Why do Con home nurses do this

[crazyemt5150]

ok we get a call for diff breathing. As well pull up the lovely nurses direct us to the room where the pt is lying down with a NRB at 15lpm. I put the Spo2 sat on and the pt is sat at 86. As I asses the pt my pt gets the hist and all the good stuff. The nurses said that they found her an hour ago like this. She has a history of CHF COPD Pnuemonia all that good stuff so I check lung sounds to here Rhales and Ronchi and deminished lung sounds bi lat. She isn't moving any air. Ok real quick what are we trained???? CHF pt's when having diff breathing you sit them up correct??? So i asked the nurses why didn't they sit the pt up and they replied they didn't have time and I also asked why did they wait to call us for an entire hour??? they said they have other stuff to do OMG do you guys run into these type of calls or is it just me

[riskynremtp]

It's every where you go. I wished I could give you an easy answer. It's easy to say "stupidity", which is true in some cases, but more importantly it is an over all lack of training. We can't expect them to know what we do, because they NEVER will. But, some of them should know ALOT more than they do. There are some good nurses in these places. Sometimes, you just have to look VERY hard to find them, and they are usually the LPNs, and CNAs doing the RNs work. :?

[Dustdevil]

OMG do you guys run into these type of calls or is it just me

We all do. However, you should take note that us, in the hospital, experience ambulance crews bringing in the same types of patients also laying supine, and with NRB masks running at 2lpm "because she's COPD!" all the time.

This is certainly not exclusive to nursing home nurses. At least they gave her appropriate oxygen.

[riskynremtp]

You are 100% correct. There are alot of "screw up" medics out there. Usually, they are easy to spot. They think they know it all......

[EMSSCOTT]

I was just having this conversation with my partner last night. We get dispatched for "the unknown bleed". When we get there we see no blood no complaints but then again we are askedto take the patient for a eval because or alzheimers we cant get the RMA. So my conclusion to my partner is that they should take the word "skilled" out of "skiled nursing facility"...

Scott

[Ridryder 911]

I was just having this conversation with my partner last night. We get dispatched for "the unknown bleed". When we get there we see no blood no complaints but then again we are askedto take the patient for a eval because or alzheimers we cant get the RMA. So my conclusion to my partner is that they should take the word "skilled" out of "skiled nursing facility"...

Scott

Hmm..maybe you to reconsider whom is skilled. Just because you do not see any active bleeding, does not mean there is not any hemmorraging. Did you perform a rectal hemmocult or check for their hematocrit? Did they (SNF) have lab results showing a decrease in H & H ? Was there evidence of anemia, slow leaking bleed, etc.

What caused them to call EMS or suspect bleeding? Then why would EMS want to refuse so fast?

R/r 911

[itku2er]

Well in defense of the nursing home nurses WE ALL ARENT LIKE THAT. Some of us actually know our jobs and we do it. But it takes more than one or two people in a facality to make a change I know I have tried. But there is no excuse for allowing a Resident to lay there for an hour who was in obivious distress. Did the nurse get written up? Did you report her?

[mattlott]

first off sit the patient up, try the nasal canula at 3-4. But my pet peeve is they are COPD I am going to knock out their hypoxic drive. NEVER WITH HOLD O2 if the patient needs it. If the hypoxic drive goes out bag them. This does not mean you go straight to the NRB. It means you work up. You might even try a brochodialator treatment first.

hell if they are that clamped down assist ventilations get the patient air.

Hypoxic drive is never an excuse to watch a patient suffocate.

[WendyT]

You wanna hear the BS I have to put up with my mother in the nursing home she lives in, I told them if for any reason should anything happen, even the small stuff . . . .I'm to be notified ASAP!

When her lower denture went missing, I get a call from her friend who tells me did you know your mother's lower denture is missing. Well that's where I turned red as a lobster, I thought I am verbally going to kill someone and she said dont mention my name, because she is a companion to my mother and I pay her privately-long story.

I get there and I am talking to my mom, she has dementia and I said where's your denture and she doesnt know of course but what heck I'm going to ask. I goto the front and I said, where's my mother's denture and they said they didnt know and I said oh,k when did this go missing and they said well it's been a 11 days. So I got real loud and said, doesnt it say in my mother's file that if anything should go wrong, even the small stuff you are to notify me either way and they just look at you dumb founded.

I'm not a racist but the philipino's are the worse bunch, they took my mother's clothing to the wash and now 3 outfits are missing. I said what is wrong with you ppl, can you NOT read? On the cupboard door it says FAMILY DOES LAUNDRY.

I caught this woman walking out the door with my mom's night gown and I said excuse me but where are you going with that, she said a patient down the hallway, about 5 doors down doesnt have any nightgowns. I said I dont care, there are other gowns she can wear, (they look exactly like hospital gowns).

I have yet to talk to the director about this, because its pissing me off.

[vivibonita]

because or alzheimers we cant get the RMA

How dare you, try to suggest RMA???!! Who gave you the right to refuse better treatment to your pt? I know you are going to say you didn't, but you tried by bringing that RMA up.

I ask the same question Teri did... how did you, in all your wisdom, know there was no active bleeding??