Friday, September 15, 2017

Who Will Be Held Responsible for Nursing Home Deaths in Hurricane Irma?

I just have to rant. It sickens me to hear about nursing home residents suffering and dying in recent hurricanes. There's the haunting photo of people sitting in wheelchairs in water over their laps in the Houston area. But a later photo showed them all OK after being evacuated. At least no one died from that debacle.




Janice Connelly of Hollywood placed a memorial of balloons, 
flowers,
candles and signs for the eight people who died at the center.  
Credit Scott McIntyre for The New York Times
However, the 8 (so far) deaths in the Hollywood Fl rehab center are inexcusable. I hope the administrator and their owners are held responsible for these deaths.

Cooling measures are basic nursing care. And apparently the staff was doing their best to hydrate and cool patients. Obviously they needed more assistance and direction.

They also didn't ask for help when they needed to. Who was not there to ensure the disaster plan was being appropriately effected??? This is the responsibility of the administration and they FAILED their emergency planning and their residents miserably! This facility has been cited in the past for issues with generators and were well aware that they had issues with meeting codes for emergency planning. They corrected the issues, but FAILED to improve on the situation.

There were at least 3-5 days of accurate warnings about the severity of Hurricane Irma and potential disastrous effects including the challenges of power outages and downed trees. Hurricanes are not unusual happenings in Florida. They have a known "hurricane season" and there are evacuation signs up all over the state, so this isn't something new or unusual. Social media and television coverage for days were showing multitudes of preparation ideas for even basic things like how to bottle water and freeze bags of water for ice and drinking water.

Common sense tells you in a power outage scenario common to hurricanes, that generators need to be efficient enough to keep temperatures from becoming high enough to affect human life. Or you need to have a Plan B to sustain. And an emergency plan in place to say ask for help! In this case, a hospital was across the parking lot. Transfer your patients if you can't maintain cooling measures! The storm had passed by then.

CNN
Nurses and personnel working in long term care facilities are always the lowest paid and most overworked. No doubt. This is not on them. This is on the shoulders of the people in charge and the owners who did NOT ensure the comfort and safety of the residents. And in light of multiple failed routine checks by the governing agencies, this is pure criminal Abuse and Neglect at the highest level! These people who died were most likely bedridden and helpless. They relied on the staff to care for them and to protect them.

I am always one to say we have to look at both sides in a situation because there are always 2 sides. But this just wreaks. I cannot defend the owners and administrators in this one!

So let us all learn from this situation. Emergency and Disaster Preparedness planning is a pain to develop and to write policies!!!  But it's essential. And then we have to educate staff repeatedly and review when we know a potential disaster is coming. We can never assume that we can leave decision making to the low man on the totem pole. The buck stops at the top and that's who needs to be held responsible. These are the people who must be highly trained, present and active during disasters and emergencies.

But we MUST also ensure the tools are working, up to code and available. And that the disaster/emergency plan is being worked as it was designed to do. Drills are not just annoying time wasters! They help us to move into a crisis mode quickly and make correct decisions. They help us to learn where the strengths and weaknesses are and to improve our planning.

Owning and running long term care facilities is not just about making money and sitting back and letting the workerbees work their asses off with very little resources to try to make 99,000 residents in FL alone safe and comfortable. This is a HUGE responsibility to care for our rehabilitating and aging loved ones with the utmost respect, honor and care. This is a deplorable situation and one that should spark changes!!!

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Thursday, September 7, 2017

How Does an Electrocardiogram Work?

By Dsealy - Own work, CC BY-SA 4.0, Link

I hope this post is useful especially to student nurses and to those who need to educate patients about ECG/EKGs.😊



Doctors use a test known as an electrocardiogram, also referred to as an ECG or EKG, to measure the heart’s electrical activity and detect any anomalies in one of the most important organs of the body. An ECG makes a recording of the timing and strength of electrical impulses as they flow through the heart. Coming out in a moving strip of paper from the ECG device, the recording is then
read and interpreted by the doctor to see if the heart is working normally.
While it may seem simple to understand, how the test actually works is truly a mind-boggler, especially if one does not know how the heart works in the first place.

The electrical system of the heart
The heart is composed of specialized tissues that are capable of creating electrical signals that cause the cardiac muscles to contract. In every contraction, the heart works by pumping blood out to the lungs in order to absorb oxygen and to deliver it to the cells all over the body.

Particularly, the sinus node, also referred to as sinoatrial node, is the tissue that’s responsible for generating electrical activity throughout the heart. Located in the atrium or the upper right chamber of the heart, the sinus node sends out an electrical impulse in every fraction of a second, traveling through the atrial muscles, which causes them to contract. The impulse then travels through the atrioventricular node in order for it to reach the ventricles of the heart.
As the electrical impulse flows through the organ, the heart normally contracts, or beats, about 60 to 100 times in a minute at rest in most adults.

Understanding the ECG reading

Every activity of the heart can be seen through the electrocardiogram reading, which appears like a line graph with valleys and peaks. These peaks and fluctuations actually represent the “waves” of signals flowing through the heart. The P wave represents the electrical signal sent through the heart’s upper chambers. Meanwhile, the QRS wave indicates the electrical activity in the lower chambers. Lastly, T wave records the heart’s activity as it returns to rest.

By MoodyGroove at the English language Wikipedia, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=2581061
Reflected on the ECG print, the size and shape of the waves and the interval between each wave reflect the rate and regularity of the heart activity, which is valuable information for your doctor as it will help diagnose your condition. Aside from shedding light to the heart’s rhythm, the ECG can also determine possible heart muscle damage as well as detect abnormal levels of blood electrolytes, including calcium and potassium.

How it is performed
An electrocardiogram is a painless procedure that often takes only a few minutes. It may be done at the doctor’s office or as a laboratory procedure at the hospital. Since ECG equipment is portable, the test can be carried out almost anywhere. For patients admitted to the hospital, your heart patterns may be constantly monitored by an ECG system.

During the test, the patient may initially be required to shave the chest, arms, and legs to provide a smooth surface to attach the electrodes in the ECG cables. Once the area is cleaned, the patient is then asked to lie on a bed, where several ECG cables and leads are attached to the skin on the chest and on each arm and leg. These cables are connected to the machine that records the patient’s heart activity into print.

The three main types of ECG
An electrocardiogram is required by the doctor depending on three different purposes. The resting ECG is when the doctor wants to know how your heart works while you are at rest. The second type, exercise ECG, is requested if the doctor wants to determine the heart’s reaction to activity. This test may be done while the patient is walking or running on a treadmill. There is also what we call the 24-hour ECG, which monitors the patient’s heartbeat the entire day.

The ECG is an essential test that can detect any damage to the heart so you and your healthcare team can prevent it from getting worse. With the convenience of the test results and your doctor’s intervention, the least you can do is to make changes in your lifestyle and to be more proactive in dealing with your own health.


Friday, September 1, 2017

Arrest of Utah ER Nurse is Deplorable Act!

There is a firestorm on social media about this atrocious act against a Utah ER nurse for advocating for an unconscious patient's rights. We all have a lot to learn from this issue and to take actions to prevent the same situation from happening in our own backyard! THANK YOU Alex Hubbels! 

Please share.




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