View unanswered posts | View active topics It is currently Sun Dec 21, 2014 10:45 pm



Reply to topic  [ 14 posts ] 
 Taking on the SNF staff about labs & meds 
Author Message

Joined: Wed Dec 30, 2009 1:46 pm
Posts: 3213
Location: WA
Post Taking on the SNF staff about labs & meds
Just when things seemed to be going quite well at the SNF, the evening shift nurse last night told me Derek had been ordered a UA, CBC, and a whole page of lab tests including thyroid [she showed me the order]. The 'care manager' [the only nurse on the floor I don't like] had faxed the PCP and told him that Derek had lost weight [about 12 pounds, net, since his admission in December] and [because of state surveys, no doubt] she was demanding a battery of tests! So they got the order as well as an order for Periactin, for 'anorexia'. He eats an amazing amount and is not thin by any means.

Well, I hit the roof, without losing my temper. I told the evening nurse [and wrote a note and signed it to that effect] that under no circumstances was he to be ordered lab tests without my consent unless he has symptoms of acute illness and that I didn't consider a slight loss of weight, in a terminal illness, to be acute. AND that Periactin is anticholinergic and that he must not have it!! I also added that no medications, other than antibiotics, are to be ordered without being first approved by his neurologist.

I had a terrible night trying to sleep after this. Am I being overly reactive to these issues? I can't wait until Monday when the 'care manager' is back at work to hear her explanation. I had just a few days ago discussed with her the possibility of Hospice/Palliative care. Her comment was, "I don't see how Hospice can do anything that we can't do!" :evil:

_________________
Pat [68] married to Derek [84] for 38 years; husband dx PDD/LBD 2005, probably began 2002 or earlier; late stage and in a SNF as of January 2011. Hospitalized 11/2/2013 and discharged to home Hospice. Passed away at home on 11/9/2013.


Sat Mar 26, 2011 5:40 pm
Profile

Joined: Sat Jan 03, 2009 2:59 pm
Posts: 1978
Post Re: Takiing on the SNF staff re:labs & meds
Pat,
I don't think you over reacted at all, they know you are there every day, this to me seems a little underhanded to say the least .

_________________
Irene Selak


Sat Mar 26, 2011 5:49 pm
Profile WWW

Joined: Mon Feb 21, 2011 9:55 pm
Posts: 355
Post Re: Taking on the SNF staff about labs & meds
I don't blame you one bit, Pat. It seems to me from what little you have said about this person, that she is trying to throw her weight around, maybe climb the ladder. You KNOW Derek's history, and thank God you are on top of things. Imagine what could have happened if they had gone ahead and given him the Periactin. I just admire the fact that you could keep calm - I don't know if I could have!!!!!! :evil:

_________________
cared for Dad who passed away on January 28th 2013 R.I.P.


Sat Mar 26, 2011 6:04 pm
Profile

Joined: Sun Aug 29, 2010 5:46 pm
Posts: 610
Post Re: Taking on the SNF staff about labs & meds
What about also circling back to his PCP on Monday to make sure that the orders can be rescinded and to make sure from that end that tests and meds are not ordered without advising you, and that med changes must be through the neurologist? You caught these but what if someone conveniently forgets to tell you others? This is incredible.

Julianne


Sat Mar 26, 2011 6:16 pm
Profile

Joined: Wed Dec 30, 2009 1:46 pm
Posts: 3213
Location: WA
Post Re: Taking on the SNF staff about labs & meds
Yes, I'm going to fax the PCP this weekend. Actually, his PCP is out of town and the guy who is filling in wrote the orders. But I'll fax the memo to his PCP. Through the years with Lewy I have seen this sort of thing happen all too often where medications are concerned. As I posted before, it was a psychiatrist who ordered Risperdal for him when he was briefly in a nursing home in AZ recovering from a hospitalization. That was a major disaster. He obviously did not bother to consult Derek's neurologist! I sometimes wonder if doctors communicate with one another or bother to read their charts. :|

_________________
Pat [68] married to Derek [84] for 38 years; husband dx PDD/LBD 2005, probably began 2002 or earlier; late stage and in a SNF as of January 2011. Hospitalized 11/2/2013 and discharged to home Hospice. Passed away at home on 11/9/2013.


Sat Mar 26, 2011 6:32 pm
Profile

Joined: Fri Jan 15, 2010 9:33 pm
Posts: 3437
Location: Vermont
Post Re: Taking on the SNF staff about labs & meds
Oh, Pat, this sounds so much like what I went through with the former head nurse at the ALF and the CNPs. I hope you have a better outcome than we did. Lynn

_________________
Lynn, daughter of 89 year old dad dx with possiblity of LBD, CBD, PSP, FTD, ALS, Vascular Dementia, AD, etc., died Nov. 30, 2010 after living in ALF for 18 months.


Sat Mar 26, 2011 8:29 pm
Profile

Joined: Wed Oct 28, 2009 11:53 am
Posts: 969
Location: Ocala, FL
Post Re: Taking on the SNF staff about labs & meds
Pat, dear... My heart aches for you and my thoughts are with you.

_________________
Leone Carroll (75); wife of Dale (75) who passed away March 23, 2011


Sat Mar 26, 2011 8:53 pm
Profile

Joined: Sat Oct 06, 2007 4:28 pm
Posts: 770
Location: LA
Post Re: Taking on the SNF staff about labs & meds
Pat, in no way were you out of line. Thank God for a wife like you!

Dorthea


Sat Mar 26, 2011 9:07 pm
Profile

Joined: Wed Dec 30, 2009 1:46 pm
Posts: 3213
Location: WA
Post Re: Taking on the SNF staff about labs & meds
Thank you, one and all, for your support and your reinforcement of my actions. Sometimes I have strong doubts about whether or not I'm over the line and, obviously, I'm not afraid to speak up. :P

_________________
Pat [68] married to Derek [84] for 38 years; husband dx PDD/LBD 2005, probably began 2002 or earlier; late stage and in a SNF as of January 2011. Hospitalized 11/2/2013 and discharged to home Hospice. Passed away at home on 11/9/2013.


Sat Mar 26, 2011 9:38 pm
Profile

Joined: Fri Jan 15, 2010 9:33 pm
Posts: 3437
Location: Vermont
Post Re: Taking on the SNF staff about labs & meds
Speaking up for your LO who can't speak up for him or herself is critical in their care. ! Lynn

_________________
Lynn, daughter of 89 year old dad dx with possiblity of LBD, CBD, PSP, FTD, ALS, Vascular Dementia, AD, etc., died Nov. 30, 2010 after living in ALF for 18 months.


Sat Mar 26, 2011 10:05 pm
Profile

Joined: Sun Oct 04, 2009 10:18 am
Posts: 276
Location: Washington State
Post Re: Taking on the SNF staff about labs & meds
Hi Pat. Considering how involved you are and how you are obviously skilled at nursing and excellent at caring for your husband I think it was really underhanded of the evening care nurse to take action without consulting you. In fact, I wonder if it is against the SNF's statement of rights. Tests are one thing but changing meds are another. This sort of thing is so dangerous for our loved ones and it creates so much more work for us! I think long and hard about any med change and consider all the factors -dosage, side effects, anticholinergic, etc. before suggesting or allowing a change.

I'm convinced that, in general, doctors don't communicate with each other or read charts. Especially when one is covering for another. Good luck to you with this situation.

_________________
Annie, daughter of brave Marie, dx 2007 and in ALF


Sat Mar 26, 2011 10:17 pm
Profile

Joined: Fri Jan 15, 2010 9:33 pm
Posts: 3437
Location: Vermont
Post Re: Taking on the SNF staff about labs & meds
I can certainly attest to drs. and CNPs not communicating about my dad. If I didn't coordinate, it didn't happen, until the hospice nurse came on the scene. Then she did a great job, but that was after I had to fire the psychiatrist. :roll: Lynn

_________________
Lynn, daughter of 89 year old dad dx with possiblity of LBD, CBD, PSP, FTD, ALS, Vascular Dementia, AD, etc., died Nov. 30, 2010 after living in ALF for 18 months.


Sat Mar 26, 2011 10:45 pm
Profile

Joined: Sat Jul 31, 2010 5:28 pm
Posts: 317
Post Re: Taking on the SNF staff about labs & meds
Pat, if I am ever in a Nursing Home, I hope to heaven that I have an advocate like you in my corner. Derek is so blessed to have you. Nan


Sun Mar 27, 2011 1:42 am
Profile

Joined: Tue Aug 17, 2010 9:20 am
Posts: 184
Location: So Cal
Post Re: Taking on the SNF staff about labs & meds
Pat, you are a woman much more reserved than I! I'm sure the entire floor would have learned of the mistake and of my opinion of the care manager. You handled it perfectly. I can't wait to hear the outcome once the care manager is confronted with her grievous error. Please keep us filled in and good luck to you in settling this. Sher

_________________
Sher (53) married 29 years to Ken (66) who was diagnosed with LBD in 2008, but it most likely began many years before.


Sun Mar 27, 2011 12:52 pm
Profile
Display posts from previous:  Sort by  
Reply to topic   [ 14 posts ] 

You cannot post new topics in this forum
You cannot reply to topics in this forum
You cannot edit your posts in this forum
You cannot delete your posts in this forum
You cannot post attachments in this forum

Search for:
Jump to:  
Powered by phpBB © 2000, 2002, 2005, 2007 phpBB Group.
Designed by STSoftware for PTF.
Localized by MaĆ«l Soucaze © 2010 phpBB.fr