Pea-n-Me
DIS Legend
- Joined
- Jul 18, 2004
- Messages
- 41,394
It really can’t wait when beds are tight, unfortunately. I usually tell people we don’t like this any more than you do, but as I mentioned before, censuses are very high everywhere, and things happen where specialty beds are needed. People who don’t need that “level of care“ anymore (which is a bit ironic, isn’t it
), such as someone going to rehab, will be the first to move. As for the IV, in acute care, IV’s are usually kept in, especially when there are still some issues like perhaps needing more IV diuretic, or IV antibiotics, and of course in an emergency, seconds count, and it takes a little while to get an IV in, so if it’s already there it makes it easier to give resuscitative meds in an emergency. (Otherwise they may need to be given in a drilled shin bone or in their neck, and no one wants that if there’s another way.)There was something I thought of when reading yesterday.
Going to interject a story from my own experiences. One day a nurse asked me to help reposition a very large man. I told her we should use the lift, as we’re required to do, and she said they’d been lifting him without it. So we each took a side of the pad to “boost“ him up. Well he was dead weight and he didn’t move when we pulled him. Needless to say, I injured my back. I finished my shift and wound up in Occ Health over 12 hrs later and it was still in active spasm. It was the first time that had ever happened to me. I got in quite a bit of trouble with them for not using the lift. We’d been told that if we were injured and not using proper equipment or not following proper protocol, they would not pay for care or time related to any injuries that occurred. Every single time I talked to the practitioners related to that injury, they reminded me about protocols and before I went back I was counseled yet again. I was good for a few years until i had to help lift a 300lb lady in an emergency and got a nice neck injury that put me in severe pain and unable to turn my head (with a large knot in my muscle that remains to this day). That launched me into PT, which I never got to finish before I got pulled back for Covid. The second week I was back with a Covid pt who tried to pull out his breathing tube and I had to hold his arms while he was fighting me so he didn’t injure himself. Next day, I could not turn my head again; the neck was re-injured. Again, I finished my shift, then DH and DD had to come to Occ Health to get me and drive my car home as I could not move enough. That was what, 16 months ago and the pain still returns when I am tense and my muscles get tight.
Some people have way worse stories. BUT, this is why, if there were doubts about getting Mr L up and out of bed alone or even with two people (which is expected nurses will use judgement on), then they will often ask for PT to assist. You never know what conversations take place, either, as nurses and PT’s work together regularly, so they may have said something in cases past like “Don’t try to do this by yourself”, or, “When you have [a certain situation] always call us first”, etc. People want there to be black and white rules in hospitals (things must be done this way, etc.), but it’s not like that. It can’t be, because every patient situation is unique, and each situation is always evaluated on its own merits. So it’s not always possible for outsiders to come in and say this should’ve been done or that shouldn’t have been done, etc. There are always two sides to a story and when both sides are heard, then it often makes sense why staff do things in any given situation. Things like this come up a lot and you realize when you hear them how unique things often are. But these are things that nurses are trained to do, ie to think critically and to use professional judgement. To read these stories they sound like bumbling idiots, but I know they’re not, even not knowing them personally. I’ve worked with enough nurses to know that you cannot pass that course of study OR be hired with a ton of competition for every job, without being pretty good. You also mentioned a couple of days ago their staffing ratios are 1:3 but they were running at 1:5 - that’s outrageous! That’s 66% more responsibility than they are supposed to have given the type of unit they are. (Think of that on your own jobs, or say, motherhood - instead of three kids, you have five.) No wonder nobody was answering lights - they were likely all in rooms providing care to people who were climbing out of bed and pulling things out, or with people who were actively dying (we had two on my unit this week) and trying to give them and their families a good experience, fielding calls and discussing concerns from all families, and lots and lots of other things. Hopefully this helps explain things a little bit. I do hope your experience at rehab is better than the past several days were.
@easyas had some good thoughts, I hope you don’t mind my posting something I’ve thought about. Could it be that, given your difficult experiences in the past, that you go in to new hospital experiences a little too, what’s the word… aggressively? I say this with the most love I can muster, but it is really hard to start out on a good note when people are writing names down, criticizing staff and making demands, etc. I know there were reasons and things that were or weren’t done that were unsatisfactory. Absolutely get it. But staff were also placed in an unfair situation trying to take care of not just Mr L but every other patient on the unit when they did not have enough help to do so properly. It’s sad, really, and I’m sure staff left their shifts last weekend not feeling very good about things. Not good for anyone. I do think easyas had a good point, we all know how very competent you are
it’s easy to get caught up in doing for someone. We probably all do it to some degree as wives and mothers, etc. But wasn’t he mostly in the chair at home and had a lot of difficulty moving around there? Catching these leg infections early might help keep him out of the hospital, as will trying to keep some of the fluid off (which impedes healing when blood can’t travel through the excess fluid in tissues). I’m happy to talk to you about ways to do that as it’s something I have to talk to people a lot about. It’s complex, so we can do it by PM if you want to. Keeping the fluid off is one of the things that will help keep him on a good path and feeling his best. Moving around as much as he can, and regularly, will help mobilize the fluid so it doesn’t pool in his legs. I can’t remember if you said he has a walker, but that will help him move. Also reclining with his legs up when he’s resting so that venous blood can travel past his hips when he’s stretched out will also help mobilize the fluid. Caregiving is not easy, at all, but you’ve taken such good care of him, you really are to be commended. It’s clear you are fully committed to him. He’s fortunate to have you. I know these are just words on a message board and they probably don’t mean much, but I was serious when I said that a soft approach with staff can sometimes be more productive than a strong arm one. I’m imagining going to the hospital, though, is a really stressful experience, especially given the previous experiences. But maybe see what happens if you try to lighten up a little bit, maybe try out my candy tip 
and see what happens. Going to the rehab floor is maybe a chance for a new start. I’d recommend not going in there complaining about the move last night (there’s nothing any of us can do to change that) or what have you, but rather focusing on what the plan is going forward to help him gain his strength back and to keep him out of the hospital in the future. Hugs, and prayers for a better day today. 
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to all of you! Thankful always for all of you, too 
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(The one after her also had some helpful info and tips for us, though.) I'm hoping we can keep him feeling OK here at home now, and he has a follow-up with his primary on Monday.
I feel like mine is 5 going on 15 - the attitude stinks! (Not to mention the armpits already...my living room seriously smells like sweaty boy armpits 
) Lots of sympathy and 
You should be resting! Do you have anyone you can hire to mow for you? I know you like to do it, and maybe you find it relaxing, or distracting. But get some rest! You need it right now!!
