Nursing Homes - Your general experience?

[vs-eh?]

Rid, you are exactly right to expect the above items from field paramedics and I for one believe that professionalism is paramount in how we interact with patients, nurses, doctors and other medics as well as the general public.

With that being said, it is the "Paragods" out there that think they are the end to all ends and God's gift to EMS that are giving "real" paramedics a bad rap. Arguing with nurses, questioning Docs and nurses as to their care only shows ignorance and arrogance, not intelligence and professionalism.

Sorry, when you see the same thing and hear the same story for the hundredth time, it tends to get a little old.

I can only be so "professional" when I'm handed an envelope and have a back turned to me without even saying a word. I can only take so much lip service and "oh's and ah's" when trying to explain a current patients situation that me and my partner could ascertain after 30 secs with the patient and looking at their history. When all my questions or my partners get the "I'm not sure" or the numerous almost script like answers...

So who is a "paragod" and who is a "real" paramedic? Honestly, outside of this forum, I have never heard of the term paragod. Do people use this term commonly outside Ontario and in the US?

[MedicRN]

Sorry if anything that is BAD DISPATCHING and services looking to validate their expenses. So what like 10 people show up for some 80 year old's cellulitis in a NH? LOL...It reinforces my gongshow mentality of aspects of US EMS. No doubt crews go L+S to shite like this...

Having worked as a dispatcher, I could only dispatch what I could get out of the NH staffer calling. Many times it was an aide calling because somone else told them to and they didn't have the faintest idea of what was going on :dontknow: and would not go find someone who knew anything. :banghead: After having been burned at least once, most services would rather 'over dispatch' to a NH than be caught with inappropriate resources (we've all been dispatched to '2-day hx of SOA, A/Ox3, no current difficulty' and arrived to find the patient pulseless, apneic and rigored!!). :banghead: :banghead: :banghead:

When HIPAA first hit the fan, it was like pulling hen's teeth to get ANY information out of a NH. They were too scared of getting fined! While working on an ambulance, I can't count how many times I was given a SEALED envelope marked 'DO NOT OPEN. FOR ER PERSONEL ONLY.' :banghead::banghead: I could hardly get a history out of anyone because I 'didn't need to know that information. You just need to take them to the hospital.' We soon learned to just load the patient and go to the unit to make an assessment and (heaven forbid) look at the paperwork. In cases like these, this was the only history (event and PMHx) we had to work off of. :dontknow:

[Imagine89]

The nursing homes I've seen are pathetic, and unclean...downright depressing many times.

A friend of mine was telling me a story where when asked why he was called she replied "he said he was having chestpain about an hour ago, but i didn't believe him. I figured you could check him out. He's in the bathroom right now." Friend enters the bathroom to find his patient unconcious on the floor in full cardiac arrest.

I'm not meaning to overgeneralize, but i don't have much nursing home experience, from what i've seen and heard, they're sad, sad places...

[TerrfyinFlyinSrvc]

v/s as follows "B/P-120/60, P-80, RR-14, Temp.-98.6, SpO2-97% RA".

Bet ya a nickel most of their pts have the same recorded vitals....including a few of the dead ones. :roll:

[itku2er]

Bet ya a nickel most of their pts have the same recorded vitals....including a few of the dead ones. :roll:

:roll: :roll: :roll: :roll: :roll: :roll: :roll: :roll: :roll: :roll: :roll:

[JPINFV]

Well looks like we are gonna beat this dead horse again.. :roll: :roll: ..I will say it once again not all nursing home nurses are lazy or stupid or dont know their patients......I for one know my residents....I give a detailed report to all EMS providers that come into the facality to pick my residents up when 911 is called.....but like i have said numberous times before it works both ways we also get EMS providers that come in the facality with attitudes that suck to say the least.....so its a two way street there is good and bad in both professions and it shouldnt be, the respect and considerations should be from both sides not just one but you guys know as well as i do that sometimes when you come into the nursing home you have the attitudes of oh no not another NH patitent and treat them less than adequate unless it adds to your services pay....which is just as bad as the nurses not knowing the residents conditions and past history....like i stated before it is a TWO WAY street......to get respect you have to give respect ...

SNFs have the same problems that EMT-Bs and transport companies have. For every good one there is, there is at least 5 that have nurses that don't speak the native language, refuse to give report, and are willing to put patients with MRSA of the nares in a triple room with patients who don't have MRSA (I've been on that discharge, and looking back, I wish I fought more with that LPN. That isn't about nursing or medicine, just common sense). Furthermore, no one remembers the good experiences. Out of the 2 or 3 good SNFs that I remember being in, I can only remember the name of 1, but I can recall 5-6 really bad ones in my area.

So, think back. When was the last time that you had a good experience with a transport company or an EMT-B. When was the last time you had a bad experience. Just because we call out the bad does not mean that we know that good ones exist.

[Scaramedic]

You cannot generalize all Nursing Homes as bad anymore than you can generalize all ED's as being bad. In my career I have seen horrible nursing homes I would not take my dog to die. I have also seen ED's that had staffs I wouldn't take my dog to after he died.

I have found some great patient care in nursing homes, I have found caring staff that did know their patients. And yes, I have seen horrible care and ignorant staff. That list of excuses is amazing VS, its the same excuses I have heard in NH's across in this country. It is human nature to remember the worst of things, and we tend to focus on the bad NH's. As far as bad reports from staff I have gotten those off the floor of some well known hospitals. When we talk about good or bad NH's what we are really talking about is staff, and that comes down people. Every occupation has its good and bad, don't believe just look around you at work, or for some look in the mirror. :wink:

In closing please keep in mind that due the costs of longtime health care and the greed of a lot of owners NH's are often dangerously understaffed. So try to be patient with the staff that tries to deal with impossible situations. Oh and keep in mind that with the over 65 crowd getting larger everyday its going to get worse.

Peace,

Marty

:joker:

[thbarnes]

I have a nursing home horror story!

The other night the entire EMS system of our county was wrapped up in transporting patients on vents from a nursing home to the hospital during a power outage. Why the nursing homes had no generators with 8 patients on vents, I don't know, but the nursing staff at the nursing home just made it worse. There weren't enough BVMs to go around, which meant some patients weren't being ventilated at all and were cyanotic (pockets masks?). Those patients being ventilated with BVMs weren't being ventilated adequately. No reports from the nursing staff, no one directing us to the rooms of patients on vents, no help loading patients, nothing. We had no preplanning for this type of incident because we didn't even know the nursing home was allowed to have patients on vents!

The chaos didn't end there. We were unloading on the ramp of the ED when the ED nurses (who have never met us at the door before) walked out and told us we had to 'go somewhere else'. No explanation, just that there was no more room. A huge COBRA violation to 'divert' an ambulance in your parking lot. If they couldn't take us, the MD should of walked out and met the ambulance, looked over the patient, taken an oral report, and handed the Paramedic a signed transfer form to take them 2 miles down the road to the next hospital. We got on the radio and called the ED on the taped radio frequency. We made them broadcast on the radio system that we were being diverted from the ambulance bay.

If EMTs and Paramedics had the union representation and lobbying efforts that nurses have, we would be making more, regardless of how professional or educated we were, because in my opinion RNs aren't always that professional (and can be downright dangerous), but they still make the big bucks.

[thbarnes]

And I love the 'full arrest' calls I get to the nursing homes only to find two to three RNs making two to three times as much as I do pounding on the chest of a very awake, very alert patient.

[TerrfyinFlyinSrvc]

We got on the radio and called the ED on the taped radio frequency. We made them broadcast on the radio system that we were being diverted from the ambulance bay.

That's sweet. 8) I'll have to keep that one in mind.