Cousin P in ER for cat bite yesterday

Discussion in 'The Watercooler' started by TerryJ2, Dec 21, 2012.

  1. TerryJ2

    TerryJ2 Well-Known Member

    [FONT=Comic Sans MS, sans-serif]Nipper bit and scratched P either Sat night or Sun morning, and it got infected.

    S, from Visiting Angels, noticed it and alerted the nurses at M assisted living. They put antibacterial cream on it and bandaged it. It got worse, and S got on their case to look at it again. She called me because she felt like they were blowing her off. (They were.) I called them and asked them to call the in-house dr. The nurse called back the next day and said that the dr would see her in person whenever he came in, but they didn't know when; he will show up when he shows up.

    The nurses at M changed the bandage two days ago, but didn't change it yesterday.

    S and I took her to pain mgt for her every-other-month visit so she could continue receiving pain medications for the nerve damage in her tailbone, and the dr didn't ask much about the tailbone and he focused on her leg. Dr. B said, "Why didn't the nurses do something? Does she have a doctor?" (Ya think?)
    "This one wound is very deep." (fyi, he's Lebanese and has an accent, but he's blue-eyed and fair-haired. Interesting guy, smart and nice.) "It is very infected. You should take her to a specialist and have her xrayed, and maybe take her to a surgeon."
    Wasn't expecting that. I told him that the M doctor was alerted and said "no oral antibiotics until he saw her," which could take several days. I suggested taking her to an urgent care (doctor-in-the-box) and they could give us an opinion and some tests and a referral and he said that was a good idea. (Typically, assisted living places use visting physicians and they can work just in the local area, or the entire state of Virginia. You really don't know when they'll show up but it's usually once a week.)

    While S was taking P to urgent care, I went straight back to M and met with-the Dir of Nursing. I had several things to talk to her about (complaints and suggestions) and she apologized and took responsibility. She is very sweet and very smart but last wk there were two patient emergencies, and this week there is an audit, plus a training going on, and she has paperwork piled to the roof. These "intrusions" are common and it has now become a series of excuses. If you know there's an audit, get a temp secretary, Know what I mean?? If you've got hands-on patient emergencies and need someone to attend the nurse's station, hire a temp. You don't have to be a rocket scientist.She found where the cat bites were documented in P's file and she was appalled that it had gotten to the point it had.

    When I got to urgent care, the physician's asst had already examined P and called the ER to say that P was on the way. She said, "Why didn't M do anything?" (Ya think?) The plan was to take P to the hospital, across the street, to get her IV antibiotics and an xray.
    urgent care also had me fill out a form for the Health Dept because it was a cat bite. Uh-oh. I sure hope this cat doesn't have to go to Kitty Heaven the way Lupia did 2 yrs ago (some of you may remember the Cat from H*ll that I had to take through the airport from LaGuardia, and later, when she bit me and I hate to get antibiotics). I'm planning to re-home this cat, Nipper, and negotiate with-the city if necessary.

    The good news is, the Health Dept. will call M and ask why a report wasn't filed. :)

    We got to the hospital, and they said, "Doesn't M have nurses? Don't they have a doctor?" (Ya think?)

    P's blood tests came out clean, the xray was clean, she finished the IV antibiotics, and S took her home. (I had to run home to pick up difficult child's paperwork AGAIN because he was doing community svc work and needed the signature.)The hospital gave explicit instructions on how to treat the wound.
    (Explicit. They. Will. Follow. These. Instructions.)

    I with-the Dir of Nursing again. I told her that I expected P's expenses to be reimubursed.
    Thankfully, she didn't argue. I was all set for a fight.
    I'm going to rehome Nipper. He needs a tougher roommate who can train him and play actively with-him. He is very, very, very smart and bored silly. (I posted a sep note for cat people about that on the wc)

    P did very well in the ER. She was extremely tired, and her leg was sore, but I think she didn't mind all the attention. She is very worried about Nipper (deservedly so) and told every single doctor, "It wasn't his fault." Michael was there--the one in the ER who kissed her hand and sang to her in French. Boy, the two of them really play off of one another. Today is his birthday and Pandora gave him a kiss on the cheek and wished him a very happy birthday, and that he would live another thousand years. He said, "I'll never wash that cheek again." Then she had to show him exactly how Nipper bit her leg (never mind that at first she couldn't remember how it happened). She lifted off the blanket, pointed her toe straight in the air like a ballerina, then swung her red and badly swollen leg over the edge of the gurney and dangled it back and forth and explained how the cat was sleeping under the bed, and then grabbed her. A perfectly believable scenario, actually. And it got better with every telling.
    S and I were laughing our heads off. (Thank God for S.)

    P is going to have a fit and cry for weeks when I re-home Nipper. But she cannot care for him or care for herself after he has bitten and scratched (and this is about the tenth time but by far the worst). It has become a burden and a health hazard. I love him but he's too frisky for her. He's young and full of himself and really needs an active home.
    I saw P this a.m. and she seemed to be doing better. The ER dr said that every day would bring marked improvement, and if it did not, to go back to the ER immediately.
    I leave for Calif tomorrow ...

  2. susiestar

    susiestar Roll With It

    I forgot to mention this on the thread about rehoming Nipper. BEFORE you start to search for a home, ask Animal Control what the law says about rehoming an animal with a bite history. When we lived in OH we were shocked to learn that if we gave an animal with ANY record of biting away, we would ALWAYS be liable for damages caused by the animal biting someone. no matter how many homes he had, or if it went through the SPCA or humane society or any other group, as the people who owned him wehn he bit the first time, the financial liability would be ours for the rest of his life. the law in OH was very clear. We had to pay to have this cat put down because any time he didn't get what he wanted, he would go and find Jess and bite her, hard. If she wasn't home he would wait and as soon as he saw her he would go over and chomp on her. We HATED having to put him down, but we couldn't risk that liability and we couldn't keep an animal who kept biting with no provocation except not getting what he wanted the second he wanted it.

    I hope the Health Dept has a FIT at M assisted living. Their actions were nothing short of neglect and in my opinion totally unacceptable. So they had 2 emergencies. So. What. If that is all they can handle, they need to only have 2 patients. Period. No excuses make this acceptable. That wound should have been checked daily. My gma was in assisted living for about a decade and on the independent side they would examine any injury or wound twice a day. Minimum twice a day. I was there when Gma had cut her hand on something and even though it was minor they came and checked it right after breakfast and again right after dinner. When she went to the side with more help they checked those things three to four times a day. No bandage was EVER left on for over 24 hrs! Not ever.

    This place isn't inexpensive and they need to be more responsible and responsive to P's needs. she is not capable of verbalizing her needs as well as some people, and that is why they need to figure out how to do their jobs more effectively. in my opinion this just is unacceptable and maybe you need to complain to the corp office or owners or whatever the top mgmt that runs the place is. You also should problem ask DHS to do some spot checking to be sure that they are up to standards. Here there is a dept in charge of elder care facilities and they are part of DHS and they would take this very, very seriously. Any infection that requires IV antibiotics is very severe and likely could have been prevented from getting that bad with prompt, proper care.
  3. TerryJ2

    TerryJ2 Well-Known Member

    Absolutely, it could have been prevented. It would have been such an easy fix.
    Total neglect.
    I spoke with-the Dir of Nursing today and gave her an update on Pan. Then I told her because it had been documented and not cared for, it was neglect and I expected to be reimbursed for expenses.
    Her eyes got really big and she was silent for a minute, and then she said okay.
    Then she started making notes about the nurses and how they called the dr, etc. and I could see that she was going to try to pin it all on the doctor. That is so sad. Nothing is going to change. The nurses still blow off half the pts, and they are the dr's ears and eyes, and if they can't make clear what the pts needs are, then the dr's hands are tied.

    What do pts do who have no private caregiver like Visiting Angels, or family members? Scary, scary, scary.