Mr. Shoe is in the hospital

Miscellaneous and Personal Stuff I Must Share
241

Yeah, I’m pretty much shuttling the “look and visit the facilities” responsibility to his parents. Frankly, I don’t have much choice. They have been helping me with some logistics - sharing food from neighbors, and they’d planned to come over to mow before my neighbor took care of it - plus I’m on their way to the hospital so they’ve been giving me rides. And actually, I haven’t eaten at the hospital cafeteria yet; it’s literally a few minutes from home so there’s no point.

One of the acute care facilities we’re considering is on the top floor of the hospital he’s in right now - a separate entity that rents space in the same building - and that would provide some continuity (some of the same drs.) plus be super-close for us. It is, however, on the smaller side, while what’s looking like the other top choice is a bit farther away but not by much (about 15-20 mins. as opposed to 3-5 mins.) and is bigger and part of a huge and well-renowned facility.

Pets: we have cats, and I doubt either one would travel well. I’ve been showing him pics on my cell phone instead.

Thanks, everyone.

242

Another vote for ‘yes, do check out the rehab centers’. WhyNot pretty much covers what you should look for.

Do not trust that ‘they’re all reputable’, because they’re not.

Long story short - my brother recently landed in rehab and, because we thought they’re all about the same, we didn’t check it out. It was a pit. “follow your nose” would have been an excellent first step in eliminating this place. I won’t bore you with the details, suffice it to say we removed him after three days. Fortunately he was in good enough shape and we were able to stay at his home with him until he could manage for himself. Brother wasn’t anywhere near as bad as your man, so yes - make damn sure the place they send him to is fit for human habitation.

243

However, it is OK to delegate this to his folks
I think I saw in another thread that the AC in your car died; I think this is another project to delegate.
Hope things stop ganging up on you soon.

244

WhyNot, that is an excellent list.

We went looking at nursing homes while my father was in the hospital (alzheimers, bladder infection). After viewing six places, we were getting depressed. Rather than wait on us, the hospital shipped him to a place that had an opening. Thank all the gods and little angels, the place was fantastic and the care and respect he received was terrific.

Yes, thank the CNAs. They work hard and have immense patience with their charges. They do not get paid what they are worth. The RNs also.

Sending all my wishes for clear lungs to your husband Purplehorseshoe. Remember to breathe for yourself too. :slight_smile:

245

CNA = Certified Nursing Assistant, for those of you out there who, like me, woulda had to Google it. I’ve also seen “Patient Care Technician” on some of the forms at this hospital, but I’m not sure if that’s the same thing.

246

Another thing - try to get him sent to a actual rehab facility, not a skilled nursing facility or extended care center that does rehab.

IME, the “rehab” done in those places is a joke. They’re primarily interested in getting people well enough to make the nursing home aides’ work easier.

247

Oops. I’m sorry! I’m not sure how it works in Texas, but here in Illinois, a CNA has to have taken a certain number of college level nursing classes with 40 hours of clinical supervision - either a stand alone CNA program or the first semester of a Registered Nurse program, or equivalent training in the military - and pass a written exam. They are licensed by the State. An RN (Registered Nurse) or LPN (Licensed Practical Nurse) may work as a CNA without a CNA license, as long as their RN or LPN license is in good standing.

A Patient Care Technician is not licensed. While there are PCT training programs available at vocational schools, and having a certificate from one of them makes you more hireable, a PCT does not necessarily have any training at all, or they may have training provided on the job.

248

They have the same basic education, about 6 weeks, but the patient care technician has another week of training.

Sorry, WhyNot, but they are * certified* by the state, much different than a license.

Looking for a rehab facility, you must look at the number of RNs to CNAs or PCTs they have. PCTs can do actual rehab. CNA not so much. CNAs do care. Turning, emptying bed pans, and getting folks up into chairs. PCTs do passive ROM standing, etc. You need to see what their actual PT (Physical Therapist) to other ratio is.

I was a CNA in Missouri before becoming an RN. It was a 6 week course. The “college” courses are a joke. It’s a 6 week course held over a semester.

249

My bad. But I’ll continue the nitpick.

“Since June 1992, CNA training programs have not been required to issue certificates and the state does not issue credentials, certificates or license to CNAs.”
…but when you take the exam and pass, you get put on the Illinois Health Care Worker Registry by the state.

So it looks like they are neither “certified” *nor *“licensed” by the state, but put on the registry after meeting the requirements, which generally include education and clinical experience. :slight_smile:

250

Considering that he cannot speak, breathe off the oxygen vent, or move his hand well enough to write his own name, he will be going into acute long-term care first once he’s moved out of the ICU. Once he’s off the ventilator, then he might be moved into in- or out-patient rehab care.

Speaking of, the next person who assumes I’m some housefrau with nothing to do all day will wind up in the ICU on a ventilator themselves. I posted earlier that there are basically two main facilities we need to choose between. His parents looked at one of them yesterday and was planning to visit the other today. I trust them - they have Shoe’s best interests at heart, of course. One of his doctors took me aside today and asked if I’d made a decision. I said, “His parents visited {X} yesterday and was hoping to go look at {Y} today” and he said with this impatient tone, “Yes, yes, his parents. But you’re his wife! What about you?” I stammered out something unintelligible about trying to continue working and that his parents were retired and had the time, and now I’m 50/50 pissed at him, for acting like I don’t care about my husband or something, and at me, for not having the goddamn presence of mind to react properly in situations like that. (I never do.)

I’m either at the hospital, at work, at home asleep, or in the car driving from one to the other. Fuck ANYONE who things I have spare time or energy right now. Even for something as important as checking out where he’ll be moved to. I’m sorry, I’m delegating that to his parents. Fuck. You.

(Not “you” as in Dopers.)

251

Maybe the doctor has seen too many overbearing parents who try to usurp the rightful place of the spouse in making decisions for a patient? He might have been awkwardly trying to support you. Though lord knows you’re probably just an exposed raw nerve at this point, and he could have been a lot more diplomatic about it!

252

Like the previous poster, I got the impression that the doctor wanted to make sure that your desires were not being overlooked. As the wife, what you want should come first. He should probably work on how he communicates.

I’m sorry you’re going through this difficult situation. All you can do is the best you can. Don’t forget to take care of yourself too.

253

True enough, sorry. Went through a bad experience recently with that, makes me a bit jumpty.

I would suspect that the doctor was trying to be supportive of you getting to make the decisions. I’ve seen several situations where a patient’s birth family rode roughshod over their spouse, so he may be afraid that’s what’s happening to you. Lotsa doctors just have crappy personal skills.

QUIT FEELING GUILTY THAT YOU CAN’T BE EVERYWHERE AT ONCE AND DO EVERYTHING. You’re doing great. Take all the help you can get your hands on. I think having his parents do the site visits is awesome.

254

I don’t feel guilty, redtail. I feel cranky that people act like they’re trying to make me feel guilty…

255

Well, shoot… now I feel guilty that I feel cranky about people feeling guilty for feeling like they made you cranky by making you try to feel guilty for feeling cranky when you were really feeling cranky about people thinking you were feeling guilty. And shit.

256

Ha. :slight_smile:

I was so cranky about personal stuff up there earlier that I forgot the medical update: he’s supposed to get a PEGput in tonight or - more likely, given the surgeon’s schedule - tomorrow. If all goes well, that’ll be the last tube out of his head! (Not out of his body, he’ll still be tube-fed for a while, but at least they’ll move the location.)

257

as someone who has done plenty of rehab - real therapy - in a Skilled Nursing Facility I resent this. not saying it’s always perfect but I am saying good therapists doing good therapy can be found anywhere, in any facility.

I happen to live somewhere very rural so people don’t always have the same choices as in a city. family can ship their members further away to go to what you call an “actual” rehab center, but only sometimes. sometimes it’s not an option.

a good therapist is never doing anything but their best for the Patient, not the staff of a nursing home.

:mad:

sorry to hijack, Ms Shoe. I honestly wish you all the best and think that someone (the in laws are fine) should check out the facilities in person.

258

Good deal. I hope it goes well.

259

I’ve been following this thread for a week or so now, and I just realized I haven’t posted! I’m really sorry that you and Mr. Shoe are having to go through this, but it’s really good to know that he’s making such good progress towards recovery. It sounds like you’re doing pretty damn well considering the beating that life has been giving you lately.

In situations like this, people on the health care end of things do tend to forget that the patient’s family members may have other things going on in their lives. It’s hard, but try not to take their assumption that you’ve got nothing else on your plate aside from medical care as a criticism. Someone has to keep the whole operation going, and that generally involves doing full-time work for pay. Mr. Shoe’s parents and his doctors most likely just aren’t thinking about the fact that you’re essentially working two jobs right now. It sounds like you’re managing the juggling act pretty well, but there’s no way you can do everything all the time, and I’m sure anyone who thinks about it for a minute realizes that.

I hope things keep on going well and that the fluid production settles down soon. We’re all rooting for you over at the Legend household!

260

Nah, no apology needed, JackieLikesVariety. I’m happy to get multiple opinions and various input on what’s going on. This is all, obviously, very new to me. (Oh, and thanks InternetLegend, I saw you posted while I was typing all this up, on preview.)

PEG stent surgery is scheduled for 9 a.m. tomorrow morning. Shoe is soooooo looking forward to it - he was in a pretty damn good mood all afternoon after being told it was scheduled for first thing tomorrow and what it would mean for him. The little #$%&* tried to yank out his nasal tube a few times earlier - lucidly, not in his sleep. He knew what he was doing. Little fucker.
OK, so the two acute care facilities. His parents have seen both, and here’s what I know as fact, plus what I’ve gathered from them as their impressions:

"K:" is in the same building as his current hospital, just a different floor and a different provider (they’re tenants of the same building).

~vs.~

"B:" which is about fifteen minutes away and part of a completely separate health care system.

Pros for "K"

  • it’s about three minutes from my home and his parents’ home
  • it’s in the same building, so to make the move, Shoe need only ride an elevator up two floors
  • it shares doctors with the ICU he’s in now, so he’d have some degree of continuity (mostly the same drs. reviewing his X-rays and files)
  • it shares labs, C-T scan facilities, etc. with the hospital he’s in now, so if he needs extra testing, it’s, again, an elevator ride away

Pros for "B"

  • more staff, including (and this is a biggie) an on-staff gastroenterologist at all times
  • bigger facility (better funding … ?) with more exercise equipment, bigger rooms, etc.

Cons against "K"

  • no gastroenterologist on staff - if they need one, someone has to call down to the hospital that’s currently caring for Shoe and ask the GE doc on staff to come up

Cons against "B"

  • a bit further away for us, not much, just a bit
  • an ambulance ride is required to move him there initially
  • a one-block ambulance ride is required if he needs major tests, etc. (at least, as long as he’s on oxygen) to the main hospital a block away from the acute care building (it’s a BIG facility, and, yeah, anyone in Dallas can guess that one, I didn’t change the initial)

Here’s a hitch: “B” also has acute rehab facilities, which is the next step down in terms of care level. We’re thinking, maybe, possibly, that the best course would be to have him go to “K” for the acute care initially, and then possible move him to “B” once he’s sturdier and more in need to occupational and physical therapy rather than, oh, say, oxygen to breathe.

As I understand it, we can’t move him to “K” or “B” for the acute care, say “nope, not the right place!” and then move him to the other. That’s a lateral move for care, so the insurance provider wouldn’t approve it. He can, however, move from one to the other as his care level changes/steps down so that’s why we’re considering what I outlined in the paragraph above.

I’m gonna rustle up a clean pot, make some pasta, read (I treated myself to the next Game of Thrones and now I’m so ahead of the damn TV series) and go to bed. If anyone has opinions or advice on the whole K vs. B thing, I’m happy to take them into consideration. I’ll post again tomorrow once I know how his tummy stent went in.