In the course of our clinical rotations, our class has to visit a number of long term care facilities and local hospitals to put into practice what we learned in the classroom.
It became apparant to a few of ues yesterday that we have, until now, been spolied by the excellent standard of care we saw at other facilities. The place we were at yesterday left us angry and sad at what we saw.
The first inkling of things to come was given to us in the lobby. We gathered there, waiting for our instructor to arrive and assign us to residents (they don't like it when you call the people in these places 'patients'). There was a blue binder on a coffee table in the lobby that had a 'public' sticker on the front of it. My curiosity led me to pick it up and start to read the information within. What I saw shocked and saddened me.
It was a State report. Every nursing home and hospital in the US has to be inspected by the state regularly and they all have standards to maintain. Some places do better than others, obviously. The place we were at last week didn't have any recent violations. The place were were at yesterday had MANY. Too many, and they weren't for things like leaving lids of trash cans and laundry bins. Residents had broken arms and legs because of negligent nursing, many people developed decubitus ulcers (bed sores) because they were left in their own urine and feces for extended periods of time and weren't turned adequately.; one person suffered head injuries and broken ribs because 2 CNA's decided that they'd use an incontinence pad to transfer said person from bed to chair. The pad tore, and the person fell to the floor. Whilst the state inspector was there, she observed a nurse lifting a resident's Foley catheter bag over her head, thereby letting the urine in the bag run back into the bladder. The resident in question subsequently developed a UTI and kidney infection and it took TEN days for the staff to coordinate well enough to get the person treated with antibiotics. That's disgraceful.
Within the first half an hour of our arrival on the wards we saw pretty much everything that we'd been told NOT to do being done with gusto. We were literally gobsmacked at the lack of compassion the CNA's and nurses there had for their patients. They threw them around like they were sacks of corn - omy friend came very close to smacking a CNA in the face because of the way she was treating a resident. The resident was very thin and frail, but the CNA was brutal in the way she touched her and moved her. My friend is the gentlest, most timid person I've ever met, but yesterday she was more animated and angrier than me!
At first I thought that money was the issue, but the nursing staff there are paid just as well as the staff at the first home. They're not understaffed, either, and there's the same ratio of residents to nursing staff. It's not about the money or ratios or staffing, it's about compassion and attitude. The attitudes I saw yesterday were just about the worst I've seen, and compassion was decidedly absent. I felt so sorry for the residents there; they're trapped there with death being the only way out. I tell you, death must look like a pretty darn attractive prospect for some of the folks in that place.
I have a way of placing facilities on a scale of stars: 5 stars is the absolute best, a place that I'd be happy placing my own mother in, and 1 star is a place that I wouldn't put a cockroach in, let alone a living himan being - and my mother would be placed there over my dead body. The first place we worked at was a 5 star facility. Yesterday's experience: one star, and that's being generous.