Now What?

hi chuck, i updated plaxo for you.... how are you doing? i will be leaving for amsterdam wednesday may 4, back on may 11. arlene will be at my house with my puppy and doing the manual for you.... speak to you soon. bonnie

May 9, 2005

Janet, I am sending this to you because I don’t know what else to do ….

FYI, Sharon never received her meds on Sunday. I was there with her most of the day. She’s supposed to get them at around 1:30 pm. The shift changes at 3 pm. No one bothered to give them to her. After several attempts to find the nurse who dispenses meds, Sharon finally got them at around 4 from the next shift, and an hour later she got her regular 5 pm meds.

This is probably what led to her latest infection about which you will read below.

Today, I was there again and no one had taken her temperature. I took it. It was within normal range, but high for Sharon. It was 98. [Sharon runs normal at 97. By the time she reaches 99, she’s in big trouble.] But she was feeling better and did get her medications. I left around 2 pm. I called her at 3:20 and since her temperature had not yet been taken, I asked her to take it herself. It was 99. That’s not good.

I instructed her to get to the nurse’s station and ask for Tylenol and have someone take her temperature.

Long story short, they told her they were told ‘NOT TO TAKE HER TEMPERATURE’ and gave her some song and dance about the Tylenol….but after the stink I made yesterday, they went to the trouble of giving her the 5 pm. Meds…..

Then someone did take her temperature and gave her Tylenol.

This is not asking anything other than basic care. Yesterday should never have happened, nor should I have to be there every three hours today.

I just think this should be documented.

May 9, 2005

Susan, since you asked......

Today has been hideous. The only reason I came there at all today was because Sharon's phone wasn't working. I came in with the dog just to fix the phone and go home. I found my sister in the middle of the room, pale as a ghost, shivering from head to foot. I rushed to the nurse's station and alerted them that Sharon needs help. "She's fine," I was told. "I was just in her room." I said she's shivering, she's got temperature. "No she's just upset about her phone."

Come on. She was obviously ill. Sharon's there for a reason. .Let me remind you, that Christopher Reeve's recent death was caused by the same sort of opportunistic infection to which paraplegics like Sharon are prone. These infections are serious and life-threatening. During these episodes Sharon is seriously impaired cognitively, has virtually no problem-solving skills. It goes without saying, she is weaker than usual and virtually unable to move. Sharon requires total care. She is not even aware that she is sick until you point it out to her.

"I'm just cold," she told me. "Is the window closed?"

I had to knock a few heads and I know I made a couple of enemies today, but just because Sharon requires little care when she is well, is no excuse for assuming she is self-sufficient. Hardly.

Maria and Dennis were the only bright spots in an otherwise wretched set of experiences. Apart from Dennis, Sharon received minimal to zero care today, and only that because I made such a stink. Indeed, if I didn't make a stink she'd be sleeping on urine-soaked sheets and you'd find her lunch and dinner trays sitting in her room; her dinner tray is probably still there as a matter of fact. .

Dennis took charge and was wonderful....but apart from he and Maria, I have few compliments left for the remaining staff.

I left for an hour to bring the dog home and returned as quickly as I could. A nurse did bring her afternoon meds, and said she'd be back to check on her. I thanked her but I sat there from the change of shift until 7 p.m. and not a person came in to take her temperature. She started to feel better but then her temperature spiked again. I frantically went out to the nurse's station. "Who's on this evening?" I asked. "I don't know. Can I tell you later? Who are you? I'm busy right now."

Not the response for which I was looking after the day I'd had.

I raised another stink. I spoke to the nursing supervisor. Asked that Sharon's temperature be taken, that they help her to catherize again, and give her some tylenol for her fever. And for my troubles, I was told off by the two nurses..I DON'T CARE. At least they finally went into my sister's room.

What galls me more is that when they came into her room.....finally....they entreated my cognitively-impaired, fevered sister, "You know I take good care of you." I informed the nurses that it was I, not Sharon, who complained and that I'd do it again. Sharon's health is my responsibility.

I am totally disgusted. Sharon requires so little attention most of the time; which is why now that she needs attention, the cavalier attitudes are so appalling. You know that my sister Bonnie and I are aware of the difficult job that you do; why?

I finally left after Sharon's temperature was finally taken, and a Tylenol was administered. I presume she'll be catherized; at least I hope she will.

Sent: Tuesday, May 10, 2005 8:11 AM

Subject: RE:
Hi

I hope that you had a nice vacation. I am leaving this Thursday for a week. I spoke to Arlene yesterday and she was upset about Sharon, who was not feeling well. She got together with Dennis, the unit manager, and Maria and I believe felt better after that. Change is always hard but it is a challenge dealing with the nursing industry and change is inevitable.

See you when I get back.

Chuck

I am flabbergasted....this is Arlene, by the way. I was just checking emails.

It is now Tuesday and I have had to call your office again because no one has bothered to take Sharon's temperature today. I did and then after I left, I had her take it herself and guess what? It's up again....This is not an extraordinary request...this is basic, simple nursing. Indeed, Sharon was told again today that the nurses were instructed NOT to take her temperature! May I ask what logic rules that?

Heartfelt platitudes about change are falling on very deaf ears at the moment.

Your human resource issues and staff turnover do not explain why no medication was dispensed on Sunday; nor do th ey explain how someone in such obvious distress was ignored.

Yesterday should never have happened....never. . I was there in her room with her all afternoon until 4 on Sunday........The prophylactic antibiotic is part of those afternoon meds that she got 5 hours too late, and this may be why she had the infection in the first place.

I shall make sure bonnie gets your email.

Just so you know, this is more than upset.

Have a lovely vacation.

Arlene

chuck, we would like to see you alone. if later you want to call maria or anyone else into our meeting that would be fine..... thanks bonnie

Subject: RE: Meeting May 25

I have put it on my calendar. There is no reason not to have nursing
represented as I am aware. I was not pleased with getting a phone call from
Janet L, Esq. yesterday and finding out that e-mail that I had sent you
was being forwarded to her without my knowledge.
Chuck

Hi Bonnie: I spoke with Chuck last Thursday, when you gave me the heads-up that he was back. I was going to write you but I have been busy taking my husband from doctor to doctor these past few days and didn't get a chance to write you.

Chuck was really taken aback that you were upset. He feels that you and Arlene have a certain comfort level bases on the staff and that your unhappiness is directly related to the change of DoN and the staff. He also said that Arlene may have overreacted.

Point of information, he was upset that Arlene was using your e-mail when she contacted him. He may have written things that he did not want her to read. I had to review the e-mail twice to figure out that it was Arlene who copied me and not you, while you were away.

He also said that Sharon forgets things. I do not recall exactly what specifically he was referring to, but the implication as I recall was that her forgetfulness was exacerbating the problems she was having.

He is very upset that you are upset with him and JH@R. That is probably why he wants this meeting with you and Arlene. I said that it would not be wise to have you upset. Probably because you do so much for the place. I did NOT tell him anything about your intention to leave money to JH@R in your Wills.

My other client who complained, was saying that her family member is dirty and always in the same dirty clothes when she comes to visit. Chuck has written her off as a complainer and suggested that she should take her family member to another facility, which she refuses because it would give Chuck too much pleasure to get rid of her. That is NOT the impression that I got when I told him that you and Arlene were upset about Sharon's care.

I believe that he will work with you to insure that your concerns are addressed. Please don't get emotional or defensive. You are justified if Sharon's health is compromised by the quality of care and if the poor quality of care persists, you have every right to call in the Office of the Ombudsman who is charged with protecting the frail institutionalized elderly. My other client calls Chuck a master manipulator, so keep that in mind.

Let me know what happens.

As for dinner, my husband has asked when, but since his stroke and with the wedding coming up, I would prefer to wait until after the wedding, so I have something to look forward to.

Be well. Stay strong.

Janet

hi janet,  thanks for the heads up.  arlene has said from the beginning that chuck is a master manipulator and i preferred to see the nice side of people.  i always thought you get more with honey than vinagar, until now.  arlene made a big mistake letting them know that when sharon is running a fever, she is forgetful.  they are jumping all over that.  anyway, the quality of care has rolled all the way back since the last director of nursing left under a cloud or "I don't know what"!!! she was young and great and really turned the place around.  since she left, all the good and caring staff has left and all that's left is the flotsom and jetsom as i call them.  arlene and i are back on 24/7 watch so they don't kill sharon...

chuck knew i was away, arlene was in my house watching little buster, who did chuck think he was getting e-mails from!!!!!!

we have a meeting tomorrow at 1:00 i will let you know what happens....

janet, what's with your husband, did he have another stroke??? i hope not... why the doctors?? we can hold our dinner off til july, after the wedding... and janet, thanks for always being there for us.............. bonnie