Nursing Home Rant!!!!

[CraZyNOTRT]

To get started im a paramedic, and had my first CPR sat night.
i work for a private ambulance service so we do manly just transports but every now and then we will get calls from nursing home to go to the hospital. its supposed to be non emergency type stuff. it usually takes us 25-60 mins to get to a facility.


Called out as non emergency shortness of breath and we are about 35 Mins away.
arrived on scene to find a 64 y/o White Female, laying in bed, alert to nothing (pt is in vegitative state from major stroke a year ago). Head to toe shows a diaphoretic pt that has a trach with humidified O2, has an albuterol nebulizer mask on her face (? why i dont know she breaths through the trach), abdominal feeding tube, and a urine cath(With dark brown urine),hands lips feet turning blue Cyanosis. vital signs BP N/A (to weak of a pulse), pulse is 124, respitory rate is 24-26 shallow, lungs full of fluid.
So i hurry to the nurse to ask some questions and to get paperwork and med history.
Me: when did this start?
Nurse: 6:45 pm checked her SPO2 was like 55 (blood O2 levels normal is 95-100) (its now 7:50pm)
Me: is this her normal mental status?
Nurse: yes
me: how many albuterol treatments did you give?
nurse:2
Me: does she normaly breath like that?
nurse: no
Me and my partner load her up real fast on the cot, put on high flow O2 15lpm, and get her in the back of the ambulance. I hand the EGK leads to my partner to put them on, while i look for an iv site. She has NO vains. Looked at the EKG (OOOO SH!T). Sinus tach w/ Major ST elevation in all leads. (she is having a massive heart attack). Looked again for an iv site still cant find a vain. turn back to EKG>________________ asystole (OSH!T OSH!T). Pt vomited all over to cot and floor. yell at my partner to start CPR, i grab the suction and intubation kit, Tried Twice to intubate and keeped hitting resistance, put trach back in and baged the pt through the trach. told my partner to hall @ss and and tell dispatch to warn the receiving hospital CPR in progress.

Thing about private ambulance your in back of the ambulance by your self no fire dept to help you.

Im im back doing CPR by my self for a 4 mile transport.
Get to the hospital. give report to nurse (Im out of breath)
ER staff work on the PT for 15 mins, and called her. shes dead.
4-5 mins later nurse goes in room to do something.
patient has a Spontaneous heart rate with a Blood pressure.
all the ER staff runs back in to room, and starts working on her again.
as i was leaving the ER she started coding again.

I dont know if she made it.
So to list all off her problems she had a UTI, probably septic shock, pulmonary edema, and a MASSIVE heart attack.

AND NOW MY RANT!!!!!
Why the hell did the nursing home nurse wait that long to call for an ambulance? did the nurse get his degree out of a cracker jack box? did he not known the signs of a heart attack and respitory failure?

And to the patients Family, if your family member is a vegitable. PLEASE sign a DNR (DO NOT RESUSCITATE order), there is no quality of life, if its there time to go, let them go.

 

[captain]

Oh how I do not miss working in the back of an ambulance... thanks for reminding me why I got out of that business 10 years of it...

CAp

 

[Airavata]

While you're at it, to the families of people in that state: visit them regularly. Make sure they're getting proper care. Make sure the staff is doing what they should. That that woman was in that condition means no one at the home was really doing their job properly, and no one from her family was coming regularly to see if she was doing ok or not, is unacceptable. If she's intubated, cathetered, and otherwise non-responsive, it might be time to consider hospice and home care rather than an expensive facility, especially one where they aren't properly caring for their patients.

 

[erikm12]

My wife is a RN at a home, has been for a few years. I hate to hear the stories she tells........All I can say if you have someone you care about at a home, I hope you visit them a lot! Don't be afraid to speak up about something and go to management if you have a problem or issue that is not being taken care of the way you think it should be.
My wife has finally decided to go to a hospital to work.....I feel bad for the ppl that she will be leaving behind, as she seems to be one of the few who take proper care of the patients and treat them like people...not a hinderance
whos interupting your ass time........
Pretty tame post as this is a huge sore spot for me.............

 

[Rauzer]

My wife is a Nursing Home Administrator, I currently have a year of school left, year of AIT, and I'll be one also. Like it or not, it's about money. When they send a PT out, they lose money on the bed and money to pay your company. Chances are this happened before with the PT and everything was OK. They will keep them as long as possible and do what they can. May not be the "right" answer, but the bottom line is it's a business. And I certainly agree with the DNR.

 

[CraZyNOTRT]

My wife is a Nursing Home Administrator, I currently have a year of school left, year of AIT, and I'll be one also. Like it or not, it's about money. When they send a PT out, they lose money on the bed and money to pay your company. Chances are this happened before with the PT and everything was OK. They will keep them as long as possible and do what they can. May not be the "right" answer, but the bottom line is it's a business. And I certainly agree with the DNR.

yeah well if the PT dies, they loose alot more money then having a PT in the hospital for a few days. they would make more money if they kept the patients healthy.

 

[Rauzer]

yeah well if the PT dies, they loose alot more money then having a PT in the hospital for a few days. they would make more money if they kept the patients healthy.

Of course thats true. Neither of us knows the history of the patient. Seems like it was time for them. Dont think you can blame it on the nursing home.

 

[twotonevert]

A DNR is very important if that is what the patient wants. All I want to explain right now.

 

[071300r]

that has got to be a stressful job I would not want it

 

[BusaBret]

My wife is a RN for over 15 years. She has worked in hospital, home health, hospice and private care facilities. Last post was med director of a 60 bed ALF/SCALF facility. Sometimes it is not the nurses fault. Their hands are sometimes tied by the corporate mindset behind the facility. No this does not excuse the total lack of care but they do have to follow company guide lines as well as those laid out by the state they are in. These facilities as well as hospitals are NOT about patient care anymore. They are a business and ran as such. The nurses and their licenses are left hangign in the wind while the company covers their own hindside. My wife carries a LARGE liability policy on herself for this reason.
Posted via Mobile Device