I am soooo angry! My poor mother-in-law has not been well. Ever since returning to the nursing home from the hospital she has been doing very poorly. At first, I thought it was because she was not completely over her bronchial infection. But her lungs were clear. What was even more clear was the fact that something was wrong. I would mention it and mention it to the staff at the nursing home. My daughter also mentioned that she thought her grandmother was in pain because she would draw her leg up as if she were in pain.
Wellllll......it turns out she has a UTI!!!!! And on top of that they did not put STAT on the lab specimen and it will not go out until tomorrow morning (I found this out after it was too late for me to run it over to the lab myself!!)
She has not been responsive, animated, looking well for weeks. I mentioned it and mentioned it to anyone and everyone and they have just poo pooed my concerns. Tomorrow, I am going in there and blowing the roof off. (Okay, so I am not really going to be that nasty, but I AM going to make sure my concerns and feelings are known. If I am not taken seriously I will complain to the the Ombudsman!!! When she had a incontinent episode her urine was very strong and bad smelling. Combine that with the fact that she has been behaving like death warmed over and you would think they would have given her lab specimen some priority.
She can not verbalize these things and so they think everything is hunky dory.
Now, I know they are overworked and they really are some wonderful people, but this better NOT happen again.

God forbid, if this ever happens to me I hope I have someone like you to run interferience. I feel so sorry for some of these poor helpless souls. The more stink you raise the better they will hear you. The squeeky wheel gets the grease, remember that!

You go girl! You have to stay on top of things when a loved one is in a nursing home,believe me! My mom was staying in bed, unusual for her, and I asked her what was wrong. She was still talking at this point, so she told me her stomach hurt. I called a nurse in, and next thing you know, she was off to the hospital, turns out she had a perforated ulcer and was bleeding inside. Please! Keep tabs on your older folks, at their homes, yours, or in a facility. My Mom has been gone from us for 17 months now, I miss her every day.

I can just see the concern and love in these posts. Though I strongly believe we must take responsibility for our own bodies and those of our loves ones, I have experienced that particular situation from several perspectives, both as a relative and as a nurse/consultant and would find it difficult to place blame exclusively on the facility. I wonder if your loved one is already being treated for a UTI based on symptoms and the UA is simply to verify the diagnosis therefore, not a stat procedure.

Most of the people who work in nursing homes are truly called by God and treat the work as the honor it is. But even the most well intentioned cannot address the myriad of problems presented by so many elderly and infirm patients in their care. Even the best of caregivers can be overwhelmed by constant exposure to pain, disease, and death. Families all seem to demand a level of care that can only be provided by a family member or a private nurse.

The patient load necessary to support a nursing home is very high and the work is extremely difficult. Infections and complications of every kind are common and personnel must divide their time among so many patients all of whom suffer from the myriad of problems that result of aging and immobility.
Using an aggressive approach may only offend an already overworked staff and cause them to avoid your loved one.

My suggestion would be to approach the nursing home staff as a team of which you are a member. Ask if there is anything that can be done to treat the problem and avoid it in the future. Then become an active participant in the care.

Smile

Ladies,
This is a subject that is near and dear to my heart. I have viewed both sides, have seen the good, the bad, and the unforgivable...

Listen to me, and if you don't do anything else while your love one is in a home, DO THIS.... keep a daily journal. Please...for their sake and your own...keep a journal.

Nursing home staffers are overworked and yes, they are underpaid. I have seen some that I swear they had wings growing out of their back and they became a part of my family. I have also witness cruelty, abuse, and behavior that should have brought jail time. Of course I reported it before you ask. These facilities are sometimes limited by actions they can take against people OR even FOR the patient. I've seen women who were mean to the patients be given a tap on the hands and sent back to work. I've seen a guy who shoved an old man who could barely walk because the poor dear wet his pants....the man in question was scolded. Is this justice? NEVER! Then I have seen nurses who sat with me round the clock when we thought Daddy was dying. They visited the hospital when he required treatment there, on their off days. Then I've seen CNA's and some nurses who would call long distance to find out how we were coping after Daddy's death. These women couldn't afford the long distance call.

When you go to talk to them, don't try and reason with them. This is no time for reasoning. HAVE FACTS and be ready with a soltuion, at least from your point of view.

While SMILES is 100% correct in saying that you should have the "team" mentality and that you expect (we all do) our love one to get the best care possible....but reality is this. NO ONE....(pay attention) NO ONE will give your love one the 1-on-1 care and love that you will. Some will, but not every worker, not every shift. You learn to depend on the ones you know WILL, and the ones you know or suscept WON'T you watch...and show up at odd hours, and ask tons of questions of them. If a worker knows you are involved, and if they know that you will be around, they are more likely to give better care. Okay...Queen is now stepping down from her soapbox. I truly must write about my experiences with caregivers, the good and bad. I will some day, when I've healed properly....

Hope this helps and didn't come across as too preachy...I only want the best for your love one too...

KEEP A JOURNAL....

JJ

Boy are you ever right JJ. The good are very good and the bad are very bad and almost all are overworked. However, I think the bad often get worse and even the good can become defensive when attacked. A Journal will certainly help you to know who to trust and will give you evidence if you need it.

Of course there are plenty of times you have to fight for what you know is right for someone you love, but I'm just not sure it's correct to blame the facility for a UTI. They are so common in the elderly no matter how good the care and to go in on the attack without adequate knowledge could simply cause more problems for someone you love.

As to doing a UA stat, it costs much more to do it immediately and Medicare often won't pay. For that reason, the treatment sometimes begins prior to the UA and it the test is used merely to confirm the diagnosis. As to you taking the urine to the lab, I don't think the facility can legally utilize a family member to transport specimens due to contamination factors, etc.

Not trying to excuse the facility here, but just trying to help you get the best care possible for your family member.

Just my perspective.
smile

Well, yesterday when I went to drop off mom's meds and ran in to check on her I was so agitated by the expression on her face and her lack of response to my questions. I became pretty fearful and worried and I know my agitation showed through in my behavior, tone of voice, etc. I even started crying I was so worried about her. I kept asking questions because I didn't know what else to do.
This morning I called to see when the lab specimen was going to be taken to the lab and it was getting taken first thing this morning. I told the nurse that I was glad because I would come over and take it over if they needed me to so it could be there when the lab opened.

Apparantly, I unintentionally upset the nurse. She told the charge nurse who is a dear person. The charge nurse called me and reamed me up one side and down the other. She basically told me what smiles said in her post (only she was really angry). I was so upset and crying because these people do work so hard and do a great job, but I don't think they really listen all the time. They think mom's behavior is normal, and maybe it is normal behavior for her NOW. But, she has changed so drastically in the past few months that it scares the bejeebies out of me. I told the charge nurse that I was in no way trying to be demanding or threatening. I know yesterday I was a pain in the neck, but I did not think I came across that way this morning. I told the charge nurse that when you are on this side everything is so unclear. You don't know how things work, how to communicate well, etc. It was a horrible conversation. And what made me feel soooo terrible is that I think so highly of the charge nurse and how committed and dedicated she is. The nurse my MIL has right now is not my favorite cuz he is so grumpy and unapproachable. How are you supposed to be of a help to your loved one if people hold you at arms length. I know things are more complex, there are sicker patients than my mom, problems popping up, etc. But, I don't know what to do because I am so worried. I can't even imagine how this post must sound I feel so many things whirling around in my head. One good thing is that my sister-in-law flew in today and will be here for the next three weeks and will be visiting my MIL everyday. She can deal with it because she is the medical power of attorney at this point anyways. I am on nursing home sabbatical.

I'm so sorry you had an experience that has so clearly upset you. What sounds like lack of affect in your mother in law's demeanor is often a result of infection in an already fragile physical system. It is something that should be closely observed because if it becomes worse, it may be an indication of complications, etc.

As to dealing with the staff, sounds like you have, or at least had, a real advocate in the charge nurse. Maybe she felt that she was being accused of incompetence when you asked to take the specimen. It's her responsibility and if she does not meet that responsibility, she is in trouble with the facility and the nursing board. Also, if she's a good nurse she will take responsibilities very seriously.

It seems that the situation upsets you in many ways. Nursing homes affect people's emotions in unexpected ways. Perhaps you could more easily deal with the problems as they arrise through the ombudsman or if they have one, chaplain. Or if all else fails, the administrator.

Most of all, it's obvious that you just want to help someone you care about. But sometimes finding a way to help that doesn't further stress the system is difficult.

Maybe you could work through the Patient Representative or Ombudsman or Administrator more easily.

Keeping you in my prayers.
smile

I had considered speaking to someone else, but I didn't want the charge nurse to feel like I didn't trust her and was going over her head. I had no idea when I offered to take the specimen that it was illegal, might be construed as criticism, etc. (again being on the outside not knowing all the ins and outs and rules, etc)
This afternoon when my sister-in-law talked to the charge nurse she was told by the charge nurse that I had reamed her nurse up one side and down the other. I REALLY didn't do that. I think your advice about talking to an administrator or someone is good advice. I do not want to jeopardize the good relationship I feel we have had with the staff. I haven't had any problems (at least that I know of) up to this point and Mom has been there for 7 months. So, I don't know. We'll see where things go from here. Mom does have a fever of 101 now and her feet are really swollen and the charge nurse is very concerned. You have to understand, I love this charge nurse. She is really great. The one criticism I have of the whole nursing home is that they don't listen to us when we tell them what we know about mom's personality and health problems. Also, it has been an adjustment having her in this nursing home from the last nursing home she was in. We moved her from one half an hour away to her present residence. This one is located is much closer, is the one we originally wanted her in, and we go to this town more often than the other. In the old nursing home they welcomed you asking questions, getting involved, helping out. They loved, encouraged and appreciated family involvement. In this facility, I feel like I am intruding if I even ask a question. I guess I just need to find out how the resolving of misunderstandings, or conflicts, whatever are handled.
Thank you all for your imput. I really value what you have to say. (insert heart graemlin here)
I am hoping to hear that mom is feeling better tomorrow. They started her on massive doses of antibiotics, so hopefully there will be an improvement by tomorrow afternoon.

Talk about being between a ROCK and a HARD PLACE

What a situation this is. Personally cuz I would not be put off or threatened by any nurse, charge or otherwise. They work for you an should have a better bedside manner. Listen to Smile and see the Administrator if you feel theres another problem and always make sure theres someone else present when dealong with Ms Big Shot Nurse. The truth doesn't seem to be particularily important to her so watch it!!!