-)
Just kidding, mostly.
Oh that's horrible,that poor lady couldn't even die in peace.
How sad that she had to die in an ambulance instead of in HER comfort zone. Shame on them.
This is not in the spirit of hospice. I am always cautious when transferring comfort care or hospice patients who are actively dying. I wouln't want them to die in the elevator when leaving the ICU. How sad for this patient and her family.
In addition to the attorney son giving admin a piece of his mind, I hope the service providing hospice services does too.
Were that my parent i would also be livid. I dont think it was monetary, but stupidity.
"We'll give you the rest of report in house." After pulseless and apneic, I think I've got it, thanks. Time for lunch.
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