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Topic Pesky nurse Go to previous topic Go to next topic Go to higher level

By Pearly4 On 2008.12.29 17:06
I am so angry I could scream. My mother's home service agency had their monthly check with her today, sending a nurse who is so aggravating and irritating I'd like to bat her one. Today my mother mentioned chest pains and falls. She told her the chest pain was not new and was diagnosed as chest wall pain 10 years or more ago. She has had stress tests, ekg's, etc. with no problems being found. As far as the falls are concerned -- she has an advanced Parkinson's, she falls, dummy! They (chest pain and falls) are not accompanied by faintness, lightheadedness, dizziness, vertigo, sweating, nausea, are not long lived, or frequent. The falls and chest pain are not related. Yes, I realize some heart problem could have developed in the interim, but she has an advanced Parkinson's, takes 10 different pills over a complex medication schedule and refuses to take any more -- would we treat it, no. Do I actually believe it's anything to be concerned about -- no. Did her FORMER doctor, no. Do her current doctors? No.

This woman knows nothing about medications and has accused me mismanageing her meds -- (Hello, dummy, it's a common generic! She knows nothing about Parkinson's which I realize might be fairly common among medical people, but is argumentative, demanding and just plain nasty to my husband and I. She seems to feel we're less than adequate caregivers to say the least.)

And there's another problem -- her FORMER internal med (no great shakes that he was) quit his practice with two weeks notice! Closed, shop, moved out, left town. We were referred to one clinic in town where her records were supposed to be transferred. Have they? No. Is the old clinic open so we can get them? No. Thanks doc!

So having mentioned the history of chest pain and the falls to the nurse, the "nurse" tells me she was required to report it to her physician, her physician (new doc, without records, and no history) requires we bring her in for an exam this week- a 3 day week, during which she has only one opening at 10 a.m. tomorrow requiring me to leave work, my mother to miss day care, and my husband to transport both of us to the appointment wherein they will no doubt find nothing amiss and send us on our way.

I fully intend to carry in my letter to the doctor listing past and present history, cc the nurse, the social worker who visits, the Aging Resources case manager and all her other physicians and hope to put a stop to further episodes of this from this idiot nurse who has less medical knowledge than any nurse I've ever met (and I've met and know quite a few having worked in hospitals, and offices for 20 plus years.)

Just a rant I guess -- I don't expect anyone to wave the magic wand. Just had to get it off my chest.

By lurkingforacure On 2008.12.29 20:13
Thank you for sharing this story so the rest of us can know these things can happen. I think you are right to take everything you have and let the folks you mentioned know the situation. I would also ask, if you can, for a different nurse from here on out-surely this type of thing happens and people should be able to ask for a different nurse under these circumstances. I would imagine this nurse has probably had a request to be switched before, no doubt others have found her personality less than ideal, it would be interesting to see her file.

Good luck and never worry about ranting here, what one person may view as a rant may well provide new valuable information to others.

By rajenriver On 2008.12.30 15:19
When my FIL was transferred into the hospital after he was kicked out from the first NH he was in, his records were supposed to go with him. We thought they had been transferred to the new nursing home, too. They were not! The Dr. at the nursing home put it in the records at the NH that my husband refused to take his dad to any specialists for support. Basically, they said that my husband would not offer any support which is horribly wrong. They had no knowledge of all the tests we had at Mayo, nor did they have any history from the Geriatric Dr that we were going to.

We ended up going back to the Geriatric Dr and paid $20 to get a copy of the records, then we had two more copies made. In addition, we got all the records that the NH had and made copies.
Pretty crazy!

By Pearly4 On 2008.12.30 17:36
Arrive at doctor's office. Wait, wait, wait. Move to exam room. Wait, wait, wait. See doctor who takes history because still has none, orders ekg, blood work, and xray. Wait, wait, wait. Leave room for blood draw. Wait, wait, wait. Back to room. Wait, wait, wait. Leave room for xray. Wait, wait, wait. Back to room. Wait, wait, wait. Leave room for ekg. Wait, wait, wait. Wait, wait, wait. Wait, wait, wait. Doctor arrives. Xrays shows small amount of fluid, first of blood work shows increased anemia (chronic problem). Wants stress test -- last one two years ago normal, causing great deal of discomfort for months afterward in back and in left leg with nerve problems and all the added stresses for Parkinson's patients of increased constipation from increased pain meds, loss of mobility and generally increased symptoms. My mother refuses test. I agree.

OK, could be some weakening in the heart. If they find something and it's surgical are they going to operate? No. If they find something nonsurgical will they medicate? Yes. Increased meds, increased problems from meds, increased issues for caretaking. Is she suffering? No. Is she in constant pain or debilitated by this problem. No. When she's not in a wheelchair she could outwalk us! Are we sure it's heart? No. She has Parkinson's, could be related to coughing or choking. Chest pain could be related to refusal to accommodate the disease and be simple muscle stress. No real pneumonia, just a little fluid. Could she die of a cardiac related problem? Yes. Might have anyway since mother, father, two sisters and a brother have. Two living sisters with heart problems, one with a stroke. Yep, could die of cardiac problems.

Will she incease her diet in iron rich foods? No. Would it cause constipation if she did? Yes. Will she take light diuretic and HUGE potassium supplement? Maybe. Will they cause more constipation or bathroom issues? Possibly. Wasn't she in last month because she needed more fluids because she wasn't drinking enough? Yes. And now we need to take a diuretic? Yep.

Are we into the end of life cycle where everything complicates everything else and causes issues in every other area of her life. I'm afraid so.

By annwood On 2008.12.30 22:24
Very well stated. I keep going back to the "never ask a question if you don't want to know the answer". Did the physician finally understand that you are not abusing your mother? From my perspective it would be a blessing if she died suddenly of heart problems instead of the continual downhill course of PD which will leave her with no dignity.

By Pearly4 On 2008.12.31 05:44
I guess you've summed up our thoughts exactly -- I think the doctor understood it was her decision and not ours and that it was obvious she wasn't being abused. I know two of the other doctors will come down on her if it comes to that. She definitely seemed more informed on the Parkinson's than her previous doc and seemed to understand that there would be dyskinesias or no mobiity and that the falls were going to happen - once she heard from my mother that they didn't seem to be involved in the chest pain, she shrugged her shoulders and said "we aren't going to be able to do much about the falls." Prevous doc thought it was mismanagement by neuro that caused the falls and she could be protected somehow in a nursing home! (Sure - tie her to the bed, that'll work!)

I thought of writing another very carefully worded letter back after we get the results of the blood work to sum it all up -- have to work on that wording for a while! Something along the lines of we'd prefer nothing agressive but only palliative care at this point - meaning, as you said, a kinder death than Parkinson's. I do hold POA but haven't invoked yet -- both her other docs would support that being invoked if necessary but we're working around it as yet. If she can feel like she's "in charge", she's more easily worked with than against.

Thanks for your responses!

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