[NPInfo] that PMR pt

Sat Nov 3 12:17:28 PDT 2007

I am so so sorry. I understand being caught in the middle. I do not know how you can ever leave your daughter/or nurse hat at home when it comes to family. I also feel that we are made to feel guilty for caring, and really the fault is with the non family caregivers, as they should know that family members that have  a medical background are going to share extra medical  information about the patient, and offer lots of cautions, and "watch for this and watch for that", and do double checking, and actually if the nurses and facility staff are confident, they would appreciate and see it as a sign of help, instead of a negative. 

  I do think however, we subconsciously think others think the same way we do. 
  For example you are a caring nurse, so in your brain, other nurses are caring at the same level. I am the same way.  Or if you are so tired, you forget to tell the nurses to dot every i and cross every t, and you know what? they are getting paid to do a good job. They are not getting paid to be a family member, but they are getting paid to do what is reasonable and prudent for a nurse with the same level of training we had, and then you give them even more information about your mom, so now they have extra knowledge in which to make decisions. Where is the accountability? It makes me mad. You did not expect the nurses to be a daughter, just to listen to you about her cardiac risk. And also, there are non medical family members that get very involved because they care, look at Linda's husband. That is the way it is supposed to be.  We all know that "the talking heads" say make sure you are assertive, and dont assume the nurses and doctors know about your loved one, but
 then when you try to give information, you almost feel there is passive agressive hostility or actions at times. 

  Sorry that was my soap box, but again I am so sorry that happened to you and your mom. We truly are sometimes between a rock and a hard place, regards, Carla

Paula Sumner <nurse_healer at yahoo.com> wrote:
  Hi Cara, no she did not survive it. she was up in ohio and i was in nc so did not know details until after she died. I told various nurses there of her cardiac hx-silent MI in the past and asked that it be put in her care plan. I was naive enough back then that i thought all nurses had the same ethic about care that I do/did.
My family did not want me to be too involved as I 'would get my nurse' on as one nurse told me as a criticism once at a ce class. kinda like dena, i guess, lol.
paula

Carla Anderson wrote:
Thank you Paula regarding my dad. I am very sorry about your mom. Did she survive the MI or was it fatal? Regarding your job, those patients are fortunate to have you. I think ALF's and LTC facilities need NP care to provide continuity and reduce errors. Carla

Paula Sumner wrote: He will go into the snf wing when he comes back, and if not on hospice, I will put him on it. The facilty uses fall pads beside the bed.
I am sorry to read about your dad's experience,Carla. My mon had a silent MI that was missed-her arm pain they felt was from her falling into a door frame.
paula

Carla Anderson wrote:
One suggestion if it is possible as he is weak, make sure his studio in the AL has thick carpets with a thick pad, if he is not trying to roll a weelchair over. If they wont let you alter the rugs, get some thick fluffy portable non skid rugs in the bathroom and around the room, so if he falls he will not break a hip/arm. My dad broke two bone, and he had no osteoporosis, and the floors were like rock. He had only been there the one night, and I told him to take his walker from the bed to the bathroom, but he did not and fell. And that led to his death 3 days later. He could not recover, perhaps had a clot. It mortified me that places for seniors had floors like cement. Carla 

Paula Sumner wrote: no family here, son in ohio. the doc and i cared for him in AL (past 3 weeks). I don't know what his future is, but i expect him back on hospice. he had no resp sxs at all. Everything about him was not as one would expect it. 
paula

Carla Anderson wrote:
Was he a fall risk in assisted living? Did he have famiy there? Did he have secondary lung cancer with siadh syndrome? Did they do a CT scan that showed a lung cancer? and then ever a PeT scan? Who was caring for him in the assisted living? Family everyday, or did he have hospice? Carla Anderson, Oregon

Paula Sumner wrote: he had prostate ca several years ago and surgey. what is weird i that he had spine films and chest films-negative except his compression fracture last spring. He was failing in his apt so we put him in asst living-had a lot of muscle pain, was incontinent since prostate surgery, was bowel focused and needed help stooling. The pred nisone we started last week pretty much eliminated his pain, but his legs were weaker r>l, dev foot drop. that is when we admitted him. CXR shows a cavitation in a lung, ct scan shows his manubrium almost eat up (never c/o pain there), a mass in the kidney and maybe liver, and in his spine! 
paula

"Rogers, Barbara" wrote:
Paula
Do you know what the primary cancer is?

Barb

-----Original Message-----
From: npinfo-bounces at nurse.net 
To: npinfo at nurse.net 
Sent: Wed Oct 31 17:47:42 2007
Subject: [NPInfo] that PMR pt

That pt I asked for info on PMR about (and got the only list reply: send to rheumatology) -he dev foot drop so he was admitted to the hospital--has mets! what a shock. we came to like this guy, and care about him-it is just stunning news. 
Paula