Greetings all! Things here have been interesting as always. Saturday morning brought about a very angry daddy, and that is putting it mildly. We have been experiencing the typical welcome to home health care and how horrible it can be woes. However, what I found on that particular morning was by no means acceptable no matter what. We have heard horror stories from families with home nursing, but I think this will enrage you all.
Elias is on 20 hours continuous feeds, hanging new feeds every four hours. Every night we prepare the "bottles" to put in the bag. For Friday night into Saturday the nurse was to rinse and flush the bag at 2 am and 6 am and place the feeds after flushing. Usually, when the nurses dump a bottle into the bag they rinse it and place it on the kitchen counter. I only saw one bottle at 7 am when I woke up. I looked in the refrigerator and saw one more bottle than should be there. When I went into Elias nursery to confront the nurse about this I notice his feed bag was still pretty full. I asked her what time she had placed those feeds, she very quickly told me she could not remember. I asked her if she had a guess? and she replied I don't know, sometime in the last few hours. I then asked her where the second bottle was, knowing full well the answer and what had happened at this point. She said there wasn't one, she only had to place one feed in the bag. I asked her how could that be? You are here for a ten hour shift for a child that gets fed every four hours, that means two feeds in this shift time. She claimed to not understand what I was saying. I asked her if she thought the feeding pump was not working correctly. She said I guess that is possible. Why wouldn't you bring that to my attention then so I could have it checked out. She had no response and began to gather her belongings and quickly made her way to the door, as I followed her yelling at her that I was not finished talking to her yet. I needed answers. She left! I examined the flow sheet and her nursing notes and noticed that she had signed off rinsing the bag at 2 am & 7 am...but she couldn't tell me what time she put the feeds up? This was a forgery on a daily flow sheet that I have proof she did not do. In case you have not been able to figure out the issue...SHE MISSED A FEED TIME FOR ELIAS!!! Judging from the time the feed bag emptied she placed them at 600-630 am. I have two theories, first she fell asleep (which is grounds for termination from the agency) and hoped to slip this by. Second, she had a tendency to stop the feeds for medicine, flush with water and then wait a period of time before restarting feeds. While in some cases this is a normal practice due to drug interactions, Elias is not on any meds with that problem. We had repeatedly asked her to not to do this. I think she did it again and forgot to restart the feeds again until much later. This to me is gross negligence and she should not only be fired from the agency, but lose her license for nursing. Especially, because she signed off on the flow sheet acknowledging this was done at the designated times. When I call the on call supervisor to report this and tell her that I NEVER want to see that nurse near my house again she was very sorry to hear of the incident, but honestly wasn't too surprised!! I also noted that we would tell the nurse not to wake Elias for diaper changes or suctioning. However, she would tell us in report she changed him several times and suctioned, as well as changed his clothes every night, even when not needed at times when he was awake. On the flow sheet she would have him marked as asleep during those times, but with the cares done. Another example of inconsistent documentation. Makes me wonder what other things she signed off on that were not accurate.
By refusing to allow her back this puts us in quite a bind. She was the only Monday- Thursday nurse they could find. While they have been looking anyway because we felt Elias was not gelling with her, they have not been successful. So Monday morning will bring an interesting and not so pleasant conversation as to what are we suppose to do. We are also going to talk with another nursing agency, but that process can take up to two weeks to get started. Katharine is working overnights for one more week, so that leaves me to stay up round the clock with Elias. I might be able to get a few hours of sleep after Katharine wakes up in the evening, but it will be 3-4 hours at best. So we hope the nursing agency can pull off a miracle. Regardless, I would rather stay up around the clock than have that poor excuse for a nurse back in my home. Words can not begin to describe the anger I felt. I was literally shaking as I talked to her. I do not think I have ever been that angry at anything in my entire life. We are quickly learning that there are not too many "quality" nurses in the home nursing field. There is a sort of diminished work ethic among the majority, but it certainly makes those few that are worthy of the nursing title shine like gold. We know that things will eventually settle in, but it does not make it any less frustrating now.