@@MountainPearls Yep, expecting people to do more than the bare minimum for shitty pay and little to no benefits is unrealistic. Employers want more and more but give less and less.
I seriously wish that all the healthcare teams in the world could all just freaking AGREE on a UNIVERSAL chart format. So confusion like this would never need to happen... smh I suppose I can dream
This is why if you got a family member in a home you got to check on them. Or if you are in one tell your friends if you don't got family so they can check. Alot of this confusion happens because there's a crazy amount of paperwork and it's not always done completely or on time.
The beginning of the phone call is almost verbatim of multiple different conversations that I have had calling nursing homes to get med lists or MAR info. They literally ask me which wing almost every time, transfer me 4 times to eventually speak to the manager who then questions whether the patient lives there or not. This is all too real.
The whole health business needs to go away and come back with actual health care. And free health care at that. Me it's hard taking care of patients who are always mad and about what everything cost because they're not getting told how much everything cost for them to have those procedures and sometimes they'll procedures they don't even need it out just doing it to rack up the bill. You can easily see fault with the whole system not just with the nurses or the doctors or the CNA the whole system whoever is managing it is doing a horrible job.
This was my family trying to get the nursing home to tell us which hospital they had sent my uncle to. You would have thought he was an imaginary person we had made up just to annoy them.
I work as a CNA and some of our nurses don’t know the names of the residents on the unit even though they’ve worked with them for months now. One of them was even gonna give milk to a lactose intolerant resident. Most don’t even know which diet the residents are on.
Gotta love HIPPA: if a family member is not listed in a resident's chart as a formal contact, staff can only share very limited information. As a former long-term care RN and director of nursing, you have to diplomatically handle cousins-twice-removed, church members, and former neighbors who haven't seen your resident for 10 years demanding privileged medical information we cannot legally disclose.
Wow thats bad! I forget names a lot and I have ADHD and I still would remember that kind of stuff...probqbly why my friend that works at a retirement home keeps telling me to appy there😂@sunnylaurie91
Fair enough. I've given this response along with let me check their progress notes, because literally never seen this pt a day in my life till 5 minutes ago, and the report I got was "every one is the same "
This is freaking accurate. Except missing the fax machine and faxing over the cover letter only and them explaining their fax is only on once every two weeks
@@neverdidIeverchangethis every shift! Report- they’re all stable, nothing has changed except watch bob. He fell yesterday. Then Bettys daughter calls for an update for some appointment you’ve never heard of. Like hold on. Never seen them before but give me two min and I’ll look it up
SNF NURSE HERE, FIRST OF ALL, you got lucky someone answered the phone.lol. everything else is spot on. Too many pt , not enough info or help, nobody knows nothing. ...........just runnn nnnnnn for your life
As a nursing home nurse of 39 years I got a chuckle out of this. I'm positive this does happen but not from this old gal. I made sure I knew my residents down to their favorite socks to wear. I had to retire due to two pulmonary embolism. I really miss my sweet residents.
There isn't always time when you're an RN in charge of 100 plus residents. It's a hectic environment as you know, there's no time to ask the residents which favorites socks they'd like to wear.
@@victoriat8481 Right? I worked inpatient rehab attached to a residential care facility. Skilled/assisted living. We had an interesting mix of "true rehab" pts, hospice, and long term pts waiting for a room to open up. Some people were there by plan, transiently, on their way home or to residential care. Some people just ended up there after their hospital stay and with no family around to care for them or place them, they just stayed there as wards of the state. During COVID the latter type of patients would show up straight from the hospital, nothing but the gown they came in with. We were lucky to be able to offer them socks at all, let alone get into a discussion about their favorite ones. Imagine trying to provide incontinence care to 30pts who all need it badly, without soap... or zinc paste... or briefs... because the shipment hasn't made it in yet. I'm convinced anyone who regards long term care as anything but "hell on earth" has probably only worked assisted living.
@@MNP208or maybe she wasn't an RN. There are other certifications/levels of nursing and I'd imagine the 'lower level' nurses probably spend more quality time with their patients/residents
@@rjr6912 Maybe, but I'm guessing not. When I worked there, a RN or LPN was in charge of multiple CNAs. They save $$ by having only one nurse per shift.
This made me cry tears of rage, remembering my grandmother's story. It works both ways, I'm sorry to say, and I wish so much she'd had a doctor with your compassion, Doc Schmidt! The elder care system is broken in a big way. 😭
I'm an EMT and the struggle is real when trying to get a report from the nurse at the nursing homes. I find it easy just to talk with the aids they seem to know more!
Because we do know more. Some of the coordinators at my last job didn't even know residents existed unless they were causing trouble. That's was stupid.
Ours was "thank you for calling bla bla retirement community where we live life to the fullest everyday.' What a joke!! On weekends no one was at the front desk and the phone automatically rang to the kitchen! I used to bitch about it all the time, Dr, nurses and pharmacy used to call.
I’m a long term care nurse and I’ve never had a Dr. call me from the hospital. I could for sure tell them when any med was last administered because it’s most definitely on the EMAR. I could literally send the Dr. a fax that says “ FYI residents legs fell off today “ and I would literally only get back an “ ok to monitor “
Usually it was the ER MD's: we'd send a copy of the current EMAR with diagnoses/problem lists, med lists, and times of last administration of meds with the resident via the ambulance that would somehow get "lost" (i.e., ignored) between the ER door and the ER room.
After working at a a place like this, I can definitely relate. They’re so horribly disorganized 🤦🏻♀️. Lots of the workers have lost the will to genuinely care. We also had a revolving door of new workers all the time, because people were quitting left and right. I was often roped into doing things I wasn’t trained to do, despite only being a receptionist, because we were so horribly understaffed.
I was the RN in a nursing home for 3 months and was in charge of 100 patients. With one death and one new admission a day I knew NOTHING about a single one of them. Usually when I was transferring them out was the first time I was laying eyes on them. Hence why I only stayed for three months and everyone you talk to is new. It’s a terrible job that no human can do well.
@@linjubar She's saying it's impossible to do a good job with the limited resources available. Obviously in an ideal world with proper staffing ratios things would be different.
@@linjubar it’s not that simple. They often hire new grads and the RN works on their own with the RPNs calling them with concerns and questions on 150 patients. It’s extremely stressful. The RNs who last the longest in many homes are older, experienced RNs who want out of the hospital but still want to work. They seem to handle it better then younger nurses although we have some great, young nurses too because some LTC homes offer full time with benefits which is definitely a major pro in the nursing world where most jobs are part time with no benefits
I’m an occupational therapist and when I have to call a precious nursing home for the pts PLOF….it’s crazy!!! I’m told the pt is total assist and doesn’t walk…..yet I’m looking at the pt and she is over here turning cartwheels???
OMG you are hysterical!!! I am an NP working in nursing homes and calling is the MOST frustrating thing ever! And then the waiting music and crap: “ do you like home cooked meals? Well here at Manor Care, our chefs....” CHEFS? HAHAHA my dog wouldn’t touch that food!! I feel your pain! MAkes you wonder how some nurses even got their degree. Many are amazing but some......... UGH. Thank you for your videos! You bring a lot of sunshine :)
Its amazing how it is always everyone's first day on the job or they have never worked on that hall before! Same story, different facility literally EVERY SINGLE TIME! This video is sadly so true!
My dad spent his final months in an assisted living home. I have to say, the number 1 qualification in a nursing aid (etc.) is just CARING. You could tell the ones who cared and the ones who were just ... there.
Im so proud this doesn’t happen in my aged care where I’m working as a unit manager. We always make sure we send all the relevant paperworks (health summary, care plan, list of medications, ACD etc) when we send a resident to a hospital. Also, whenever doctors from hosp ring us, there will always be that permanent RN in charge who can always provide relevant information relating to pt care. We have a good system in our computer where we can track things so easily. Didn’t realise those things are a luxury in other places. Im really privileged in my workplace. Not perfect, but it’s the best nursing home that I’ve worked with so far. :)
Wow sounds great. May I ask what the company/facility is or at least even what state it is in? My husband has been in 3 different long term care facilities in central IL & all of them are like the example phone call in this video when I ask about something to do with his care whether it's on the phone or even in person - 'I don't know, I just got here & haven't had him today, or I was gone the last few days' - & I have to ask usually a minimum of 3 people to get something close to an answer of the info I'm asking for. Most the time I frigging give up. We are at their mercy.
I used to work in a SNF and I was taking care of 25-30 patients. And yes, I have no clue what their baseline is and what meds I gave the day before 😭 here let me pass you on to our gardener 😭
... I’m sorry if this sounds ignorant but is this an American issue? Like over here, our nursing homes have strict medication records and when transferred, every info goes with the patient, it’s rare for them to call NH unless it’s about patient property or discharge. We also have a visiting Doctor who reviews the meds given and progress (if any) and they communicate with GP... isn’t this the same procedure of in USA?
As someone who’s been a CNA in multiple Nursing Homes the past 7 years I just have to say this. Yes, we are under staffed. Some people can’t handle the work, and just leave. No two week notice. Sometimes they don’t even tell us they’re leaving. Our job doesn’t stop, we go 24/7. We are trying. I love CNA work. I know lots of CNA’s who do. Sadly it does come with bad people, like any job. Who don’t love what they do.
"Can't handle the work" or refuse to tolerate a dysfunctional work environment? Sticking it out when you're being mistreated is not a sign of strength or accomplishment - you're only letting those in charge know they can keep taking advantage of you
@@tonyabrookes9931 ...or are underpaid, or the schedule is excessive or poorly structured, or they're poorly trained, or are just young, immature and misjudged an "entry level" job, or have crises or other high-stress situations at home, or have their own problems with mental health or addiction, or there's unethical treatment of the residents, or the residents' state is just too heartbreaking...
As someone who is not living in US and came randomly to your comment one year later I just wanted to say thank you for all your work and I hope you are doing well.
Doc Schmidt, please know that your videos are hilarious and I truly enjoy your content. I have shown some of your videos to people who don't work in the medical field and they enjoyed your content as well. The struggle of healthcare is real and your video/content makes it more bearable. I also appreciate the doctor/intern's point of view. You are truly talented with humor and acting and I hope to watch more of your content as you progress through your career.
When it came time to find an assisted living facility for my parents, friends warned me about this! I did research, visited many places, and talked to people who lived and worked there when the sales agents took phone calls. We found a good place that calls about everything!. Even so, I have a go-bag with all their medical records, power of attorney, insurance information, and DNRs. It has come in handy several times.
Aged care facility RN here, I don't know about the states, but here in NZ we have electronic systems for medication administration and it takes a few click to tell meds last give time.
Some of our nursing homes still have paper MAR but still it's easy to go in the MAR and see who initialed they gave it. The nurses he's depicting are just lazy or being difficult
@@NoNakersAllowed assuming we are near the med charts when he calls, that's the primary issue. I always give the dr a call back if I'm miles away from the treatment room etc or offer to fax they charts. Best bet.
Oh believe me SNFs and LTCs have their gripes about hospitals too. Sending "stable" patients back who wind up going back in 3 days, taking patients off meds that we finally got their conditions under control with bc you view acute care as one big experiment, and NEVER sending the documentation (POA activations, hard copy narc orders, AVS), and most importantly the patient back to us. Often in pain or pissed off.
As a nurse in a nursing home I gotta say. This is usually our experience calling hospitals for medical records when we receive admissions without need lists coming straight from hospital. No one ever knows anything and you must speak to several different nurses before being transferred to case manager who sends an out dared me list.
Yup I'm a nurse at the hospital and the paperwork we send with people is so minimal after such an intensive management plan on the ward. The handover is done verbally over the phone and you just gotta hope the person who answered the phone wrote it down OK
Rosa is my favorite. such a sincere sounding goodnight at 10am🤣 also the "anything good? like pants on her head? the residents here are a HOOT" 💀💀💀 that would be me at a nursing home for sure
I'm glad to know that funeral homes aren't the only ones who can't get info out of nursing homes. Good luck finding a Dr or nurse who knows anything about any patients. We actually had the only Dr on staff and only 1allowed into the facility to care for the patients, therefore the only 1 who could sign a death certificate or who would know anything about this person tell us they never heard of her before. She had been a resident for something like 10 years and he was the home administrator.
I was an X-ray tech that traveled to nursing homes to do imaging on the residents... This is unfortunately not exaggerated... Even when you are there in person you cant find any staff, and when you do they are clueless to their own patients 9 times out of 10. Nurse: “Why did you find me?! You need to do Mr. Y’s left leg Xray, because it’s STAT.” Me: “well, are you sure it is for his LEFT leg?” Nurse:” I’m positive! Why did you come find me? I’m busy!” 😡 Me: “Because Mr. Y’s left leg was amputated 20 years ago, and there’s nothing to Xray..” Nurse: “Then do the right leg” Me: “I can only do what the doctors order says, legally. It’s like a prescription... Also, he says his right leg is fine, and it should probably be for his neck..” Nurse: “...Are you sure?” Me: “ That’s what the patient said.” Nurse: “Come back to this facility later. I will need to call the doctor.” 😑😑😑😑😑😑😑😑😑
Sadly that is usually because SNF's are so understaffed and most nurses are taking care of 20-35 patients each (night shifts I have seen up to 50 patients each). It's impossible to properly provide adequate care and know the medical hx, meds, etc for so many patients. Basically the shifts are one giant med pass. Once 9am meds are passed it's already noon then it's 3pm. It's exhausting and frankly quite dangerous so many nurses leave after a short time. Hence why it does feel like everyone is new or it's their "first day". I left after a year and am so grateful to work crit care now where I have the time and resources to care for my patients and keep up on their POC.
Haha, now I know the issues go both ways. I work in a care facility and so often the nurses have to hunt down medical information when a patient is transferd from the hospital.
I’m confused about why anyone would suggest a universal chart as a solution. Hypothetically any chart would enable a nurse to rattle off meds and hypothetically any nurse would have a clue what her patients baseline was. If she didn’t she’d answer the question as accurately as she could with whatever reservations she had; God knows among her own at work that’s what they mostly do all day anyway (chatter). I thought what was remarkable was it’s pretty rare for a doctor or anyone to criticize anyone in healthcare.. the problem is apathy usually… but I think mandated staffing ratios might help. Some states have them. Last I looked there is no federal staffing ratio for nursing homes. At times I had 15 patients as a CNA and some were total care (feeding, diapers, mobility issues, possibly combative, likely confused). It’s hard on the LPNs and RNs too bc they end up changing diapers and possibly with falls and or bedsore issues. Anyway it seems courageous for a doctor or anybody for that matter to make fun of a situation that sorely deserves it.
@@shirleyjeanhaney8535 I agree mandated staff ratios would help, but I think it’s pretty obvious that there needs to be a mandatory charting system. It would stop so much confuse, a lot of these calls wouldn’t need to happen, everyone would know what information and where the information was located, etc etc.
I spent 4yrs of my life working in the USA with Kaiser and we computerized the medical record "chart" for the entire continuum of care. So you could go from a nursing home affiliate, through any dept of the hospital, including the morgue, and all your information was accessible by users with correct safety access. So a doc could look back into med record and see when last blood thinner given. No lost papers. It was hard to translate clinical needs for the programmers but we got there.
On the other hand, I've been in a nursing home and completely filled out a transfer sheet only to have the ED staff toll it unopened because "they didn't need information from a nursing home RN to make a diagnosis". Goes both ways!!!!!!!
This is SO on the nose in some cases. Our experience with 2 different nursing homes was: Call to check on Dad since I can't physically get there that day: "We don't know where he is" They literally LOST MY FATHER. While I'm on the phone with multiple people trying to find him, a call beeps through - it's the hospital. They have my father, are discharging him and want to know who's coming to get him. Dad was at dialysis the day before, BP bottomed out (as it always did) & he was transported to the hospital. Nursing home blamed dialysis center for not telling them he was being transported. Dialysis center blamed the hospital for not informing nursing home he was there. Hospital blamed the nursing home for not tracking their resident's location better. Dad was "missing" for almost 18 hours before the nursing home ever realized it, and only realized it when I called to check on him. I advise nursing home we're taking Mom out for a day trip the next day. They tell me they will make sure she has her meds before she goes and that we have them with us to give her at the appropriate times. During the trip, Mom has a massive diarrhea blowout. We're talking a blowout of epic proportions that requires over an hour of cleanup in a rest area bathroom, which was embarrassing for Mom & difficult for us. We came prepared with extra clothes, etc, but we weren't expecting something like this. Turns out someone screwed up the meds and had given her 3x the amount of stool softener she was supposed to have that morning - resulting in the massive blowout we had to deal with while traveling. And to top it off, they sent us out the door with even more stool softener in her daily meds that we were supposed to give her. Half the time, the right hand didn't know what the left hand was doing. It was incredibly frustrating.
Yes, this video is sadly extremely accurate to my experience with my husband having been in 3 different facilities in central IL. Also have experienced similar to with your Dad but they just 'lost' my husband for an hour or two within the facility. It drives me crazy that not only can I usually not get an answer with any details when I call to check on him by phone, I usually do not get my questions actually answered when I am frigging there in person!!! Oh I get a reply/response, but not usually one that answers my questions. They drive me crazy but we are at their mercy.
Based off of what I've read I blame the dialysis center. They are supposed to send the resident back to the facility/wing/room that they originate from; since he was sent to the hospital instead, nursing home should have been informed. Depending on the amount of time that had passed from when he was supposed to return from dialysis, might assign some blame to the nursing home. Like, if they are gone an for an hour past the expected return time no big deal. If they're gone a day or more... someone should be checking up on that. But there's no excuse to call EMS for a patient and not inform the nursing home.
It's so much fun responding to nursing homes as a paramedic. I once had a nursing home nurse tell me she'd never met my healthy patient with no complaints but a CNA said the patient "didn't feel well" So the nurse called an ambulance. The CNA said she just wanted the nurse to check on the patient.
This is so sadly accurate! Sounds exactly like a conversation I have in one out of 5 calls to nursing homes. Sometimes I get patients with severe dementia in the ER and nursing home didn't even bother to send over med's list or tell uns what happened. Only information is from the paramedics: "they called me because ... um ... they felt her condition kinda is less well than normal."
Having my mom go through four separate nursing facilities for rehab after a botched surgery, I can only say how KIND you were in this video. The level of incompetence I witnessed overall, but in one facility in particular, left me terrified for my mother’s safety. The really sad part is that it was a hospital that started her down the whole path, by releasing her after cutting a hole in her colon, treating only the ensuing sepsis instead of repairing the hole, and nearly killing her with painkillers due to staff not keeping proper records (she had stopped breathing, but was saved by her nephrologist who just happened to be at the hospital and remembered she was there for an unrelated procedure and liked her enough to take the time to find her room and say “hi.”) Took us six months to get her home for something that should have taken a max of two weeks to recover from completely, left her refusing any future procedure that isn’t life-saving, and us with an attorney bill that ended up with the outcome, “Sorry. She lived.”
Working in ER. Saw a patient who was sent from his nursing home for stroke symptoms (new hemiplegia) that started 7 hours before that. I call the nursing home, asking why it took them so long to send the patient here. The nurse over there says it's because patient looked fine, other than the new hemiplegia, but in the end they decided to send him here anyway because the hemiplegia was not going away. 7 hours after onset. ...
Families sign an advenced care directive stating what they want done if their loved one deteriorates. They say comfort care only not for hospital, we are not qllowed to send them to hospital. We spend all day trying to contact family to inform them of the change in condition as we are legally required to and the family finally answer a phone and demand they be sent to hospital despite signing the care plan that says dont send them to hospital. 🤦♀️🤷♀️
I did a shift as an agency nurse in a care home, phoned an ambulance for resident with chest pain unresponsive to medication; I got told not to come back, the ambulance call out was too expensive
This makes me want to cry. It is VERY accurate. Spot on. 😭😭😭😭 It costs over $7000 a month for my mother’s care. It's a shared room and they suggested she needs a companion 4-6 hours a day, at an additional cost of $50+/hour! They had a mother’s day brunch last week, but it was $50 for guests! WTF? I want to scream!!!!!! How can anyone afford decent care?!?! She's already been there 4 years and is physically ok, but has moderate dementia. A “nicer” place would cost $12,000/month, but I'm not really sure it would be better. She lives in an area outside of San Francisco, CA.
You have it good. My dad broke his neck so we paid for a companion 12 hours a day. The nurses constantly complained that they could take care of him and if we thought he needed a companion we should take him home: (mind you the companion isn’t a registered nurse, some of them weren’t even nurses aids) so we cancelled the service and he died within a few months
This is Soo fucking sad because I LIVE IN FUCKING AUSTRALIA AND I STILL RELATE. What in the actual world is going on, when I can relate so hard to this from the other side of the actual world
Believe me, this is NOT how things happen in every long term care facility in America. In my facility none of that would happen. I work for a non-profit organization which may be the reason. We see plenty of problems on our end after they rerturn from hospital as well. Some nurses think since their patient is going to a nursing home they don't need to bother with a report other than vitals. And we've been getting alot of residents back from hospital with bed sores that they didn't have in our facility. Neither is perfect and you have competent and incompetent employees in both nursing homes AND hospitals.
I hate how accurate this is. I work as a receptionist in a nursing home and I try and do everything I can for the nurse or doctor calling since I know half the nurses won’t even pick up the phone when I transfer it
I've worked as a CNA in these places. It was great when I was on staff with others who actually CARED for the residents. So many are so overworked. Worst night was two aids for 40 residents. Awful. RN later, and I appreciate a good CNA. Always help your CNAs. Charting was getting better as I left the homes. But not great before. I remember asking a nurse there what was hypokalemia. She had no idea. I saw it on the outside of a chart. Oh dear.
Trying to discharge patients to LTCs as a hospital nurse is much the same, I feel your pain! They seem to be actively working to make continuity of care impossible, though as in all situations, I’m sure there’s more to it behind the scenes.
I worked in two different long term care facilities and is not that bad people. There’s all kind of employees, the ones that don’t care and the ones that are diligent in their work because they care about the residents. I tried to take care of them the way I want my grandparents to be treated, and I felt horrible when I wasn’t able to because we were understaffed. I was a CNA. I felt really bad when in the start of my evening shift a client asked me to shave her facial hair, as a women I understand how that bothered her, but because I got busy with other residents that were in need of more urgent things I didn’t have the time to help her, around two hours before the end of that shift she passed, that was a horrible evening to me, she looked just fine for someone in hospice. And I didn’t do the one thing she asked me.
I understand why you feel so bad, but there was only so much you could do. You had to juggle many competing needs among your patients. It sounds like you really care and worked hard, and she would have seen that and appreciated it.
I'm stressed just hearing this phone tree. It's incredibly frustrating dealing with hospitals and health facilities as a patient, so it's so helpful to see how it is from a doctor's perspective too. Rough.
Working 10 years in SNFs as an OT and this is spot on. We know more about the patients meds sometimes than nursing since we usually see the same patients everyday and work on med management with them.
Honestly working in a Nursing home for more than 13 years, this happens more with Dr than with nursing staff, I've had to call hospitals multiple times after admissions to get ANY info at all.
I’ve been a nursing home nurse for over 15 years I have been in this business for over 27 I started after I got out of the military and couldn’t find a job in my chosen field. I can tell you that trying to talk to some of the doctors and explain to them what the patient was actually doing is sometimes one of the most difficult things you will ever find. Some doctors have their heads stuck up in an orifice where the sun doesn’t shine. Not to mention the fact that when we send a patient with clean skin and get back a patient with stage III wounds makes you wonder what they’re even doing at the hospital
It works both ways. I can’t even begin to tell you the horrible wounds I’ve seen on my hospital patients that come from nursing homes, and I know for a fact that the NH caused them because these are patients that had NO skin issues when they left our hospital. Please don’t act like the NH or SNF’s are innocent
@@KD-vf6yq agree however I don't believe PAC even happens in the acute setting. Not necessarily the nursing staff's fault however, patient ratios are demanding and leave very little time for basic care needs.
As a side note of my previous comment. We CNA medication AIDS are usually treated very poorly by Drs and Hospice staff. I’ve called them about seriously injured or even dead residents and have had them do everything from being rude, refusing to send someone out, All the way to telling me to do something beyond my licensing and straight up hanging up on me!
It’s funny, because in nursing homes we have a hard time getting hospital records. Patients often come in with incomplete orders, then when we call the hospital, there is no one there to clarify the orders. And if they are post op and in pain, they definitely don’t have a triplicate.
And they never come with scripts!! I can ask 3 times in report about them being sent with pt or escribed, oh yeah it's taken care of, 3 hours later they show up at 10pm with no scripts
This is painfully accurate. Working for the medications reconciliation team at a hospital, this was ALWAYS painful to deal with. I ask for a MAR and they send an order report. I talk with the nurse, and they can't pull up the MAR as the patient a discharged to my hospital...
"I was on vacation, you were on vacation, the patient was on vacation..." "yeah I got that but who even called us??" "No clue but no one here...." "Dispatch clearly told us someone here called for this patient, can ANYONE tell me why?" "I have no idea and I'm the only one here" "Okay well I guess we'll go then" "Oh no she has to go to the hospital!" "WHY?" "Because you're here to transport her....I think the doctor ordered it" 🤦♀️ sincerely Paramedics everywhere.
So much this! my favourite was one who we were called for because he was slurring his speech so they thought he might be having a stroke. Turns out half his tongue had been surgically removed a while back due to cancer, think that might be why his speech is slurred? I've several times run into situations where nobody can explain why we were called, and the patient refuses to go to hospital, yet the nursing staff insist they must be transported. I tell them I can't kidnap the person and the nursing staff gets all upset. You give me a medical problem that they need to be seen for, and documentation to state that they aren't competent to refuse care, and then I'll consider transporting them without consent. Until then, Goodbye!
I watch your channel for months now I absolutely love it I just realize that you’re in Ohio and possibly at University Hospital in Cleveland? I actually lived right there my mom was an ER nurse. I love your humor In the channel it keeps we laughing throughout the chaos
It's so sad how true that is...I'm an EMT and this happens nearly all the time...it gets really sad when you have a parient with neurological issues and the nurses can't tell you if the patient ever had similar issues or if part of their behavior is normal :)
i was a regular charge nurse at a nursing home passing meds and changing wound dressings for 60 bariatric residents & covid positive patients on the ONLY admitting floor in the facility. barely had time to sit or even answer these phone calls 😭
I work in long term care as a nurse.I care for up to 44 residents during day hours or up to 80 at night. Do I know each medication that every person took the day before? Nope! The correct response to the doctor would have been I’m not sure but hold on a second so I can check the EMAR.
I worked in a SNF as an SLP. I don’t think it was that bad, but once nursing outright lost a patient (not dead - just gone) and blamed therapy. Luckily PT and SLT documented seeing her, but she was MIA when OT showed up. This tiny lady with dementia was sitting at the damn bus stop in front of the building. She was returned thanks to a great bus driver who knew better. It was my first day and I was the first person they blamed when she went missing. I’m typically a school SLP and tried to make the jump to medical.
This if F-d up. I've been a hospital RN and a Nursing home RN. Number one, the DOCTOR IS NEVER GOING TO DO THE CALLING ABOUT ANYTHING! 2nd, At our facility we send the Administration record from PCC (not hand written) showing when the patient had every med over the past week. Don't put all nursing home in this light. You know what WE in the nursing homes are seeing more of after our residents are IN THE HOSPITAL for longer stays???? BED SORES. More bed sores from hospitals in the past few years than I've ever seen. Then there's the night they sent a man back to our facility who was in respiratory distress with no oxygen and 3+ pitting edema.....after which I told the paramedics not to bother going any further and BACK TO THE HOSPITAL ER HE WENT!
As an ER nurse, I either get paperwork on a different person altogether, no paperwork, or medics could not find the nurse before bringing the patient in. So no baseline can be established. Even had one time where the medics didn't even leave a name/address of the facility and pt was altered, so it was fun trying to discharge her. These places need more staff.
"Can You Spell Jones", LOL😅!! "Blood Thinner~Lisinopril"🤦♀️:( I seriously had to TEACH some Staff at my MIL's Nursing Home how to properly help her use the COPD inhaler...Can't make this stuff-up.
this is why i stopped calling the nursing home for anything 🤣 its hard to even get through to somebody that can be helpful or get through to somebody at all
Omg!!!! Yes! Getting info from nursing homes is so hard. I’m an RN and sometimes we are the ones dealing with this fun lol. I have a new found respect for interns. Sometimes you’re just as lost as we are
Yeah, I have a number of SNF patients. Hate calling their because this is what I get all the time too. Same in person though for my Q 2 month rounds. Everyone is new each time I go.
The SNF I work at as an RN has been referred to as "a unicorn" and omg if this is accurate most of the time, it really is. I can't believe this is the norm. If I handled a call like this, I'd get written up. We have our issues with staffing yeah but we know all of our patients. If you gave me a resident name right now, I am sitting at home but I could cold recite every major fact about all 31 of them and I do not have any of their info in front of me-we are a rehab unit and our average length of stay is 1-3 months, with some LTC overflow as our LTC is a smaller unit. I cannot list off everyone's meds cold, but could tell you whether or not they're on a med if you asked me without looking it up. I am not some super nurse-far from it lol-we just have enough staff that we know everyone. Ironically our local hospital kinda sucks imo. The reports I get from there are vague at the very best (one nurse, at 2pm, did not know that our mutual patient who was returning to us had had their colostomy reversed 3 weeks earlier) and outright inaccurate at worst (was told a patient had a peripheral IV when they had a PICC). Dressings are several days old, and most come back with pressure ulcers too. We had one resident who had come in with a pressure ulcer from a previous facility, we got them all healed up, sent them out to the hospital for 3 days for a minor procedure, and they came back with a reopened stage 4. One diabetic patient had not had their blood sugar checked for over a day and they knew they were diabetic-they pinned it on the CNA but unless the CNA had worked over 24 hours, I think it was a communication problem. They've also done some pretty shocking things with narcotics but I will leave that one alone to avoid doxxing myself.
This problem would be solved if they do proper handover. As an part-time carer working in nursing home, I feel many things changes when you come back and if there is no proper handover you will be like "I just started working today"
So true! Also, sometimes handover in the morning is done properly, but you happen to not work that day or you work afternoon shift and you miss on sometimes really vital information. I've seen situation when a carer had to explain why they didn't use fluid thickener for a resident. Nurses told some staff in the morning (like, 4 people) that resident will now be on thickener but never changed the list given to care assistant (that we were not allowed to change ourselves). Those situations are dangerous for residents! There has to be some better way to go about this
Also looks like there wasn’t a proper handover from the ER to the floor because when I give report to EMS and the ER from the nursing home I always include allergies, blood thinners, and antibiotics as well as what was going on with the patient. Also our paperwork includes “last administered dose” I also can’t count how many times I’ve faxed over the same document to the hospital multiple times, and my confirmation went through and they claim they haven’t gotten it. I’ve also gotten shit reports or no report from the hospital, so to act like this is just nursing homes is ridiculous. I’ve also called and asked to be transferred to the nurse taking care of one of my residents and been transferred to the patients room.
@@JesionWer I saw problems like this with my dad's nursing home. Shifts didn't communicate with each other. I'd get calls from people on different shifts asking the same questions.
Hi, pharmacy tech here. I'd just like to add that it's not even the pharmacist making the calls most times. Usually it's us having to slog through all that. The pharmacist only really steps in once we actually get ahold of someone who knows what's going on.
@@LB81RN the first nursing home my mum was in was just shut down for negligence and the second is under criminal investigation for her death for this very reason. They couldn't even get her name right in her file and they had her for almost 10 years
Long term care facilities can charge 6 figures and yet this is honestly their staffing situation.
My grandfather 7k a month. Hell I should have just quit my job and had him pay me 2k a month.
I work in one true story.
No. We actually give a crap, we work hard and we take good care of our people. ❤️
@@MountainPearls yeah CNAs are treated like absolute trash. Just do-bodies that take the brunt of everything.
@@MountainPearls Yep, expecting people to do more than the bare minimum for shitty pay and little to no benefits is unrealistic. Employers want more and more but give less and less.
I seriously wish that all the healthcare teams in the world could all just freaking AGREE on a UNIVERSAL chart format. So confusion like this would never need to happen... smh I suppose I can dream
Wouldn't that be nice.
This is why if you got a family member in a home you got to check on them. Or if you are in one tell your friends if you don't got family so they can check. Alot of this confusion happens because there's a crazy amount of paperwork and it's not always done completely or on time.
That was the goal/plan when EMR’s were developed, but some of these LTC’s still use paper charting 🤦🏼♀️ in 2021 I can’t wrap my head around that.
What a dream that is. 😩
@@i.am.heather Wait really? I’m actually curious, can you elaborate on that?
The beginning of the phone call is almost verbatim of multiple different conversations that I have had calling nursing homes to get med lists or MAR info. They literally ask me which wing almost every time, transfer me 4 times to eventually speak to the manager who then questions whether the patient lives there or not. This is all too real.
When you just want to know her baseline....
How is it legal to be this incompetent
The whole health business needs to go away and come back with actual health care. And free health care at that. Me it's hard taking care of patients who are always mad and about what everything cost because they're not getting told how much everything cost for them to have those procedures and sometimes they'll procedures they don't even need it out just doing it to rack up the bill. You can easily see fault with the whole system not just with the nurses or the doctors or the CNA the whole system whoever is managing it is doing a horrible job.
And the “hold infomercial” was a nice touch too. Extremely accurate.
BECAUSE too many facilities are too darned big!!!!
This was my family trying to get the nursing home to tell us which hospital they had sent my uncle to. You would have thought he was an imaginary person we had made up just to annoy them.
Omg 😂 I’m so sorry that happened to you but your comment killed me 😂 I hope your uncle is okay now
Some people take “He’s not our problem anymore” too literally 😭
I work as a CNA and some of our nurses don’t know the names of the residents on the unit even though they’ve worked with them for months now. One of them was even gonna give milk to a lactose intolerant resident. Most don’t even know which diet the residents are on.
Gotta love HIPPA: if a family member is not listed in a resident's chart as a formal contact, staff can only share very limited information. As a former long-term care RN and director of nursing, you have to diplomatically handle cousins-twice-removed, church members, and former neighbors who haven't seen your resident for 10 years demanding privileged medical information we cannot legally disclose.
Wow thats bad! I forget names a lot and I have ADHD and I still would remember that kind of stuff...probqbly why my friend that works at a retirement home keeps telling me to appy there😂@sunnylaurie91
All of this is 100% true! Don't forget the "yesterday was my first day with the resident so I don't know" response to all questions.
Fair enough. I've given this response along with let me check their progress notes, because literally never seen this pt a day in my life till 5 minutes ago, and the report I got was "every one is the same "
This is freaking accurate. Except missing the fax machine and faxing over the cover letter only and them explaining their fax is only on once every two weeks
@@neverdidIeverchangethis every shift! Report- they’re all stable, nothing has changed except watch bob. He fell yesterday. Then Bettys daughter calls for an update for some appointment you’ve never heard of. Like hold on. Never seen them before but give me two min and I’ll look it up
lol true
Rosa had me believing she was the RN listing off those meds😂😂😂
RNs actually know what the meds are used for
@@NoNakersAllowed yeah, maybe sometimes I guess lol
Thats more med names she said correctly then any hospice nurse ive ever spoken with lol
🤣🤣
🤣🤣🤣
SNF NURSE HERE, FIRST OF ALL, you got lucky someone answered the phone.lol. everything else is spot on. Too many pt , not enough info or help, nobody knows nothing.
...........just runnn nnnnnn for your life
As a nursing home nurse of 39 years I got a chuckle out of this. I'm positive this does happen but not from this old gal. I made sure I knew my residents down to their favorite socks to wear. I had to retire due to two pulmonary embolism. I really miss my sweet residents.
There isn't always time when you're an RN in charge of 100 plus residents. It's a hectic environment as you know, there's no time to ask the residents which favorites socks they'd like to wear.
@@victoriat8481 Right? I worked inpatient rehab attached to a residential care facility. Skilled/assisted living. We had an interesting mix of "true rehab" pts, hospice, and long term pts waiting for a room to open up. Some people were there by plan, transiently, on their way home or to residential care. Some people just ended up there after their hospital stay and with no family around to care for them or place them, they just stayed there as wards of the state.
During COVID the latter type of patients would show up straight from the hospital, nothing but the gown they came in with. We were lucky to be able to offer them socks at all, let alone get into a discussion about their favorite ones. Imagine trying to provide incontinence care to 30pts who all need it badly, without soap... or zinc paste... or briefs... because the shipment hasn't made it in yet.
I'm convinced anyone who regards long term care as anything but "hell on earth" has probably only worked assisted living.
@@victoriat8481 Maybe she worked in a small, privately owned facility.
@@MNP208or maybe she wasn't an RN. There are other certifications/levels of nursing and I'd imagine the 'lower level' nurses probably spend more quality time with their patients/residents
@@rjr6912 Maybe, but I'm guessing not. When I worked there, a RN or LPN was in charge of multiple CNAs. They save $$ by having only one nurse per shift.
This made me cry tears of rage, remembering my grandmother's story. It works both ways, I'm sorry to say, and I wish so much she'd had a doctor with your compassion, Doc Schmidt! The elder care system is broken in a big way. 😭
Because the owners only care about $$$$$$$$ signs.
Everything is broken and will only get worse 😀 Too many people, too much demand, too much greed, not enough $ and taking care of ourselves.
I'm an EMT and the struggle is real when trying to get a report from the nurse at the nursing homes. I find it easy just to talk with the aids they seem to know more!
Lol.... I worked as a CNA for 3yrs and was always surprised that management & RNs don't know their residents as much as other CNAs and I do.
Because we do know more.
Some of the coordinators at my last job didn't even know residents existed unless they were causing trouble. That's was stupid.
Dudeeee same
It's because we're the ones in the room with the patient the most so we're the eyes and ears of the homes lol
Vets will often ask the grooms for any meaningful information on horses because the owner or owner often doesn't know the baseline of the animal
“Thank you for calling Sprawling Meadow Waterfalls Gardens, where we think age is just a number but your health is forever!” 😩🤣💀
Ours was "thank you for calling bla bla retirement community where we live life to the fullest everyday.' What a joke!! On weekends no one was at the front desk and the phone automatically rang to the kitchen! I used to bitch about it all the time, Dr, nurses and pharmacy used to call.
I’m a long term care nurse and I’ve never had a Dr. call me from the hospital. I could for sure tell them when any med was last administered because it’s most definitely on the EMAR. I could literally send the Dr. a fax that says “ FYI residents legs fell off today “ and I would literally only get back an “ ok to monitor “
Usually it was the ER MD's: we'd send a copy of the current EMAR with diagnoses/problem lists, med lists, and times of last administration of meds with the resident via the ambulance that would somehow get "lost" (i.e., ignored) between the ER door and the ER room.
After working at a a place like this, I can definitely relate. They’re so horribly disorganized 🤦🏻♀️. Lots of the workers have lost the will to genuinely care. We also had a revolving door of new workers all the time, because people were quitting left and right. I was often roped into doing things I wasn’t trained to do, despite only being a receptionist, because we were so horribly understaffed.
Yikes!
I was the RN in a nursing home for 3 months and was in charge of 100 patients. With one death and one new admission a day I knew NOTHING about a single one of them. Usually when I was transferring them out was the first time I was laying eyes on them. Hence why I only stayed for three months and everyone you talk to is new. It’s a terrible job that no human can do well.
that sounds very illegal unless its just an assisted living facility.
@@jillianroe9461 it's not illegal. It's what RNs have to putt up with. Ratios will never change.
Of course humans can do a good job, you just need skilled and capable staff, and enough so that every resident receives the attention they need.
@@linjubar She's saying it's impossible to do a good job with the limited resources available. Obviously in an ideal world with proper staffing ratios things would be different.
@@linjubar it’s not that simple. They often hire new grads and the RN works on their own with the RPNs calling them with concerns and questions on 150 patients. It’s extremely stressful. The RNs who last the longest in many homes are older, experienced RNs who want out of the hospital but still want to work. They seem to handle it better then younger nurses although we have some great, young nurses too because some LTC homes offer full time with benefits which is definitely a major pro in the nursing world where most jobs are part time with no benefits
Also an RN , have worked in a SNF, this is SPOT ON.
I’m an occupational therapist and when I have to call a precious nursing home for the pts PLOF….it’s crazy!!! I’m told the pt is total assist and doesn’t walk…..yet I’m looking at the pt and she is over here turning cartwheels???
OMG you are hysterical!!! I am an NP working in nursing homes and calling is the MOST frustrating thing ever! And then the waiting music and crap: “ do you like home cooked meals? Well here at Manor Care, our chefs....” CHEFS? HAHAHA my dog wouldn’t touch that food!! I feel your pain! MAkes you wonder how some nurses even got their degree. Many are amazing but some......... UGH. Thank you for your videos! You bring a lot of sunshine :)
Its amazing how it is always everyone's first day on the job or they have never worked on that hall before! Same story, different facility literally EVERY SINGLE TIME! This video is sadly so true!
My dad spent his final months in an assisted living home. I have to say, the number 1 qualification in a nursing aid (etc.) is just CARING. You could tell the ones who cared and the ones who were just ... there.
Im so proud this doesn’t happen in my aged care where I’m working as a unit manager. We always make sure we send all the relevant paperworks (health summary, care plan, list of medications, ACD etc) when we send a resident to a hospital. Also, whenever doctors from hosp ring us, there will always be that permanent RN in charge who can always provide relevant information relating to pt care. We have a good system in our computer where we can track things so easily. Didn’t realise those things are a luxury in other places. Im really privileged in my workplace. Not perfect, but it’s the best nursing home that I’ve worked with so far. :)
Sounds like heaven
Wow sounds great. May I ask what the company/facility is or at least even what state it is in? My husband has been in 3 different long term care facilities in central IL & all of them are like the example phone call in this video when I ask about something to do with his care whether it's on the phone or even in person - 'I don't know, I just got here & haven't had him today, or I was gone the last few days' - & I have to ask usually a minimum of 3 people to get something close to an answer of the info I'm asking for. Most the time I frigging give up. We are at their mercy.
I used to work in a SNF and I was taking care of 25-30 patients. And yes, I have no clue what their baseline is and what meds I gave the day before 😭 here let me pass you on to our gardener 😭
Same!! I did not last long in that setting.
People don't understand that. Nurses take care a lot of people at the same time. Oh well.
... I’m sorry if this sounds ignorant but is this an American issue? Like over here, our nursing homes have strict medication records and when transferred, every info goes with the patient, it’s rare for them to call NH unless it’s about patient property or discharge. We also have a visiting Doctor who reviews the meds given and progress (if any) and they communicate with GP... isn’t this the same procedure of in USA?
Haha right!
@@tinaloye2014 we dont have a procedure in the usa lol
As someone who’s been a CNA in multiple Nursing Homes the past 7 years I just have to say this. Yes, we are under staffed. Some people can’t handle the work, and just leave. No two week notice. Sometimes they don’t even tell us they’re leaving. Our job doesn’t stop, we go 24/7. We are trying. I love CNA work. I know lots of CNA’s who do. Sadly it does come with bad people, like any job. Who don’t love what they do.
"Can't handle the work" or refuse to tolerate a dysfunctional work environment? Sticking it out when you're being mistreated is not a sign of strength or accomplishment - you're only letting those in charge know they can keep taking advantage of you
@@tonyabrookes9931 ...or are underpaid, or the schedule is excessive or poorly structured, or they're poorly trained, or are just young, immature and misjudged an "entry level" job, or have crises or other high-stress situations at home, or have their own problems with mental health or addiction, or there's unethical treatment of the residents, or the residents' state is just too heartbreaking...
As someone who is not living in US and came randomly to your comment one year later I just wanted to say thank you for all your work and I hope you are doing well.
Thank you for what you do. Im a hospice nurse and cnas have the toughest jobs of anyone in the medical field. By far.
"Alright, goodnight Dr. Spit." I nearly died choking on my own spit.
"It's ten o'clock in the morning!?!"
Yes this made me laugh out loud
Doc Schmidt, please know that your videos are hilarious and I truly enjoy your content. I have shown some of your videos to people who don't work in the medical field and they enjoyed your content as well. The struggle of healthcare is real and your video/content makes it more bearable. I also appreciate the doctor/intern's point of view. You are truly talented with humor and acting and I hope to watch more of your content as you progress through your career.
We ❤️ Doc Schmidt!
When it came time to find an assisted living facility for my parents, friends warned me about this! I did research, visited many places, and talked to people who lived and worked there when the sales agents took phone calls. We found a good place that calls about everything!. Even so, I have a go-bag with all their medical records, power of attorney, insurance information, and DNRs. It has come in handy several times.
Aged care facility RN here, I don't know about the states, but here in NZ we have electronic systems for medication administration and it takes a few click to tell meds last give time.
Some of our nursing homes still have paper MAR but still it's easy to go in the MAR and see who initialed they gave it. The nurses he's depicting are just lazy or being difficult
Damn you’re ahead of Aus, many aged care facilities are still on paper, heck a lot of hospitals still do meds the paper way
Same here in Norway. Our hospitals, nursing homes and psychiatric clinics have access to the same data base of records.
From my experience it's like that in the US but some people are dumb as rocks
@@NoNakersAllowed assuming we are near the med charts when he calls, that's the primary issue. I always give the dr a call back if I'm miles away from the treatment room etc or offer to fax they charts. Best bet.
Oh believe me SNFs and LTCs have their gripes about hospitals too. Sending "stable" patients back who wind up going back in 3 days, taking patients off meds that we finally got their conditions under control with bc you view acute care as one big experiment, and NEVER sending the documentation (POA activations, hard copy narc orders, AVS), and most importantly the patient back to us. Often in pain or pissed off.
As a nurse in a nursing home I gotta say. This is usually our experience calling hospitals for medical records when we receive admissions without need lists coming straight from hospital. No one ever knows anything and you must speak to several different nurses before being transferred to case manager who sends an out dared me list.
Yup I'm a nurse at the hospital and the paperwork we send with people is so minimal after such an intensive management plan on the ward. The handover is done verbally over the phone and you just gotta hope the person who answered the phone wrote it down OK
Aren't we so proud of how we care for our elderly?
Rosa is my favorite. such a sincere sounding goodnight at 10am🤣 also the "anything good? like pants on her head? the residents here are a HOOT" 💀💀💀 that would be me at a nursing home for sure
a second like from the doc himself!? definitely gonna comment way more now 😆
I'm glad to know that funeral homes aren't the only ones who can't get info out of nursing homes. Good luck finding a Dr or nurse who knows anything about any patients. We actually had the only Dr on staff and only 1allowed into the facility to care for the patients, therefore the only 1 who could sign a death certificate or who would know anything about this person tell us they never heard of her before. She had been a resident for something like 10 years and he was the home administrator.
oh my god
Wow!
I was an X-ray tech that traveled to nursing homes to do imaging on the residents... This is unfortunately not exaggerated... Even when you are there in person you cant find any staff, and when you do they are clueless to their own patients 9 times out of 10.
Nurse: “Why did you find me?! You need to do Mr. Y’s left leg Xray, because it’s STAT.”
Me: “well, are you sure it is for his LEFT leg?”
Nurse:” I’m positive! Why did you come find me? I’m busy!” 😡
Me: “Because Mr. Y’s left leg was amputated 20 years ago, and there’s nothing to Xray..”
Nurse: “Then do the right leg”
Me: “I can only do what the doctors order says, legally. It’s like a prescription... Also, he says his right leg is fine, and it should probably be for his neck..”
Nurse: “...Are you sure?”
Me: “ That’s what the patient said.”
Nurse: “Come back to this facility later. I will need to call the doctor.”
😑😑😑😑😑😑😑😑😑
Sadly that is usually because SNF's are so understaffed and most nurses are taking care of 20-35 patients each (night shifts I have seen up to 50 patients each). It's impossible to properly provide adequate care and know the medical hx, meds, etc for so many patients. Basically the shifts are one giant med pass. Once 9am meds are passed it's already noon then it's 3pm. It's exhausting and frankly quite dangerous so many nurses leave after a short time. Hence why it does feel like everyone is new or it's their "first day". I left after a year and am so grateful to work crit care now where I have the time and resources to care for my patients and keep up on their POC.
Omg thats so frustrating
@@AmyAnnLand, I know the S in SNF is supposed to stand for Skilled, but very highly doubt there's anyone skilled there.
@@Taric25 Nobody is gonna seem skilled if they’re overworked and exhausted…
This. No one knows half the stuff that goes on in these places
Haha, now I know the issues go both ways. I work in a care facility and so often the nurses have to hunt down medical information when a patient is transferd from the hospital.
I worked for 2 nursing homes as the Receptionist...This is so accurate 😂😂😭😭
I wish there was a universal chart. I feel like it would help ease so much confusion.
I’m confused about why anyone would suggest a universal chart as a solution. Hypothetically any chart would enable a nurse to rattle off meds and hypothetically any nurse would have a clue what her patients baseline was. If she didn’t she’d answer the question as accurately as she could with whatever reservations she had; God knows among her own at work that’s what they mostly do all day anyway (chatter). I thought what was remarkable was it’s pretty rare for a doctor or anyone to criticize anyone in healthcare.. the problem is apathy usually… but I think mandated staffing ratios might help. Some states have them. Last I looked there is no federal staffing ratio for nursing homes. At times I had 15 patients as a CNA and some were total care (feeding, diapers, mobility issues, possibly combative, likely confused). It’s hard on the LPNs and RNs too bc they end up changing diapers and possibly with falls and or bedsore issues. Anyway it seems courageous for a doctor or anybody for that matter to make fun of a situation that sorely deserves it.
@@shirleyjeanhaney8535 I agree mandated staff ratios would help, but I think it’s pretty obvious that there needs to be a mandatory charting system. It would stop so much confuse, a lot of these calls wouldn’t need to happen, everyone would know what information and where the information was located, etc etc.
A lot of stuff is pretty standardized already.
I spent 4yrs of my life working in the USA with Kaiser and we computerized the medical record "chart" for the entire continuum of care. So you could go from a nursing home affiliate, through any dept of the hospital, including the morgue, and all your information was accessible by users with correct safety access. So a doc could look back into med record and see when last blood thinner given. No lost papers. It was hard to translate clinical needs for the programmers but we got there.
On the other hand, I've been in a nursing home and completely filled out a transfer sheet only to have the ED staff toll it unopened because "they didn't need information from a nursing home RN to make a diagnosis". Goes both ways!!!!!!!
* Toss it
Gah!
This is SO on the nose in some cases. Our experience with 2 different nursing homes was:
Call to check on Dad since I can't physically get there that day:
"We don't know where he is"
They literally LOST MY FATHER.
While I'm on the phone with multiple people trying to find him, a call beeps through - it's the hospital. They have my father, are discharging him and want to know who's coming to get him.
Dad was at dialysis the day before, BP bottomed out (as it always did) & he was transported to the hospital.
Nursing home blamed dialysis center for not telling them he was being transported.
Dialysis center blamed the hospital for not informing nursing home he was there.
Hospital blamed the nursing home for not tracking their resident's location better.
Dad was "missing" for almost 18 hours before the nursing home ever realized it, and only realized it when I called to check on him.
I advise nursing home we're taking Mom out for a day trip the next day. They tell me they will make sure she has her meds before she goes and that we have them with us to give her at the appropriate times.
During the trip, Mom has a massive diarrhea blowout. We're talking a blowout of epic proportions that requires over an hour of cleanup in a rest area bathroom, which was embarrassing for Mom & difficult for us. We came prepared with extra clothes, etc, but we weren't expecting something like this.
Turns out someone screwed up the meds and had given her 3x the amount of stool softener she was supposed to have that morning - resulting in the massive blowout we had to deal with while traveling. And to top it off, they sent us out the door with even more stool softener in her daily meds that we were supposed to give her.
Half the time, the right hand didn't know what the left hand was doing. It was incredibly frustrating.
Yes, this video is sadly extremely accurate to my experience with my husband having been in 3 different facilities in central IL. Also have experienced similar to with your Dad but they just 'lost' my husband for an hour or two within the facility. It drives me crazy that not only can I usually not get an answer with any details when I call to check on him by phone, I usually do not get my questions actually answered when I am frigging there in person!!! Oh I get a reply/response, but not usually one that answers my questions. They drive me crazy but we are at their mercy.
Based off of what I've read I blame the dialysis center. They are supposed to send the resident back to the facility/wing/room that they originate from; since he was sent to the hospital instead, nursing home should have been informed.
Depending on the amount of time that had passed from when he was supposed to return from dialysis, might assign some blame to the nursing home. Like, if they are gone an for an hour past the expected return time no big deal. If they're gone a day or more... someone should be checking up on that.
But there's no excuse to call EMS for a patient and not inform the nursing home.
It's so much fun responding to nursing homes as a paramedic. I once had a nursing home nurse tell me she'd never met my healthy patient with no complaints but a CNA said the patient "didn't feel well" So the nurse called an ambulance. The CNA said she just wanted the nurse to check on the patient.
OMG this is every call I've ever made to a nursing home LMFAO
This is so sadly accurate! Sounds exactly like a conversation I have in one out of 5 calls to nursing homes. Sometimes I get patients with severe dementia in the ER and nursing home didn't even bother to send over med's list or tell uns what happened. Only information is from the paramedics: "they called me because ... um ... they felt her condition kinda is less well than normal."
Exactly the same kind of thing that the family gets when they try to see what's going on with their loved one.
Having my mom go through four separate nursing facilities for rehab after a botched surgery, I can only say how KIND you were in this video. The level of incompetence I witnessed overall, but in one facility in particular, left me terrified for my mother’s safety. The really sad part is that it was a hospital that started her down the whole path, by releasing her after cutting a hole in her colon, treating only the ensuing sepsis instead of repairing the hole, and nearly killing her with painkillers due to staff not keeping proper records (she had stopped breathing, but was saved by her nephrologist who just happened to be at the hospital and remembered she was there for an unrelated procedure and liked her enough to take the time to find her room and say “hi.”) Took us six months to get her home for something that should have taken a max of two weeks to recover from completely, left her refusing any future procedure that isn’t life-saving, and us with an attorney bill that ended up with the outcome, “Sorry. She lived.”
Wow, that is so scary. Im sorry you & your mother had to go through that
Working in ER. Saw a patient who was sent from his nursing home for stroke symptoms (new hemiplegia) that started 7 hours before that. I call the nursing home, asking why it took them so long to send the patient here. The nurse over there says it's because patient looked fine, other than the new hemiplegia, but in the end they decided to send him here anyway because the hemiplegia was not going away. 7 hours after onset. ...
Yeah, wow. Usually they’ll jump on any excuse to ship them out
Families sign an advenced care directive stating what they want done if their loved one deteriorates. They say comfort care only not for hospital, we are not qllowed to send them to hospital. We spend all day trying to contact family to inform them of the change in condition as we are legally required to and the family finally answer a phone and demand they be sent to hospital despite signing the care plan that says dont send them to hospital. 🤦♀️🤷♀️
@@btigah exactly .. or the dr tells the nurse just monitor for now ..
I did a shift as an agency nurse in a care home, phoned an ambulance for resident with chest pain unresponsive to medication; I got told not to come back, the ambulance call out was too expensive
Dear God.
This makes me want to cry. It is VERY accurate. Spot on. 😭😭😭😭
It costs over $7000 a month for my mother’s care. It's a shared room and they suggested she needs a companion 4-6 hours a day, at an additional cost of $50+/hour!
They had a mother’s day brunch last week, but it was $50 for guests! WTF? I want to scream!!!!!!
How can anyone afford decent care?!?! She's already been there 4 years and is physically ok, but has moderate dementia.
A “nicer” place would cost $12,000/month, but I'm not really sure it would be better. She lives in an area outside of San Francisco, CA.
You have it good. My dad broke his neck so we paid for a companion 12 hours a day. The nurses constantly complained that they could take care of him and if we thought he needed a companion we should take him home: (mind you the companion isn’t a registered nurse, some of them weren’t even nurses aids) so we cancelled the service and he died within a few months
This is Soo fucking sad because I LIVE IN FUCKING AUSTRALIA AND I STILL RELATE. What in the actual world is going on, when I can relate so hard to this from the other side of the actual world
You are not alone, I'm in Scotland and its the same here, a palaver trying to get info
Woow..m
Believe me, this is NOT how things happen in every long term care facility in America. In my facility none of that would happen. I work for a non-profit organization which may be the reason. We see plenty of problems on our end after they rerturn from hospital as well. Some nurses think since their patient is going to a nursing home they don't need to bother with a report other than vitals. And we've been getting alot of residents back from hospital with bed sores that they didn't have in our facility. Neither is perfect and you have competent and incompetent employees in both nursing homes AND hospitals.
I hate how accurate this is. I work as a receptionist in a nursing home and I try and do everything I can for the nurse or doctor calling since I know half the nurses won’t even pick up the phone when I transfer it
I've worked as a CNA in these places. It was great when I was on staff with others who actually CARED for the residents. So many are so overworked. Worst night was two aids for 40 residents. Awful. RN later, and I appreciate a good CNA. Always help your CNAs. Charting was getting better as I left the homes. But not great before. I remember asking a nurse there what was hypokalemia. She had no idea. I saw it on the outside of a chart. Oh dear.
SPOT ON! I've had these exact conversations so many times... The one with Janet telling you to contact the university hospital got me! Haha
Trying to discharge patients to LTCs as a hospital nurse is much the same, I feel your pain! They seem to be actively working to make continuity of care impossible, though as in all situations, I’m sure there’s more to it behind the scenes.
Oh my God, I thought this was a local problem. It's worldwide 😂😭
I worked in two different long term care facilities and is not that bad people. There’s all kind of employees, the ones that don’t care and the ones that are diligent in their work because they care about the residents. I tried to take care of them the way I want my grandparents to be treated, and I felt horrible when I wasn’t able to because we were understaffed. I was a CNA. I felt really bad when in the start of my evening shift a client asked me to shave her facial hair, as a women I understand how that bothered her, but because I got busy with other residents that were in need of more urgent things I didn’t have the time to help her, around two hours before the end of that shift she passed, that was a horrible evening to me, she looked just fine for someone in hospice. And I didn’t do the one thing she asked me.
I understand why you feel so bad, but there was only so much you could do. You had to juggle many competing needs among your patients. It sounds like you really care and worked hard, and she would have seen that and appreciated it.
As a paramedic whose company contractually covered several nursing homes in my area....
BIIIIG MOOOOOOOOD omfg
Tears..... literally...tears pouring from laughter.... choking on food and I live alone! I need to be NPO when watching you!!
At least you got her med list! 😂 I am thrilled every time a patient from a nursing home brings a med list. Doesn’t happen every often :(
I'm stressed just hearing this phone tree. It's incredibly frustrating dealing with hospitals and health facilities as a patient, so it's so helpful to see how it is from a doctor's perspective too. Rough.
“What floor is she on...” 🤣🤣
“I just clean her rooms...”
Working 10 years in SNFs as an OT and this is spot on. We know more about the patients meds sometimes than nursing since we usually see the same patients everyday and work on med management with them.
I LAUGHED SOOOO HARD. ICU RN here, and this has to be the most accurate thing I’ve ever seen!!!
Someone had time to answer the phone? Impressive!
This is so accurate it hurts.
Honestly working in a Nursing home for more than 13 years, this happens more with Dr than with nursing staff, I've had to call hospitals multiple times after admissions to get ANY info at all.
I’ve been a nursing home nurse for over 15 years I have been in this business for over 27 I started after I got out of the military and couldn’t find a job in my chosen field. I can tell you that trying to talk to some of the doctors and explain to them what the patient was actually doing is sometimes one of the most difficult things you will ever find. Some doctors have their heads stuck up in an orifice where the sun doesn’t shine. Not to mention the fact that when we send a patient with clean skin and get back a patient with stage III wounds makes you wonder what they’re even doing at the hospital
Nothing. That's why they come back with pressure areas and ulcer formations.
Yup. Seen it too.
It works both ways. I can’t even begin to tell you the horrible wounds I’ve seen on my hospital patients that come from nursing homes, and I know for a fact that the NH caused them because these are patients that had NO skin issues when they left our hospital. Please don’t act like the NH or SNF’s are innocent
@@KD-vf6yq agree however I don't believe PAC even happens in the acute setting. Not necessarily the nursing staff's fault however, patient ratios are demanding and leave very little time for basic care needs.
Truth! Send someone out, come back with stage III, reddened groins, denuded all over...wtf?
As a side note of my previous comment. We CNA medication AIDS are usually treated very poorly by Drs and Hospice staff. I’ve called them about seriously injured or even dead residents and have had them do everything from being rude, refusing to send someone out, All the way to telling me to do something beyond my licensing and straight up hanging up on me!
It’s funny, because in nursing homes we have a hard time getting hospital records. Patients often come in with incomplete orders, then when we call the hospital, there is no one there to clarify the orders. And if they are post op and in pain, they definitely don’t have a triplicate.
And they never come with scripts!! I can ask 3 times in report about them being sent with pt or escribed, oh yeah it's taken care of, 3 hours later they show up at 10pm with no scripts
Oh.my.gosh! You have taken notes on all your interactions in every practice setting!! You're a hoot!
Hold up. There ain't no doctor alive that calls for records. They ask the nurse to do that, who then asks the secretary.
I take it you’ve never heard of residents lol.
As a nurse I have spent plenty of time calling for records and report. A secretary doesn't always know what info is pertinent.
Who asks the pharmacist who asks the pharmacy student/intern who actually does it
As a doctor I have called many a time for records and had this experience. Not a resident.
@@AR-md1zq you are one of the few, your nurses must appreciate you
Loved the documentary format. This so true
This is painfully accurate. Working for the medications reconciliation team at a hospital, this was ALWAYS painful to deal with. I ask for a MAR and they send an order report. I talk with the nurse, and they can't pull up the MAR as the patient a discharged to my hospital...
So accurate! Sometimes you get a good nurse or manager but it can take a long time to get them on the phone.
"I was on vacation, you were on vacation, the patient was on vacation..."
"yeah I got that but who even called us??"
"No clue but no one here...."
"Dispatch clearly told us someone here called for this patient, can ANYONE tell me why?"
"I have no idea and I'm the only one here"
"Okay well I guess we'll go then"
"Oh no she has to go to the hospital!"
"WHY?"
"Because you're here to transport her....I think the doctor ordered it"
🤦♀️ sincerely Paramedics everywhere.
😂😂😂 Geeeez
YES. We get at least one or two of these a week 🙄
So much this! my favourite was one who we were called for because he was slurring his speech so they thought he might be having a stroke. Turns out half his tongue had been surgically removed a while back due to cancer, think that might be why his speech is slurred?
I've several times run into situations where nobody can explain why we were called, and the patient refuses to go to hospital, yet the nursing staff insist they must be transported. I tell them I can't kidnap the person and the nursing staff gets all upset. You give me a medical problem that they need to be seen for, and documentation to state that they aren't competent to refuse care, and then I'll consider transporting them without consent. Until then, Goodbye!
I watch your channel for months now I absolutely love it I just realize that you’re in Ohio and possibly at University Hospital in Cleveland? I actually lived right there my mom was an ER nurse. I love your humor In the channel it keeps we laughing throughout the chaos
Exactly why I left the industry, I dealt with coworkers like that EVERY SINGLE DAY
It's so sad how true that is...I'm an EMT and this happens nearly all the time...it gets really sad when you have a parient with neurological issues and the nurses can't tell you if the patient ever had similar issues or if part of their behavior is normal :)
This was hilarious. I’ve never dealt with it. But the cleaning lady had me crying laughing
That commercial 👌 in the beginning is so accurate 😂
i was a regular charge nurse at a nursing home passing meds and changing wound dressings for 60 bariatric residents & covid positive patients on the ONLY admitting floor in the facility. barely had time to sit or even answer these phone calls 😭
I work in long term care as a nurse.I care for up to 44 residents during day hours or up to 80 at night. Do I know each medication that every person took the day before? Nope! The correct response to the doctor would have been I’m not sure but hold on a second so I can check the EMAR.
I worked in a SNF as an SLP. I don’t think it was that bad, but once nursing outright lost a patient (not dead - just gone) and blamed therapy. Luckily PT and SLT documented seeing her, but she was MIA when OT showed up. This tiny lady with dementia was sitting at the damn bus stop in front of the building. She was returned thanks to a great bus driver who knew better.
It was my first day and I was the first person they blamed when she went missing. I’m typically a school SLP and tried to make the jump to medical.
The biggest joke is that the DOCTOR is making this phone call.
This if F-d up. I've been a hospital RN and a Nursing home RN. Number one, the DOCTOR IS NEVER GOING TO DO THE CALLING ABOUT ANYTHING! 2nd, At our facility we send the Administration record from PCC (not hand written) showing when the patient had every med over the past week. Don't put all nursing home in this light. You know what WE in the nursing homes are seeing more of after our residents are IN THE HOSPITAL for longer stays???? BED SORES. More bed sores from hospitals in the past few years than I've ever seen. Then there's the night they sent a man back to our facility who was in respiratory distress with no oxygen and 3+ pitting edema.....after which I told the paramedics not to bother going any further and BACK TO THE HOSPITAL ER HE WENT!
BTW.....I work for a non-profit long term care/rehab facility. So NO....we aren't all about money.
As an ER nurse, I either get paperwork on a different person altogether, no paperwork, or medics could not find the nurse before bringing the patient in. So no baseline can be established. Even had one time where the medics didn't even leave a name/address of the facility and pt was altered, so it was fun trying to discharge her. These places need more staff.
"Can You Spell Jones", LOL😅!!
"Blood Thinner~Lisinopril"🤦♀️:(
I seriously had to TEACH some Staff at my MIL's Nursing Home how to properly help her use the COPD inhaler...Can't make this stuff-up.
I worked at an assisted living facility and we were required to be on top of it at all times! Thourough reports, checks and balances, etc.
As a former medical record coordinator, this is hilarious 😂😂😂
Rosa has the best body language LOL, she is like "she was nice to me", probably no one is nice to her. SAD!
this is why i stopped calling the nursing home for anything 🤣 its hard to even get through to somebody that can be helpful or get through to somebody at all
Even if you work in the facility the conversations go like this😅😓
For the non-medical people watching: none of this is fiction or exaggerated.
I saw it as a relative
This is so true. I go through this EVERY time!
Omg!!!! Yes! Getting info from nursing homes is so hard. I’m an RN and sometimes we are the ones dealing with this fun lol. I have a new found respect for interns. Sometimes you’re just as lost as we are
Yeah, I have a number of SNF patients. Hate calling their because this is what I get all the time too. Same in person though for my Q 2 month rounds. Everyone is new each time I go.
Cackling at the accuracy
You just summed up the Canadian long term care system so perfectly
The SNF I work at as an RN has been referred to as "a unicorn" and omg if this is accurate most of the time, it really is. I can't believe this is the norm. If I handled a call like this, I'd get written up. We have our issues with staffing yeah but we know all of our patients. If you gave me a resident name right now, I am sitting at home but I could cold recite every major fact about all 31 of them and I do not have any of their info in front of me-we are a rehab unit and our average length of stay is 1-3 months, with some LTC overflow as our LTC is a smaller unit. I cannot list off everyone's meds cold, but could tell you whether or not they're on a med if you asked me without looking it up. I am not some super nurse-far from it lol-we just have enough staff that we know everyone.
Ironically our local hospital kinda sucks imo. The reports I get from there are vague at the very best (one nurse, at 2pm, did not know that our mutual patient who was returning to us had had their colostomy reversed 3 weeks earlier) and outright inaccurate at worst (was told a patient had a peripheral IV when they had a PICC). Dressings are several days old, and most come back with pressure ulcers too. We had one resident who had come in with a pressure ulcer from a previous facility, we got them all healed up, sent them out to the hospital for 3 days for a minor procedure, and they came back with a reopened stage 4. One diabetic patient had not had their blood sugar checked for over a day and they knew they were diabetic-they pinned it on the CNA but unless the CNA had worked over 24 hours, I think it was a communication problem. They've also done some pretty shocking things with narcotics but I will leave that one alone to avoid doxxing myself.
You are hilarious! I am a retired RN and your skits have me rolling with laughter
This problem would be solved if they do proper handover. As an part-time carer working in nursing home, I feel many things changes when you come back and if there is no proper handover you will be like "I just started working today"
So true! Also, sometimes handover in the morning is done properly, but you happen to not work that day or you work afternoon shift and you miss on sometimes really vital information. I've seen situation when a carer had to explain why they didn't use fluid thickener for a resident. Nurses told some staff in the morning (like, 4 people) that resident will now be on thickener but never changed the list given to care assistant (that we were not allowed to change ourselves). Those situations are dangerous for residents! There has to be some better way to go about this
Also looks like there wasn’t a proper handover from the ER to the floor because when I give report to EMS and the ER from the nursing home I always include allergies, blood thinners, and antibiotics as well as what was going on with the patient. Also our paperwork includes “last administered dose” I also can’t count how many times I’ve faxed over the same document to the hospital multiple times, and my confirmation went through and they claim they haven’t gotten it.
I’ve also gotten shit reports or no report from the hospital, so to act like this is just nursing homes is ridiculous. I’ve also called and asked to be transferred to the nurse taking care of one of my residents and been transferred to the patients room.
@@JesionWer I saw problems like this with my dad's nursing home. Shifts didn't communicate with each other. I'd get calls from people on different shifts asking the same questions.
This is so right on.
The funniest part is that the doctor is making this call. In real life it's the nurse or pharmacist going through all this suffering.
Hi, pharmacy tech here. I'd just like to add that it's not even the pharmacist making the calls most times. Usually it's us having to slog through all that. The pharmacist only really steps in once we actually get ahold of someone who knows what's going on.
"Age is just a number" 💀
The scary thing is this is pretty accurate.
Not in my facility it isn't!
I am walking backwards out of the room.
@@LB81RN the first nursing home my mum was in was just shut down for negligence and the second is under criminal investigation for her death for this very reason. They couldn't even get her name right in her file and they had her for almost 10 years
this made me cry 😭 😭😭 way too spot on