Adjusting

TUESDAY, JUNE 23, 2009
Monday evening Sam and I drove halfway to Tallahassee to meet Heather and family for supper. Sam met me at the nursing home to change his shirt since I was already their for a short visit. We left his car there and when we got back I decided to stop in and check in on Mom and Dad. I was about 8:45. Dad was in his p.j.s in his wheelchair. I had wanted to take a peek at his urostomomy to make sure things were looking okay.

****On day one it was rather obvious that the staff was not experienced in dealing with a urostomomy (technically known as an ileal conduit urinary diversion) patient. So train them!! An ileal conduit urinary diversion is one of the most used surgical techniques for the diversion of urine after a patient has had their bladder removed. The end of the ileum is brought out through an opening (a stoma) in the abdominal wall. The urine is collected through a bag that attaches on the outside of the body over the stoma. The bag must be periodically emptied of urine.****

I found that he still had his support belt on. (He doesn't sleep in it.) Mom told me that he had just a BM and that the “girl” had helped him. I peeked into his underwear when I took his belt off and found that he had BM in his underwear and on closer inspection found that he still had a lot on his bottom. I cleaned him up and changed his underwear after trying to find a nurse or CNA to find out what happened. Another CNA said she would look for his and then I found the nurse who was also looking for his CNA named Tonya. I explained what had happened and that he could not be relied upon to clean himself up.

The next morning I met with Shelly Jones to let her know what had happened. I also asked other questions regarding the fact that it seemed that Dad never had anything to drink and when I asked about it, I was told that it had to be thickened. Yes, but!!!! Get it already!! I am concerned about him becoming dehydrated and his dementia is affected by that as well. So I took in a bottle of Apricot nectar for his fridge in the room so that I had something thickened to give him when I am there. She said that they already had little glasses of the thickened water and we should probably have several of those in his fridge. A day and a half later, there is still no thickened water in his fridge. I also asked about Mom’s inhaler. Why was she getting it a 5:00? She is to have it twice a day. How is it split up so that it is close to 8 to 10 hours apart? She said that she would get with Debbie, the unit manager and that she would probably give me a call. That was Tues. morning. (I also asked her about how many showers they were to get a week and she told me three).

I went back in the afternoon to visit Mom and Dad as I hadn’t seen them in the morning when I was there to see Shelly and drop off the paperwork to the business office. I got there just after the shift change. For the past week I kept watching Dad’s hair to see if he had gotten a shower. His hair continued to get greasier and greasier. I asked Mom if he had a shower and she said she had no recollection of it. I ran my hand across his hair and my hands had grease on them. I went and checked his toothbrush and it was unopened. So, it was obvious that he had not been showered in a week and that his teeth had not been brushed in the whole week as well. The CNA came in to plan Mom’s shower with her and I asked about Dad’s. She checked and said that he was to have had one in the morning. She went to check with the nurse about his bathing schedule. At this point, I was getting very upset. I talked to a nurse at the nurse’s station and told her (started with Grace) what I was upset about. The morning nurse was still there and she said that she would get to the bottom of it. I then went to Shelly’s office and started to cry while explaining to her what was going on. She called Debbie, the unit mgr. and she met me in Mom and Dad’s room and we discussed this. She was not happy at all and said that she would be handling it.

On day one it was rather obvious that the staff was not experienced in dealing with a urostomomy (technically known as an ileal conduit urinary diversion) patient. So train them!!
***An ileal conduit urinary diversion is one of the most used surgical techniques for the diversion of urine after a patient has had their bladder removed. The end of the ileum is brought out through an opening (a stoma) in the abdominal wall. The urine is collected through a bag that attaches on the outside of the body over the stoma. The bag must be periodically emptied of urine.***