Ok. I love old people. They have alot to teach us. I feel bad that they have to spend whats left of their lives in long term care. There are some great homes out therebut there are some bad ones too. When I became an emt it wasnt to transport for elevated labs, or get up at 3am for a fever. (ever hear of tylenol) I love going in a nh for an altered mental status find an o2 sat of 84 and the pt has no oxygen on. duh. The other day I had to give narcan to a 70 year old pt unresponsive from a new F-patch. A drug od in a NH. I pulled the patch, gave 0.4mg and she woke up and started talking. When I got to the ER the Doc says "I'ts a miracle" in a sarcastic tone. Whats worse, is these nurses call you at all hours day and night. You have to fight to get your cot in most of the rooms. They rarely have the paperwork ready, and you can never get help transfering from the staff. I worked in a home for 9 years as an aide I don't remember it ever being like this. Whats going on? Anyone else feel this way?

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They did it again...... Called for female combative at 2329 got on scene to find a 74 year old alzheimers pt yelling, biting, kicking, spitting and swearing. Apparently she had been this way all day. Wrestled with her to get on cot. (She was in good shape for 74) restained her, after my partner and I both took a couple kicks. began to leave and was stopped by the charge nurse. Whom then informed us that we had to let her off the cot because the doc didnt want her sent. so we lowered the cot and let her go. We then proceeded to leave again(pretty pi--ed off at this point) and were stopped again and informed the doc called back and wanted her sent. At this point I was a little fed up and insisted they give her ativan first. of coarse it wasnt enough. and the pt was even more angry than before.I was so mad at that nurse especially when she told the pt not to hit the '' AMBULANCE DRIVERS" talk about insult to injury.
This one is currently at the top of my list. got called to a nursing home at noon for a pt with CHF. We went in loaded for bear, to be told our pt was "right here," at the table eating lunch. They said her doctor had come by and said to send her to the hospital because she was in CHF. No labs, no reasoning for the diagnosis, just wanted her sent out. Pt had no complaints, was totally asymptomatic except for chronic edema of her legs. BP was normal, chest was clear. Only thing we could find was A-fib between 40 and 70. She had a history of A-fib and was on the appropriate meds. When we got her to the hospital they had three other pts with basically the same story, all under the care of the same doctor. Either we were not told the whole story(Uh huh), or something ain't right.
Obviously Sir, you do not run many nursing home calls. You don't see the abuses of the patients and the system that most of us see. Most of the nurses we deal with around here don't halfway speak English, and the simplest procedures that they could do they don't have a clue about. The doctors aren't much better, they would rather send a patient to a hospital to let them deal with the patient. Maybe they know the staff better than we do.

What everyone is trying to point out is the nursing homes are sending people out that they could manage if they had any concept of nursing. No one has shown lack of caring, just irritation at nurses that could care for the patients with simple nursing practices that a student nurse should know. Anyone who will wait up to an hour for a private service to respond to a chest pain or breathing difficulty call when a MICU (fire or other provider) is less than five minutes away is poor patient care. We have one home that has a fire station virtually at their back door (with an MICU)and they would rather wait than call 911. A lot of times our dispatchers will suggest a home call 911 and the staff will refuse. So, now who cares about the patients?

You need to pay attention to what you read. It's called comprehension.
You are still missing the context of the thread. No one is griping about going to nursing homes, just the stupid calls we get from them. I have gotten way better calls from a nursing home than a 911 call.I've been at a nursing home picking up a CHF patient that they sat on to see FD coming in for a fall that was siting at the desk in a wheel chair. I have also driven 40 minutes to find a FD MICU loading the patient I was called for. You have to admit, the staff in most of these homes are not the brightest lights on the tree.

A lot of this is our fault for not educating these people on what goes 911 and what waits. But, there are the few that couldn't follow directions with someone walking them through it. I would like to try, but private companies don't want to because it makes too much sense and would probably cut their revenue. I'm firmly convinced that the foreign nurses are not taught to the same standards as American nurses, and the American nurses are there because they were fired from every hospital job they had. Some are good and do care, but they are the minority.

In the Dallas area you don't dare complain about nursing home care. The market is so competitive that you will be terminated for complaining if the company looses the contract. I have already been in formed of this after complaining about the way a staff member was treating a patient. I would love to complain, but I have bills to pay. Don't think I'm happy about having to be quiet, I would love to drop a few homes in the proverbial grease.


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