I thought I'd seen a lot,but this is a new one on me: I hired an Aide who is available through the Care Facility to help my husband with his breakfast. The day R.N. in charge of DH’s unit came to me a few days after the Companion Aide started with concerns about what the Aide’s duties were. I said, “She’s here from 8 to 9 to help him with his breakfast; to make sure he’s cleaned up so there’s no b.m on his skin, and to help him brush his teeth.” The nurse complained that the Aide was spending time in the dining room talking with her other Aide friends, sometimes leaving the dining room to talk to other Aides. “She doesn’t even sit beside him but stands, hovering at his table. She doesn’t tidy up the room, and when I spoke to her about it, she said, ‘I thought that housekeeping did that.’” The RN asked me to talk to the Coordinator of the Companion Aides Program, and “Ask the aide to come in earlier to take him to the dining room. Otherwise, my staff have to take him, and you’re paying her, and she’s not doing anything.” I spoke to the Coordinator about the complaints. The Coordinator was defensive but said she would speak to the Aide. I said that I had noticed that oral care had not been given and that there was caked b.m. on buttocks near pressure sore. The next day, another long list of complaints from the R.N. including a quote from a resident at the next table in the dining room who had observed and commented to the R.N on the lack of help given to DH by the aide. I emailed the Co–ord. firing the Aide and asking for a replacement. Co-ordinator phoned me, very unhappy. Said she had just gone to the R.N. and that the R.N. said, “I have no complaints against Aide. I didn’t see anything.” Meanwhile, as I’m on the phone with her, the R.N. left a voice message asking me to phone her. Since I was already late leaving to help DH with his lunch, I didn’t, thinking I would talk to her when I got there. R.N. phoned again within minutes, saying, “So you fired the Aide.” On questioning her, she said, “I told the Co-ord. I hadn’t seen anything, but that there are many eyes watching.’” I made some inquires on my own and was told by one staff member that the R.N. wanted the Aide to come in early to dress DH and save the staff from doing that job. I had kept the Director of Nurses aware of the problem and have added this additional info. for her.
Sorry Mary you are having this problem. Unfortunately it seems there is a lot of 'politics' going on here. Hope you get some satisfactory resolution soon.
I would strongly suggest that from now on, you get everything in writing. Write down what the duties of the aide will be; have it approved and signed by the Cooridinator; have it initialed by the R.N. at the facility. Give it to the aide personally and go over it with her. Have her sign it. If you, the R.N. or anyone else has a complaint about the aide, have them document it - time, place, complaint - in writing and sign it.
My first year on the job in special education, I learned "if it isn't documented, it didn't happen". Sad, but true.
More craziness. Here is an edited copy of one of two emails I sent to 5 of the top staff at DH's Care Facility: Dear Staff member's name, To recap our phone conversation this morning: Home Central Nurses asked Dr. D. N. to come in to see DH on Tuesday night, Jan.19. (There has been a previous appt. made for Wed. Jan. 19, but your staff wanted him to come in earlier). I posted the time of 7:00 p.m. and the new date on the calendar in DH's room. I was also told by Home Central staff about the proposed visit. Dr. N. came as scheduled, and he asked me to tell the nurses to change the order for Ventolin to "when necessary" for 3-4 days and then only if DH were in distress; Dr. N. did not want to accelerate DH's heart rate. No staff nurse attended. Three times I tried to call them by the call-light-intercom system; there was no response. I tried phoning them. There was no response. After Dr. N. left and the care aide came back to relieve me, I went to the nurses' desk to deliver Dr. N.'s message. Rather than focus on the problem, which was to phone Dr. N. and get a direct order from him, your staff choose to "shoot the messenger," i.e. me. I am very angry at the disrespect shown me. I am an R.N. with a life time of experience, the wife of one of your patients, and I am, at personal sacrifice, paying $20,000.00 a month for outside care aides (plus the approx. $3000.00 monthly fee to your care facility). This obviously reduces your staff's work load, and I don't need to be lectured to about "I should tell Dr. N." No, I should not tell Dr. N. That's not my job. It's your staff's job. If it were said once to me, or even twice, that would have been bad enough, but for your staff to go on and on, as if I were the lowliest staff member at your care facility, was inappropriate and discourteous. At least your lowliest staff member has a Union to complain to, I don't. I pay the money, and I get insulted. I PROTEST. This morning I received a phone call from Home Central, and again with the same problem. Once again I directed them to get in touch with Dr. N., that this was not my job, but theirs. I understand from the companion aide attending DH this morning that DH received the Ventalin (contrary to Dr. N.'s order to me last evening). I got in touch with Dr. N.'s office half an hour ago. I was given to understand from his office that no one from your care facility had been in touch with them. I asked that Dr. N. fax his order to them, plus a phone call to Home Central to pick up the fax, and I trust that this will be done. Your staff's time would be better spent trying to solve the problem, rather than giving me a hard time, and then me having to solve if for them anyway. On Sunday night, I had the same experience with staff and the call light-intercom. Only this night, they turned the call light off. (Again, I tried 3 times unsuccessfully.) I actually had to go out in the hall and flag someone down. Since I hire round-the -clock nursing aides, it should be apparent to your staff that if they are called 3 times in a row, there is a problem that neither the care aide nor I can handle. The problem on Sunday night had to do with with my discovery of the deep tissue infection on DH's face that had been brought to the attention of the day nurse early on Sunday, who, according to the Companion Aide, gave DH Tylenol for the pain. DH's face wasn't checked after that, and nothing was done until I came in around 4:40 p.m. and phoned the on-call doctor and got oral penicillin started right away. In summary: Your staff made the appointment with Dr. Ngui, therefore your staff should attend and get the doctor's orders. Your staff should answer call lights in a reasonable time. Your staff should keep their phone line open for calls. Your staff should solve their own problems and not try to put them off on the patient or patient's relative. Professionalism should dictate courtesy rather than attempts to ignore, blame and even intimidate. Mary 75 Health Care Representative
I didn't hear anything back to my 1st mail, so I sent it again to all 5 staff members, including the CEO, and with these sentences to lead into the email proper:
Dear Staff Member, The incidents described below are, in my opinion, examples of senior abuse, and I will not be silent about it. Mary 75 Health Care Representative for DH
Not only that but where can you move your DH to? For the amount you are paying per month for the aids..20K is a huge amount would things be better if her were at home with 24 hour care? I would be thinking Legal action with this Home Center.
I would also send the letters certified, signature required. That might get their attention and also proof they actually did receive it. There is no proof the person it was sent to received it, the same with a fax - you can have a receipt they received it, but who received it?
As Mimi said: is there another place? Is home totally out??
Update: DH's doctor phoned me and said that his original order of about 1 1/2 week ago covered everything that the nurses needed to know and the whole thing about them needing a written order from him was blown up and unnecessary. He has spoken to one of the senior staff at the facility about it, specifically that it is my right to be treated with courtesy. He also told me that if I had any further problem with anything there, to phone him and he would take care of it. I am meeting with the Chief Executive of Patient Care this Wed. at her request, and I'm taking a friend with me as a pair of neutral ears. My friend teaches nursing at 2 universities here in the area, and she is super, super personable, professional and capable. Think of Divvi, MarilyninMD and phranque?! (with Joang in the background for moral support) all combined in one highly polished package, and that's my friend, Sheila. There's no way Sheila (PhD. in Nursing [education]) will not command their respect, and therefore, I'll get the spinoff, too. My own focus will be on my right to be treated with courtesy and ask that this be ensured in the future. It's all a moot point, really. Eric is dying. But it will help others in the future, I hope.