Author Topic: Elizabeth Wettlaufer charged in nursing home deaths - Southwest Ontario  (Read 23157 times)

jellybean

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Re: Elizabeth Wettlaufer charged in nursing home deaths - Southwest Ontario
« Reply #30 on: October 29, 2016, 11:58:31 AM »
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Supposing a patient is on pain medication, and refuses to take it.
The paper work would have already been done, ie - properly checked out.
Then, what does a nurse do?  I think that this is where a hole in the system might exist.

Then it is taken back to the medication room and double checked (and wasted) or it can be disposed of in the patients room where there is a receptacle that cannot be accessed by any other patient ... as long as the nurse has a witness to sign for a wastage. Most prefer to waste it in the medication room.

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Nurse could take it themselves...

Yes, there is room for that if one is unscrupulous. However they risk the chance of getting caught if the patient decides later that they want the medication. Whomever they ask for the pain medication would check on the patients medication list on the Computer and would see that it was given and tell the patient, "you already were given the medication" and if the patient was not confused, would claim they refused it before. The nurse would then be approached to make sure she either gave it or wasted it before and failed to record it on the patient med list on the computer. 

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When a patient requires more painkillers than prescribed - can a nurse give them the extra pill, and check it out properly with the reason why?

No. There has to be a Doctor or Resident Doctor to assess the patient first as to why more analgesic is necessary or if there could be other issues happening.

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Or would she have to obtain approval at all times?

Absolutely.

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Are nurses given some latitude at such times?

There are certain things nurses have more latitude for in ICU's, ER's, however still under the guidance of Doctors usual routines in those cases.
Only Nurse Practitioners are allowed to prescribe or change medications, other than Doctors.

Thanks SAP
I did not know that a Nurse Practitioners had more authority than a Nurse.
I learn something new every day. :)

jb

« Last Edit: October 29, 2016, 12:48:38 PM by jellybean »

Sap1

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Re: Elizabeth Wettlaufer charged in nursing home deaths - Southwest Ontario
« Reply #31 on: October 29, 2016, 03:36:16 PM »
YW. Nurse Practitioners have only been around a few years and are underutilized but they are gaining ground.

http://www.albertahealthservices.ca/careers/Page11731.aspx

jobo

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Re: Elizabeth Wettlaufer charged in nursing home deaths - Southwest Ontario
« Reply #32 on: October 29, 2016, 05:37:44 PM »
I go to a Nurse Practitioner here in Ontario.  I really like her and if need be, she can refer me back to my doctor.
Good way for the government to save money in health care.

Sap1

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Re: Elizabeth Wettlaufer charged in nursing home deaths - Southwest Ontario
« Reply #33 on: October 29, 2016, 08:18:31 PM »
I go to a Nurse Practitioner here in Ontario.  I really like her and if need be, she can refer me back to my doctor.
Good way for the government to save money in health care.

It really is. These RN's are trained under Doctor's ... advanced studies. We need more out there.

Sap1

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Re: Elizabeth Wettlaufer charged in nursing home deaths - Southwest Ontario
« Reply #34 on: October 31, 2016, 11:17:18 AM »
OMG! This video came in my timeline. Elder abuse can happen anywhere in the world, however this video was captured in Ontario.

https://youtu.be/Xukq1goo66k

Sap1

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Re: Elizabeth Wettlaufer charged in nursing home deaths - Southwest Ontario
« Reply #35 on: November 02, 2016, 11:53:32 AM »
For years Ontario's healthcare system has been hit hard by illegals. This is an older article, however, I was told by Americans that this filching of free services from Canada will have stopped or at least down graded since Obamacare came in, in USA. Of course not everyone could get Obamacare either b/c of wages. So I am assuming that the filching is still ongoing. It has happened in Alberta as well that I know of but Ontario has been hard hit, leaving quite a shortage of finances for Canadians needing care. Nursing homes unfortunately are feeling the brunt more than hospitals.

http://www.nytimes.com/1993/12/20/world/americans-filching-free-health-care-in-canada.html?pagewanted=all

jellybean

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Re: Elizabeth Wettlaufer charged in nursing home deaths - Southwest Ontario
« Reply #36 on: November 02, 2016, 11:58:02 AM »
I have a few sad stories to tell as well.  First hand observation with a loved one who resided in a facility. In my own case, my brother could speak up for himself, but I must say it was not appreciated. 

I had to advocate for him, and work things out as best I could.

First thing that goes out the window, with the clients is their dignity, their self respect and their pride. It has nothing to do with their condition, imo, it is the way that they are treated on a daily basis. Even in the tone of some of the workers when they address the clients, is harsh.

Of course these same workers were as sweet as apple pie when I was present.
But unknown to them, I overheard and observed how they treated other clients when I was there..... you can figure it out from there.

He was not an impossible person either. He was not a complainer. Very easy to get along with. His concerns were real.  However, they were brushed aside.

It was obvious to me that some staff took the position that it was a job, any job is better than nothing. These places think nothing of kicking clients out either, with no other facility lined up.
I am only lightly touching on my experiences.  Some things are best to leave alone, on my part.

Our hospitals are crowded - emergency wards flooded with patients and understaffed.The nurses were stressed out, and who can blame them.

I have had first hand experience with that too - 3 months ago.

This is not an Ontario problem, it is a National problem.

Speaking of hospitals, I see the Shriners are raising funds for theirs.
They do wonderful work.  The Shriners are Masons.

jb
« Last Edit: November 02, 2016, 12:28:23 PM by jellybean »

jellybean

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Re: Elizabeth Wettlaufer charged in nursing home deaths - Southwest Ontario
« Reply #37 on: November 02, 2016, 07:05:20 PM »
Oh boy, how they can cover their behinds. Just as I thought, get her out of their facility, and let her become another employers problem.

I am thinking that she went to work half lit, reeking of booze and perhaps tippling in the staff washroom cubicle.  Warned many times, and let go..... then onward to greener fields to repeat it over and over again.

Not for one minute suspecting that she was murdering any of their patients.
Heavens No!! It was her drinking, and her combative manner. :-X

This woman sadly, needed more help than she could receive from an Addiction Facility.
As horrible as it is - she obviously wanted to stop her killing spree - and told an addiction counsellor.   I have to give her credit for that much.
Without her confession, she would still be free.

As she sat in court and heard the charges read out to her, she asked.
"Is that it?"
Makes one wonder.... Those three words can be interpreted in a number of ways....

jb
« Last Edit: November 03, 2016, 12:05:18 AM by jellybean »

Sap1

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Re: Elizabeth Wettlaufer charged in nursing home deaths - Southwest Ontario
« Reply #38 on: November 03, 2016, 11:34:55 AM »
It sounds deplorable all the way around in Ontario seniors care. What other provinces are going through the same? Perhaps staff could do a visit to those hospitals and nursing homes where care runs more smoothly? I've seen that done by a group of nursing staff from a small town in Alberta ... a group  of various healthcare workers attended at various busy city (Edmonton) hospitals to view the care standards in patient care.
One Extendicare facility in a small town had it down pat. Even if they were short workers, they made it work. If a patient can do their own oral care, even slowly, they were set up at a sink, and while they also needed a foot bath for diabetic care .... that was done at the same time as they sit at the sink in their wheelchair. Meanwhile, the care worker goes on and gets another patient set up to do the same. It's not rocket science to get organized. It means a bit of extra footwork but so be it. At least the patient will feel better and feel more useful if they can do something for themselves, rather than becoming completely dependent and atrophied.
Two Auxiliary nursing care stations attached to hospitals in different towns had the same routines. In these places, soiled personal care products never stayed on a patient for hours b/c there was a routine ... toileting, cleansing, clean products, to breakfast, then toileting again, and on to whatever activities that were given patients. In a couple hours pretty well the same routine. Sure it's busy but it's workable. Staff can sit and relax at the breakfast, lunch and dinner tables while they assist patients with eating. Staff are, or should be there for the patient, not the dollar. Money helps but I think people have lost sight of what is really important. There also needs to be encouragement from the top ... administration. The elderly require a lot of stimulation so there also needs to be Occupational and Physical therapy provided according to specific needs. Problem is, oft times the top (administration) is heavy when it doesn't need to be, and that extra money can provide therapists for the elderly.
Sharing responsibilities also works well. In one long term facility, the nurse doing all the medications would get them ready from bubble packs (which is quite easy), would crush those needed to be crushed, and then runs out and starts a couple baths scheduled for the day, while the floor nursing staff do the bed baths and other care. The med nurse didn't need to do the baths as it wasn't in her job description but it was started and worked out well for the whole team. Everyone felt the pride that good care was accomplished. Then it was even possible for the whole team to sit and do a team report on any changes in patient status.
Organization and a caring attitude is what is required. There should be no need for one worker to lift a heavy patient alone. That needs to be discussed prior to beginning the day ... "meet me at rooms such and such for a lift assist at such a time" and what has happened with the electronic lifts that most places have? Lack of organization is often a very real reason that causes patients to suffer. My thoughts for whatever they are worth. :)   

jellybean

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Re: Elizabeth Wettlaufer charged in nursing home deaths - Southwest Ontario
« Reply #39 on: November 03, 2016, 12:55:39 PM »
Thank you SAP.  There is still hope in that it can be done.

First - your wonderful examples shows the staff had two smart things going for them.

One - Team Work ( they did not let their job descriptions get in the way)

Two - A Can Do and Let's Do It Attitude.

Three - Well thought out to Achieve their Goals and then got down to Organizing it together.
WOW!!

jb
« Last Edit: November 03, 2016, 01:04:35 PM by jellybean »

jellybean

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Re: Elizabeth Wettlaufer charged in nursing home deaths - Southwest Ontario
« Reply #40 on: November 03, 2016, 07:57:06 PM »
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Not always possible, families do have their work and their lives, but otherwise - Sadly, perhaps good Advice.

On second thoughts, the very reason for placing your loved one in a long-term facility is because the family cannot give them the care that they need. That is why these facilities exist.

So where is the point? Who is serving who here??
jb
« Last Edit: November 03, 2016, 08:03:10 PM by jellybean »

Sap1

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Re: Elizabeth Wettlaufer charged in nursing home deaths - Southwest Ontario
« Reply #41 on: November 03, 2016, 08:10:15 PM »
Most other countries are bare bones at the top of chain, while in America the top is heavy with Administrators and their assistants, and then the manager and her assistants who oversee another manager on the unit and so on. They keep cutting at the bottom ... those directly responsible for patient care.

This is a dream for Canada:

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It would be great to go back to that. In America there is too much wild spending plus waste, whereas Sweden seems to have the best system financially.

jellybean

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Re: Elizabeth Wettlaufer charged in nursing home deaths - Southwest Ontario
« Reply #42 on: November 03, 2016, 10:29:55 PM »
Regarding Sweden: Does that mean that every senior has their own personal care person?
One on one only?

jb

Sap1

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Re: Elizabeth Wettlaufer charged in nursing home deaths - Southwest Ontario
« Reply #43 on: November 04, 2016, 10:19:21 AM »
Regarding Sweden: Does that mean that every senior has their own personal care person?
One on one only?

jb

I am wondering if this Doctor visited a nursing home/s or private homes. Googling their healthcare system leaves a lot to be desired and it sounds on par with Canada. I had been under the impression that since they have better systems for saving money in other areas such as waste management, that funding may be used for healthcare.
I did private care here, one on one to relieve a regular worker over a weekend. I bathed, gave medications, cooked meals, re-positioned the client every few hours (plus any necessary care) and had a bed in the same room and I would sit and talk with her during her waking hours, watch TV with her, etc. For that I had full wages. Not everyone gets that kind of care here though. She had been in an auto accident which left her mostly paralyzed and her husband divorced her. Her son was a lawyer and a great advocate for her so her finances were such she could afford to stay home with 24 hour care. 

eta:
http://www.swedishhealthcare.com/elderly-care-in-sweden-study-tour/

Interesting.
http://thechronicleherald.ca/careincrisis/1168351-a-better-way-to-care-for-the-aging#.WBy5By0rLos

I doubt this could ever happen in Canada b/c our institutions are really top heavy (extremely high paid executives in administration).

   
« Last Edit: November 04, 2016, 10:39:55 AM by Sap1 »

Sap1

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Re: Elizabeth Wettlaufer charged in nursing home deaths - Southwest Ontario
« Reply #44 on: November 04, 2016, 10:31:01 AM »

I totally agree but that is the way it happens here in Ab as well.