Monday, August 30, 2010

Nursing problems

We have been having a lot of problems with our nurses, I would appreciate prayers in this area. I am having to learn how to be a “manager” and check up on people. I have never held a position like this before so I am totally out of my comfort zone with this. But for Dillon’s sake I have to do it.

I found out a nurse was signing off on giving a medication for months and he didn’t even know where it is in my house! Needless to say I fired him, but as far as I know the agency still hasn’t fired him and told him the reason I fired him was just because I found someone who could work more days. Why didn’t they tell him I fired him because he falsified documents? Why didn’t they report him to the nursing board? Why didn’t they fire him? I don’t understand how they are “upset” at what he did but take no action about it. The medication he wasn’t giving for months was throwing Dillon’s diet off and causing him to have a lot more seizures everyday than he would have been having! This nurse was also told 4 times not to turn the volume of Dillon’s oxygen monitor to the lowest setting. It alarms for a reason, it is loud for a reason. If it is going off you need to hear it, I just don’t understand people….

Another nurse, from another agency, fed Dillon way too early one night and he projectile vomited – I know because I was here and saw it. When I asked her if she fed him early she said yes 9and she fed him in about 10-15 minutes even though I told her it had to be done over 30-45 minutes). When I told her she can’t do that she said “I am an adult too you know. I am not a child.” To which I replied that she needs to read her nursing instructions because they are there for a reason – his protection! The next morning I read her nurses note and it said that she fed him at 12 and gave meds as ordered. She said nothing about feeding him too early and too fast, nothing about the vomiting (which he did aspirate on and I had to give natural antibiotics to clear him up). We reported this to the agency and they did an investigation and she no longer works for them. (At least this agency takes falsify documents seriously!)

Other nurses keep calling off – usually at the last minute. Even when they do call off with a few hours notice we are almost never able to find a replacement. A nurse just today gave one night notice that she is quitting (because she never wanted night shift and the agency knew this – I told them myself – but they still kept her on anyways.) So now, we have 11 nights open for the month of September that we are *trying* to fill.

There have been even more problems though. As I started looking back – no one has been doing range of motion and everything I read about Dillon’s upcoming hip surgery is that it is preventable if people were doing range of motion. He may still have needed it, but not this young. Having it this young ensures he will need to have it one, two or more times in the future. Why aren’t the nurses doing range of motion on an immobile patient? I thought that was standard procedure. I now have it doctor ordered to be done every shift.

The agency thought it was ok to have a nurse who worked all day at another job come to my house that night, knowing that she was then going to work all the next day. I don’t see how that is possible unless you are sleeping somewhere and I don’t want them sleeping while caring for Dillon. He needs them to protect him or he gets eye infections from secretions, struggles to breathe when the CPAP comes out of his nose, gets pneumonia from lack of infection control and cleanliness, etc.

Nurses have not been giving Dillon oral care (I know have that dentists ordered to be done every shift as well), changing supplies, cleaning supplies, etc. His oxygen humidifier has rocks of calcium in it because no one ever cleaned it. That means he is breathing in oxygen that has that built up in the water. I made a HUGE paper (about 3 feet long on the inside of the closet door where his supplies are neatly organized into individual baskets) with when supplies should be changed and people are still looking at the list and deciding what to change and what to ignore. I really don’t know what else I can do other than to clone myself and do it all myself.

I started to interview and orient the nurses myself. Which was going great – I had the best night nurse I have had in a while this way. But she was the one who didn’t want nights and just quit. I am trying to take a more proactive approach to it all. I am now asking them if they completed the cleaning list I have posted beside his bed, if they are checking his ketones, if they changed the supplies, etc in the morning before they leave. I am doing what I can even though it is so hard for me, because Dillon needs me to.

Please pray for me in this area that I would speak with wisdom as I handle different issues that arise. Pleas pray I would know when to keep a nurse and when to fire a nurse. Please pray that God will direct me to ask the right person the right thing if something isn’t being done that should be etc. Please pray we would finally get some nurses who aren’t trying to come here and sleep but that would actually love Dillon and want to take care of him.

1 comment:

ryguysmommy said...

Let me just say first of all how much I admire you. Your strength, courage, determination and most of all love. I am mother too and I know that as mothers we have to be our children's advocates. Its our responsibility to make sure they get the best of everything. You are Dillon's voice. By being on top of his caregivers you are ensuring he gets the best and hopefully you are also helping the caregivers become better at their jobs as well. It amazes me that it doesn't seem like these people get involved in this career path for the right reasons. They should WANT to do right by thier patient. It just doesn't seem like that is the case in most instances. Best of luck!