Long Term Care Case Study

Hello Dr. Ullom, majority of the long term care facilities are under staffed. There is usually one registered nurse in charge to manage a 240 bed facility, with LPN's  and nursing assistance. I feel that these patients would benefit from having one RN to every six -eight patients with a nursing assistance. Not only would this benefit the patient but the nurse as well. Patient are placed in long term care facility with a certain problem, but ends up with additional condition such as UTI, MRSA, pressure ulcers, and etc. These issues are related to poor care they receive because of unstaffing. I'm not placing blame on the LPN or nursing assistance, but with a RN and low nurse to patient ratio, they will receive better care.

Been working at the same facility for 22 years. Started working in CT-ICU (cardio thoracic intensive care), in 1993. The ratio was 1:2 or 1:1 if patient was just out of the operating room. Now the ratio is 2:1 or 3:1, in really acute cases 1:1. For the past 7 years been in a surgical ICU (SICU). The turnover rate is high. Which means that we are working 3:1 ratio. There has been a section of the unit for step down patients, with a 4:1 ratio. The acuity is high and we have a fair amount of new nurses. Presently we have 4 nurses that aren’t off probation. With the shortage of nurses, the facility has instituted to cross train nurses to the recovery room and CT-ICU, along with floating to other units. This band aid causes more duress

Upon arriving at the long-term care facility and noticing that the toe tag on the decedent did not match the removal authorization, I would immediately inform; the decedents doctors, the decedents nurse, or whoever was in charge of the care of the decedents body at the facility. I would also call the funeral home and get instructions on what I should do next. Most likely, I would tell the facility to call the funeral home back after the body had been properly tagged. After the facility called me back, I would come back and transfer the body to the funeral home. I would follow the same procedures for transferring a body, but I would do everything I could to make sure that I was taking the correct body. It would be helpful in identifying the

Humanity is living longer these days creating the need for long-term care facilities. Today’s families need to work outside the home forcing their loved ones to enter the dependency of the extended care and long-term care facilities. More and more of the retirees are seeking better facilities for themselves because there are more options. There are more than meets the eyes in the nursing and long-term care that involves families and personnel in the decision making for their loved ones.

The three systems whose factors greatly affect the efficient delivery of services are hospitals, long-term care facilities and mental/behavioral health services. Each of these are significantly impacted by diverse influences, affecting the direction and method for health care delivery. For hospitals, the three factors are vertical integration, horizontal integration and sources of power, or stakeholders (). Horizontal and vertical integration are both structure mechanisms, but are very different in nature and their impact on the hospital system. Horizontal integration allows facilities in different geographic areas and different financial status affiliate with one another through a larger organization for the purposes of offering similar services.

If it has reached a point in time where a family member is considering moving to a senior care center, there are options to work with. Some of the most important factors to consider are the quality of service offered, amenities available, and how much one can pays each month. The monthly expenses are determined by the services that a senior needs, the size of the home, and the type of community. The following tips will help in budgeting for long-term care in Chesterfield.

I see this as a concern due to these following reasons: not all RN 's in the ED has a background in ICU or any acute care setting prior to getting hired there, the ED is not stocked with necessary supplies for an ICU patient, necessary monitoring equipment is also lacking, we do not have a Respiratory Therapist assigned to us, most of the Physicians in the ED have little or no background in Emergency Medicine as they previously worked in a Primary Provider role. I feel that these conditions are unsafe and warrant a re-evaluation of the nursing staffing for this population as nurses are being assigned to ICU patients but may not necessarily have the experience or skill to properly care for that specific case or situation. I bring this concern up because I realize that it is the nurses in the ED that have to care for the ICU patients and be potentially faced with an unsafe patient assignments, workloads or ratios. I know that I am not the only who feels this way because I am aware of a few nurses who has already filed grievance forms and has contacted the nursing union about this unsafe practices.

The statistics were reviewed with the Charge Nurse team, the ED Director, and ED Medical Director and after much deliberation, the group concluded that a reorganization of the nursing staffing was the most judicious response. Realizing the restructure would impact the lives of every staff member employed in the ED, the decision was distressing. Nurses place great value on their shift, full time equivalent (FTE), and the pattern of their working days, however, the current staffing model conflicted with the operational needs of the ED, furthermore, the facility possesses an ethical responsibility to address safety issues when identified and the current status quo did not meet the safety requirements of the patients, nurses, or

The three professional considerations that pertain to this case are similar to the ethical considerations. It was unprofessional for the nurses to call off, leave patients un-attended, and also breaking the patient legal duty to provide proper service to patients. According to (makely), “enhancing professionalism has become a major challenge for healthcare educators, employers, and personnel” (2009).

Growth in the number of the baby-boom generation that enters old age is the main driver of increased demand for long-term care. Women are more likely to use long-term care compared to men because they live longer and often outlive their husbands. The main goal of the long-term care is to provide a variety of services that help to meet a person's health or personal care needs. In addition, the services can be provided at home, in the community, and in facilities. Most of the long-term care services are expensive; as a result, Americans spend billions of dollars out of pocket on the services. The most expensive is the facility-based care, such as assisted living and nursing homes. For example, according to the New York Times, the

Nurse-to-patient ratios is not a new topic of debate for all of us who deliver care to patients every day. Only lately it has been a big issue that have caught the attention of many. Demands by the medical community for changes concerning staffing, asking for the government interventions in minimum staffing laws. Registered nurses have long acknowledged and continue to emphasize that staffing issues are an ongoing concern, one that influences the safety of both the patient and the nurse. (ANA, 2015) .nowadays hospitals are running for profit and the emphasis is not put on job burnout, stress, and endangerment of patients. Nursing shortages is a very pertinent problem, it will be optimum to have laws in place to help with the issue, however meanwhile leadership and management methods to the matter can help to mend the nursing situation and avoid many of the damaging effects of unfitting nurse-to-patient ratios.

Growing up with your grandparents has its benefits. I remember waking up to freshly baked biscuits and fried sliced ham on Saturday mornings just before cartoons. Riding to the pharmacy with my grandfather to pick up his medicine was one of my favorite trips. We would always stop for ice cream before we returned home. Soaking in the knowledge that streamed from the lips of your elders can go unappreciated until you are an adult. Watching people age gives you an understanding of what is important to seniors as they transition to retirement and lonIg-term care. Seniors value the ability to live and enjoy a life that includes independence, family, and home. In today's economy, there is a shortage of health care professionals. Home healthcare services are vital due to the aging US population and need for increased continuum of care.

1. The nurse is asked to implement a new, complex, and invasive procedure and is concerned that this may violate the state’s nurse practice act.

There are legal responsibilities that we have as professional nurses. Because of the nursing shortage, one of the major issues of concern is staffing. Inappropriate staffing can threaten patient's safety. Inadequate staffing can also affect the nurse's health,

“listen”! Can you do me a favor and give this patient the discharged instructions. I need to immediately attend several victims that have just arrived from a horrible train accident! I know that as an interpreter you’re not acceptable to do this and you don’t have the opportunity to give a patient discharge instructions. However I’m way over my head right now! And it’s very important that I assist the accident victims now! As a nurse I won’t tell anyone about you giving this patient discharge instructions, it would be confidential between you and me. Please don’t refuse my authority. Now “here”, I need to go now!