May 22, 2006

Adam and Eve - Part 1

My inner voice is urging this series of articles. Bear with me...

Some elements have been changed to protect identity.

Every time I clock in for work at the local nursing home, I wonder how many new admissions have arrived since I last worked. In two decades of nursing I’ve never ceased to marvel at the family expectations – and subsequent disillusionment of even the finest nursing home facilities.

I’ve never worked anyplace where the employees agreed, “This is where I’d like to live when I’m old.” Never.

Having said that, I do know some hidden secrets that make or break customer satisfaction. These I will share with you the next couple articles about nursing homes.

Last night our new admit was an 80-year old lady who had a hip replacement. We weren’t expecting a Sunday admission. The paperwork was not available and the staff were not prepared to change their schedule for the day. But, the ambulance pulled up right as lunch was being served and the nurse was trying to get noon meds passed.

Accompanied by a very concerned son, the patient and her son immediately began turning on her call light for various questions and requests.

“She wants side rails so she can turn easier.”

“Can we put the oxygen machine in the bathroom because it’s so noisy.”

“She’s constipated and needs a laxative. When can she have one?”

“Can she have a pain pill now?”

“Can we get her out of bed and up in the chair? She’s been lying down all day.”

“She has pneumonia. What antibiotic is she on?”

“Shouldn’t you turn her oxygen up? She can’t breathe good.”

“What are those pills? She can’t have any meds that make her heart beat faster.”

“She has a sore on her bottom. Can you put something on it?”

“Can she have another pain pill? That one didn’t help.”

“Are you planning to go home and get some rest?” I asked the son about midnight.

What they didn’t know was that her doctor had been in an accident over the weekend and could not be reached to confirm changes the on-call doctor had sent with the patient. We don’t tell “customers’ information like that.

What they didn’t know was that for every question that night, I had to make exceptions to the rules or call the on-call doctor to get an order on a Sunday night! Every time the call light came on over the door again we were saying, “There she goes again.”

I charted, “Patient seems a little insecure.”

Selecting a nursing home is not easy and it’s not something you do every day! There are many things you could learn about living in a nursing home that would help make life easier for yourself and those who take care of your loved one.

There is never enough staff, and if there was, I’ve learned that human nature being what it is, people would take longer breaks and those who demanded more would get the extra attention. So, don’t expect a perfect world in any situation.

A nursing home is only as good as you help make it. The families who really want the best for their loved one have to be involved. They must learn not to get what they want by constantly complaining (and there’s plenty to complain about), but by being involved and actually assisting with care.

Take “Martha” who has a loving daughter who is present every afternoon. She not only sits and reads to mother, but then goes into the bathroom and helps wash up. She lays out the clothes for the next day and leaves the room picked up and tidy. There’s fresh ice in the water picture and the drapes are pulled closed for privacy.

But there’s also, “John” who has no one left in his world of 90 years on this earth. He is alert and still has a good sense of humor. He must depend on the staff for his every need and he knows the staff by name. He knows whom to order out of his room because they are “worthless” and he is quick to praise the kind, hard working staff who cater to his every request like he was a king.

I sigh as I think of all the patients who are beyond knowing they are still in this world. They wander into all the rooms, dribble on their chins and green gunk matted in their eyes. Stumbling with every step and refusing to be assisted to the bathroom, they don’t smell good and they often fall down. We must give them the same unconditional love and tender loving care too.

You will find all these situations – and more – in every long term care facility.

So, what should you look for as you search for a place for your loved one? What questions should you ask yourself? What questions should you ask the admission director? What questions should you ask the nursing staff? What are the secrets to getting more attention and better care?

I’ll address these points in my next article and I'll introduce you to The Adam and Eve Care Center!

Take Care on the Journey

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