A rant about work.

I love nurses but sometimes I feel like the nurses at work and in SNFs under react. Perhaps because they are stretched WAY too thin. Perhaps because alot of the pts are end their end stages of life... 

For me unless they are DNR or hospice, if my pt tells me something is wrong, I listen. I listen and evaluate them based on medical record, on other therapists treatment, on my experience with them, on my own intuition, on what they say, how they act and ultimately I use my medical skills to decide what I think needs to happen. Sure sometimes we don't catch everything but with multiple providers I think we should listen to each other. We are all coming from different disciplines and backgrounds.

I evaluated a pt yesterday, he had just been transferred down from the hospital and he was complaining of a head ache. I let the nurses know, asked about his bp, asked them what they thought about getting him up. Talked with him a bit, did my normal chart review and research and after a bit he was ready to go to the bathroom and move around. So I took him. We did some other ADLs and that was it. When I left we were joking and he told me he felt a lot better. I told him I would be back tomorrow to work with him and he told me he would miss and that he loved me. :) The nurses were a bit frustrated with him because he was on his call button constantly. I told him cognitively he scored in the demented area and that I thought he was mostly lonely. 

 I went to see him today and he looked like death. I mean REALLY like death. The nutrition woman that comes to get his meals was even hesitant to go into his room to get his meal order. I went in with her and woke him. He was complaining of a HORRIBLE head ache. He cold hardly open his eyes. I spoke with nursing and they told me they were aware but that they had given him pain medication and that was all they could do. I went back, talked with him again and he said he couldn't do anything. I didn't press him too much because he really seemed sick. I again talked with the nurse about his BP and even specifically asked if she had contacted his doctor yet. She said "No, it's just a head ache". 

I got a text this afternoon, turns out he had multiple inter-cranial bleeds. I'm sooo sad, I wish I had pushed the nurses more. I wish that he had some family with him, sometimes pts need a family advocate so healthcare providers know what their prior normal was. I really hope that he pull through or at least that he is not suffering. 

 

There are times working in the health care field that I become so frustrated with the "process. The "cost containment" that send workers home when we could use the help, the hoops to get people the care they need... I don't know... I'm not overly excited about Obama care, so far I've seen nothing but problems in my field but I PRAY that we can get people not only healthcare but GOOD healthcare.