Last night was the first night this week I had anything like a full night's sleep. Seven hours: a luxury!
Mom's nursing home continues to be a problem; it is clear staff is overworked, underpaid and even the skilled workers are from the middle third of the talent pool at best: paint-by-numbers nurses in a job that's anything but. One of them tried to double-dose her pain meds last night, on the premise that "she missed her afternoon pill because she was at the doctor's office; she took that one late and I'm just catching her up now." Not two hours after the first dose. Hey, maybe that would be okay for an antibiotic or skin ointment, but it's not how narcotic pain relievers work and A) I expect a nurse -- any nurse! -- to know it* plus B) procedures should be in place to prevent it. You know what happens when you give frail old people too heavy a dose of this kind of pain pills? They stop breathing.
If I'm unhappy, my siblings are even more so; one was on the scene and the other is presently driving back from a road trip, seething with anger. He's the level-headed one and has been point-of-contact with the retirement home from the beginning. He'll be here today to, in his word, "sort 'em out." Alas, I fear that harvest is mostly chaff.
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* I expect candy-stripers to know this. I expect staffers at the levels that are the reason such pills are (supposedly) under lock and key, dispensation and dispensor (supposedly) tracked by logbook to know this. For that matter, I expect pill-popping bums from Rush Limbaugh down to toothless box-dwellers in the the alleyways to know this: take too many of these kinds of pills in too short a period of time and your lungs stop pushing air.
All depends on what the patient looks like. Pain control works best if it stays under control. It takes a higher dose to bring pain back down than it does to maintain pain at a controlled level in the first place. If a patient got a scheduled dose late and is now having worse pain than usual, and is maintaining their respiratory status, I'd have no problem doubling them up on their pain meds. I don't know the details, but the story as presented doesn't make it sound like a necessarily bad call.
ReplyDeleteHas your level-headed brother threatened the staff with a visit from Hurricane Bobbi?
ReplyDelete("Look, you people need to get your act together; I don't know how much longer I can hold her back.")
LRN: This was not at the patient's request, quite the reverse -- and was accompanied by a level of insistence that required getting a manager involved to sort it out.
ReplyDeleteRickn8: my big sister is even worse a fury than I am. Ponder that.
Roberta, keep big sister in reserve; why use a nuke when you can get it done with conventionals?
ReplyDeleteUnfortunately, what you describe is nursing homes everywhere you go. Competent care is an anomaly.
ReplyDeleteBeware the nicer facilities, too. They woo you with fancy buildings, but your lived one is still cared for by the same incompetent staff and high patient:staff ratios.
The *only* way to get good care is to get to know the ombudsman, complain often, show up unexpectedly, and threaten constantly.
That way they neglect everyone else's mothers and fathers to take better care of yours.
AD: it has certainly influenced my plans for when I can no longer live on my own.
ReplyDelete