Friday, April 20, 2007

Overworked and understaffed

Recent calls to local nursing homes have brought to light an issue that concerns me, and should be of concern to anyone with even the basic level of compassion for those in need. It is not uncommon for our crew to arrive at a facility and not be met at the main nurses station with information as to where the patient is located. Additionally, once we are pointed in the right direction, it is not uncommon to have the patient attended by (if attended at all) by an inexperienced LNA that has no knowledge whatsoever of the patient's baseline condition, emergent condition, or past medical history. It is at times like pulling teeth to get a clear picture of what is going on. We are given a copy of the patient's face sheet and a list of meds and ongoing medical issues, usually 3-4 pages long. By the time we have done our rapid assessment and loaded the patient, we barely have time to review the patient's [written] history before we are out at the ED.

The problem, as I see it, is that many of the nursing facilities have a tough time attracting and keeping good staff, and are constantly understaffed. Especially at night. It is a special person who not only commits to working with the elderly (and often times demented), but does so at a pay scale far below what they are worth. I'm not talking about RN's, cause I imagine they get paid a decent salary. They do have to have the commitment though, as they could pretty much have their choice as to where they want to work. LNAs and LPNs have it rough though. I imagine that the rewards of the job are similar to what they are in EMS: Just knowing that we've made a difference in some one's life is a pretty valuable fringe benefit.

So how do we as EMS providers work through the situation at these nursing homes? I've found that it is invaluable to get to know the providers there, and let them know (without sounding critical or condescending) how they can be most helpful to the EMTs (and ultimately the patients) when we arrive for an E-call. In addition, one of the things I found as a resource for the upcoming EMS Week is a pdf file that deals with how to better work together with nursing homes to increase the quality of the care we as EMS providers are able to give the patient's when we are called to the facility. I'll try to follow up with this in a future post.

1 comment:

Anonymous said...

Always an issue at the Longterm Care Facilities. I think there are always a few "shining stars" as far as staff goes, but in general most of the RN's/LPN's have little to no expereice in handling emergency situations, and cannot (or will not) do anything without a Doctor's order.