Have you ever been a patient in a hospital or nursing home,
totally dependent upon staff members to turn your body on schedule? If you
haven’t, you are in for a non-treat.
Here is the way patient care goes in many hospitals and nursing
homes.
Repositioning is SUPPOSED to be every two hours at least.
Reality: Whenever staff chooses to make the turn. That may
be 4-6 hours, no matter how it is documented.
Patients are SUPPOSED to be placed in a comfortable position.
Reality: Patients are frequently left for long periods in
positions with their heads and knees against the railings.
Patients who cannot use the call button are SUPPOSED to have a
soft-touch call button, placed under their arm so that any unusual movement
will call for help.
Reality: Patients do not get a soft-touch call button. And
if there IS a soft-touch, the call button may be placed out of reach, not under
the arm.
Patients, according to the CDC are not SUPPOSED to be on a
catheter long-term. Catheters are the greatest cause of hospital acquired
infections.
Reality: Facilities
use catheters long-term because it is easier on the staff. I call this the lazy staff syndrome, acceptable in most
facilities.
Patients who are no longer on a catheter are SUPPOSED to be
under CHECK AND CHANGE guidelines, and checked for changing at least every two
hours.
Reality: Not so. Staff likes to huddle around the unit desk
and chat about last night’s junk-watching reality show better than take care of
the reality of patient care down the hall. If a patient is so unfortunate
enough to soil their clothes immediately after being changed, hear the staff
complain.
Patients who cannot take care of themselves need an extra-wide
hospital bed for extra room when being repositioned.
Reality: Few facilities care about this special
need.
Patients receive two showers per week.
Reality: Not if you are not mobile. If you cannot take care
of yourself, showers are few and far between, no matter WHAT gets documented.
Brenna went 10 weeks in an LTAC without a shower, in spite of the extra large
bathroom attached to her room. In the last nursing home, she went 14-18 days
between showers. Sorry, being wiped down with baby wipes is NOT a shower.
Patients are well-loved by all staff members.
Reality: Patients are a return on investment and
investors have little concern about the care patients receive. As long as
facility managers receive a bonus for cutting corners, patient care will
continue to decrease.
All staff is educated on how to recognize when a patient is in
trouble and call for help. According to admittance staff, even the janitors
know what to do.
Reality: Many aides are not trained to recognize when the
patient bed is at the wrong angle for a feeding tube or how to handle a patient
with a catheter. Most staff doesn’t have a clue how to take care of a trach,
and that includes facilities that provide an RT. Brenna was left many times at
an angle low enough to cause her to aspirate formula into her lungs. I had to
frequently tighten her trach collar so the cannula would not rub her throat. I
watched two charge nurses jerk Brenna up in bed once, pulling on the catheter. And janitors certainly do not know what to
do.
Medical records are kept up-to-date and are accurate.
Reality: From my observation, medical records indicate what
should have happened, not what actually did happen. Apparently state inspectors
are not equipped enough to see that the handwriting is the same for multiple
nurses on different shifts.
Staffing is supposed to be adequate to take care of all patients.
Reality: Staffing is not based on acuity of care. No matter how many critical cases a unit may have,
investor owned facilities cut back on care; leaving patients cared for by
over-burdened staff with too many patients
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