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Old 01-06-2013, 09:57 PM   #31
dakcp2001
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Quote:
Originally Posted by twinboysmom View Post
OP, I am trying to sympathize with you but I am not sure what your point is starting this thread was. You seem defensive over the answers you were given. Because you have never had a broken hip I am pretty sure you do not realize how painful it is. She needs a catheter to keep the urine off of her skin. While she is still wearing a diaper it is for bowel incontinence. For urine, she would need to be changed many times a day and night which equals tremendous pain to her. With wet diapers she is at an increased risk of skin breakdown on her bottom (painful bed sores).

As a long time nurse I will try to give you some advice that I imagine you won't like much. Please remember that all of these rude nurses are most likely doing their best to take care of your family member. It's a tough job. You and your DH also have a tough job as well making decisions for someone who is 100 years old. But, the way you come across on this thread is difficult and argumentstive. Remember that those nurses do not work for the ER director. If you aren't happy, call the administrators. And also remember, a little bit of honey goes a long way. You don't want your family member to be the one patient that nobody wants to take care of. I sincerely hope she does well for the surgery. Sometimes they surprise you.

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Old 01-06-2013, 10:17 PM   #32
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Originally Posted by JoiseyMom View Post
We would love to let her go and be in peace, but we live in NJ, and it isn't legal. Now we can put down our pets, but not our loved ones, but I digress.

Not knowing what this morning would bring my DH brought his father from the airport to the hospital at 10:30 last night. I called our eldest to come, and he and his wife got there at 10:00 pm. We were all leaving the room but my DH, who stayed behind to tell her it would be ok if she wanted to go.

Surgery was this morning and she made it through with flying colors. She is a tough old bird. My mil (DH's mom) has said for years she is going to out live us all . They are supposed to release her in a few days to rehab, where she will be for two weeks, and then she will be sent home again.

I also informed FIL this morning while she was in surgery that I will not let him go back to Florida until he has given DH and BIL written medical POA for her for when he is not local!!
Actually, yes it is legal to "let her go." It is called "comfort care" while in the hospital. Which means her pain will be treated, she will be kept comfortable, but no medical conditions will be treated. She will receive pain medicine.

I am also sure that with dementia she would also be a candidate for hospice.
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Old 01-07-2013, 08:18 AM   #33
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Quote:
Originally Posted by JoiseyMom View Post
We would love to let her go and be in peace, but we live in NJ, and it isn't legal. Now we can put down our pets, but not our loved ones, but I digress.

Not knowing what this morning would bring my DH brought his father from the airport to the hospital at 10:30 last night. I called our eldest to come, and he and his wife got there at 10:00 pm. We were all leaving the room but my DH, who stayed behind to tell her it would be ok if she wanted to go.

Surgery was this morning and she made it through with flying colors. She is a tough old bird. My mil (DH's mom) has said for years she is going to out live us all . They are supposed to release her in a few days to rehab, where she will be for two weeks, and then she will be sent home again.

I also informed FIL this morning while she was in surgery that I will not let him go back to Florida until he has given DH and BIL written medical POA for her for when he is not local!!
OP, I'm going to stop responding to you because it is not my intention to upset and you don't seem to like what I am saying. You asked for a hospital nurse's perspective and that is what I am giving you, but if it distresses you that is not my intention. Based on the tone of your replies to me, it distresses you, so I will do you the favor of stopping.

I sincerely hope your husband's grandmother continues to recover. She will be in my prayers.
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Last edited by Disney Doll; 01-07-2013 at 08:24 AM.
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Old 01-07-2013, 03:23 PM   #34
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I guess I'm confused. If your FIL had POA and had not signed anything designating your DH or your BIL as such in his absence, I don't see how the nurses could have legally listened to your DH when he said "no foley." If he didn't have legal POA at the time, and since your FIL was not giving any directives, then they had to do what they knew was best for her, which as many have explained was to do the foley. I know you are upset that someone you care about was in pain, but I think your anger toward the nursing staff is misdirected.
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Old 01-07-2013, 03:53 PM   #35
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A foley cath is a much better option for caring for her private area. You void urine with a much higher frequency and volume, then you pass a bm. Turning her as often as you would need to (for a well hydrated person with normal voiding) would cause her extreme pain and may cause her to be combative, due to age, pain level, congnition, and comfort with her surroundings.

A foley cath can be hard to place in an elderly person, for many of the above listed reasons fo other nurses. Position and the actual tissues condition may make it difficult to place a foley. Lack of estrogen and other female and male hormones can make it uncomfortable for a pt. as they age. Also, urinary meatus postion is approximate. Everyone has slighlty different postioning and size. Not everyone is an ace in the hole with every procedure, which is why it is not abnormal to have someone who is good at it to take a turn and try. Think of it as needing an i.v team. Yes, the nursing staff can all place i.v's, but some are just better at it then others.

A nurse is a pt. advocate, if the need be. The placement of a foley cath in a 100 year old incontent woman who has not had surgery for hip repair is not a course that would be considered abnormal procedure for the intregrity of her skin and her comfort.

As noted by others, your DH does not hold power of attorney. While nursing staff would take his opinion under due consideration at the time of the procedure, it is not considered wrong to reattempt the procedure in a more private setting, at another time, as ordered by a physician.

I have worked in Geriatrics my entire nursing career, on the long term and sub-acute realm.
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Old 01-07-2013, 08:47 PM   #36
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I'm glad she is doing well. But referring to nurses as nasty women...maybe you should walk a day in their shoes. I agree her pain was not being managed as well as it should have been, but she needed the foley.... Dying from a bedsore from lying in pee etc is a horrible way to go. And changing the diaper frequently to prevent that would be excruciating for her. Our job is to be an advocate for our patient.

And as for the ER doc coming up... He would have no legal right to look in her chart or do orders on someone that is not his patient. This is a huge HIPPA violation and could get him fired.
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Old 01-08-2013, 09:04 AM   #37
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Quote:
Originally Posted by burnurcomputer View Post
A foley cath is a much better option for caring for her private area. You void urine with a much higher frequency and volume, then you pass a bm. Turning her as often as you would need to (for a well hydrated person with normal voiding) would cause her extreme pain and may cause her to be combative, due to age, pain level, congnition, and comfort with her surroundings.

A foley cath can be hard to place in an elderly person, for many of the above listed reasons fo other nurses. Position and the actual tissues condition may make it difficult to place a foley. Lack of estrogen and other female and male hormones can make it uncomfortable for a pt. as they age. Also, urinary meatus postion is approximate. Everyone has slighlty different postioning and size. Not everyone is an ace in the hole with every procedure, which is why it is not abnormal to have someone who is good at it to take a turn and try. Think of it as needing an i.v team. Yes, the nursing staff can all place i.v's, but some are just better at it then others.

A nurse is a pt. advocate, if the need be. The placement of a foley cath in a 100 year old incontent woman who has not had surgery for hip repair is not a course that would be considered abnormal procedure for the intregrity of her skin and her comfort.

As noted by others, your DH does not hold power of attorney. While nursing staff would take his opinion under due consideration at the time of the procedure, it is not considered wrong to reattempt the procedure in a more private setting, at another time, as ordered by a physician.

I have worked in Geriatrics my entire nursing career, on the long term and sub-acute realm.
I forgot this very important bit on my original post: I am glad to hear that her surgery went well and that she is on the road to recovery. I prayed for her recovery last night and will continue to do so
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Old 01-09-2013, 12:10 PM   #38
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One other reason for a Foley in a 100 year old woman would be to prevent urine retention and probable UTI. UTI's quickly go septic in elderly patients and the broken hip would become a moot point. Pressure sores (from constantly damp skin and immobility) can also easily become infected.

I hope she continues to recover.
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