First nursing home patient of the day was sent in for vomiting twice. She had a UTI, no fever so we gave her a bag of IV fluids, and antibiotic and sent her back - the staff could have just as easily called her MD and taken care of that from the facility.
The second was sent in for not acting right. He was nearly comatose, skeletal and so profoundly dehydrated that his serum sodium was sky high - 179! He didn't get in that condition in the space of a few hours - it spoke of days of no fluid or food intake and gradually deterioration not recognized by the people who he depended on for care.
Patient one didn't need to come to the ER and patient two should have been there a week ago.
Tuesday, June 3, 2008
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5 comments:
I had a patient who was in SIRS, MODS and septic shock. Family called 911 from the ECF themselves. The staff had told them she'd have to wait to see the ECF doctor before they would. Sheesh.
That makes me feel ill--I hope the people who were supposed to be caring for the second patient were reported to the authorities. Nothing makes me so furious as abuse or neglect of those who can't fend for themselves. At least you were there to help.
The nursing home is an excellent example of what happens when a nurse is discouraged from thinking, sometimes punished. If they call to transport the patient without permission from the doctor, who is rarely there, they will be in trouble. The nurses who survive are there for their ability to go along to get along, rather than their patient care skill.
Sounds like typical nursing home care to me.
Ugh! Strikes a chord with me! See my post recently about a patient from a nursing home with a mandibular dislocation for almost three days!
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