Helpful Hints for SKILLED Nursing Facilities

[MeekoBB]

the ones you don't keep getting called to unless you do admission to acute hospital transfers...

Maybe he doesn't get their "emergencies" because his service isn't contracted.

[Dustdevil]

4. Please don't let excited philipino CNA's give us report . No offense , but you get gibberish like chickenbreath for she can't breathe and sea sores for siezures .

But that's funny right there, I don't care who you are!

[zzyzx]

I'm still amazed that full arrests at our nursing homes often come in as "unresponsive." I mean, can't they feel for a pulse or at least tell if the patient has stopped breathing?

[zippyRN]

eh?

rubbish Care home = dial 999 for anything

good care home = do their own first aid, can actually assess a patient, have good relationship with primary care docs and don't ring for lift assists

Maybe he doesn't get their "emergencies" because his service isn't contracted.

[p3medic]

So, we just got sent to a NH for a diff breather, updated to a cardiac arrest...on arrival a private service ALS unit is on scene (contracted provider) so, we get to the room just as they are rolling the patient out, semifowler on a non-rebreather, on the monitor....all three leads show asystole....The staff then produces a DNR, and the privates say they are "all set"...so we run into them in the lobby, as one of them is trying to figure out which end of the ambu bag is the working end, and then decide it can wait till they get loaded....still semifowler on a non rebreather...we tell them she's a DNR, maybe the should put her back in bed, but they ignore us and load her up....medic one gets up front to drive, medic two is taking blood pressure(pt is dead)....maybe they should quit the medic gig and apply at the NH? WTF?

[AnthonyM83]

I rarely believe in chewing out, but they probably deserved one. It's one thing if they were waiting off on resuscitation until staff found the DNR (even though they technically shouldn't), but when they thought she needed CPR and they weren't doing it is pure negligence. It's the most basic core part of our EMT training.

[Just Plain Ruff]

You know what is really sad. About 75% of us will end up in these places. the other 25% will either already be dead or we'll have enough sense to set aside enough money to cover our care by homecare providers or family. We will be taken care of by the same kind of freaking morons that are taking care of patients today.

The good thing is that we are in a unique position to know what nursing homes provide good care and which one's don't.

I have had family members of patients come in off the street and ask me which nursing homes that I recommend since they know we see the nursing homes in their worst times, usually 24 hours a day.

But it comes down to involvement by family. I find that the better taken care of patients are the ones who have a family member or multiple family members involved in their care. The possibility of one of those family members coming in to the nursing home unannounced at any hour of the day makes them more apt to take better care of grandma.

My grandmother is in a nursing home and my parents see her every single day and if there is something amiss they immediately go to the administrator or charge nurse and get it straightened out. They say that the patietns around my grandma who don't have active family have less care than my grandma gets.

And one other thing, it's very very expensive to be in a nursing home and if you are paying for the nursing home care rather than relying on medicare to pay then you have a larger vested interest in expecting good care. I know I know, they should expect better care regardless of who pays but that's just NOT The case. You get better treatment in first class than coach on an airplane don't you? I know that you do because I spent a lot of time flying and I've been in coach and I've also been in first class.

You get better treatment if you buy a luxury car than you do if you buy a yugo. You should.

So if I'm shelling out 7500 a month or whatever my parents are paying the nursing home for my grandma's care and another person is only paying what medicare or medicaid will pay I would think better care comes with it.

I for one want to DIE before I need a nursing home.

[itku2er]

Ruff just come to VA and stay in my nursing home I will take good care of you and spenac and marty too. I have been following this thread reading it but havent really responded alot cause I get so emotional as I have been told by others. But Like I said before there is good and bad everywhere in every occupation. And you have to admit some EMS workers come into NH's acting like superior jackasses just because it is a nursing home. But I know that the system isnt perfect nothing in this world is but all we can do is gripe about it try to change it and deal with it the best we can, and hopefully make a difference in the world.

[Dustdevil]

And you have to admit some EMS workers come into NH's acting like superior jackasses just because it is a nursing home.

They can stuff that attitude, because you are doing a job that they never could and never would do. God bless you for it. I submit that it's a lot more important than anything us ambulance drivers are doing. And your CMAs have more education than those holier than thou EMTs out there, not to mention better pay and job security. Any EMT out there thinking he has something on anybody working in a nursing home is either ignorant or just fooling himself.

[MeekoBB]

With all due respect Dusty, in my area there are a number of CNA's in facilities that get paid the same, if not less than what the 'ambulance drivers' make.

And yes, I could not do that job. I honestly cannot handle cleaning a patient's fecal matter. As soon as I had learned that was part of their job (when i first started this field) I very quickly stopped my search for a cna course. I do give them much respect and in some facilities I value their opinions and evaluations of their patients more than a few nurses. But every facility is different and finding the ones with employees that actually value their jobs are hard to find.