# SNF will kill you...one way or another...



## sara567 (Dec 12, 2005)

99 y/o female.

sent for choking in the dining room.

show up, 3 nurses are trying to bag this lady on the ground...hey, at least they knew enough to bag.

let them keep doing it, making sure to give simple instructions whenever we are going to do something so that these 3 ladies will follow along.

get into the rig.  pt had a WHOLE meatball right on her vocal cords.  grabbed it and got it out, but prognosis wasn't all that great, and haven't found out what happened to this lady.  she was a dnr/dni.

pt hx?  multiple cva, tia, L sided weakness.


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## TTLWHKR (Dec 12, 2005)

Okay.. So she's not choking anymore..

Is she breathing? Does she have a pulse?

DNR doesn't mean do not treat...


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## hfdff422 (Dec 12, 2005)

TTLWHKR said:
			
		

> Okay.. So she's not choking anymore..
> 
> Is she breathing? Does she have a pulse?
> 
> DNR doesn't mean do not treat...



Well the geniuses were trying to bag her, so there were efforts to save her. But nurses not realizing FBAO when they cant push air? C'mon, they have to get that card every 2 years the same way we do.


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## TTLWHKR (Dec 12, 2005)

What does SNF mean?


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## TTLWHKR (Dec 12, 2005)

hfdff422 said:
			
		

> Well the geniuses were trying to bag her, so there were efforts to save her. But nurses not realizing FBAO when they cant push air? C'mon, they have to get that card every 2 years the same way we do.




I didn't mean the nurses.. I meant EMS. DNR is immaterial until a person needs to be resuscitated... :lightbulb:


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## hfdff422 (Dec 12, 2005)

I am clear on what you meant, but I felt she was not saying that they were following DNR's. She was only commenting on the frailty of the patient.


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## Chimpie (Dec 12, 2005)

TTLWHKR said:
			
		

> What does SNF mean?


Skilled Nursing Facility.


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## VinBin (Dec 12, 2005)

haha...from what I've heard, theres no such thing...


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## MedicPrincess (Dec 13, 2005)

sara567 said:
			
		

> she was a dnr/dni.


 
Whats DNI?

Do Not Intubate?
Do Not Initiate (treatment)?
Do No Intervetions?
Do No IV's?

I am SO confused.  I hate 230 am.


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## TTLWHKR (Dec 13, 2005)

Chimpie said:
			
		

> Skilled Nursing Facility.


 
Oh. I knew that. Just testing you.


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## VinBin (Dec 13, 2005)

I had never heard of DNI...but a quick google search found something....
http://www.geocities.com/ask_icu/nocode
"DNR/DNI stands for _Do Not Recussitate/Do Not Intubate_ "


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## ksEMTbabe (Jan 20, 2006)

VinBin said:
			
		

> haha...from what I've heard, theres no such thing...




I would tend to agree.  Most of the ones around here are jokes too.  THe one that comes to mind is an 86 y/o male fell 3 hours prior to calling EMS. Nurses thought nothing was wrong.... except for the sharp pain in his hip that he kept complaining about...  When we finally get there, this poor man's whole pelvis was PSD, and his BP was something like 57/35.


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## CaptainPanic (Jan 20, 2006)

Dont you just love NH nurses?? Theyre gonna be beggin for mercy when they get put into one themselves and they'll be like OH PLEASE O GOD PLEASE CALL EMS IM IN PAIN!!!!!

It'll come back to em sooner or later.

-CP


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## VinBin (Jan 20, 2006)

Are most of the nursing home nurses LPNs? RNs? Assistants? Most of the times they seem more worried about gossip than giving decent patient information...

(of course there are exceptions, there are nursing homes that looks like mansions and have the most friendly RNs and such...)


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## ksEMTbabe (Jan 20, 2006)

VinBin, all the ones I've ever been in have had like one RN, maybe one LPN, and a bunch of CNA/CMA's....Not really a good situation in general.  Actually, about a week ago, we got called out to a NH here in town for a fall.... We get there and it was some 17 y/o CNA who was supposed to have been mopping the floor, and suddenly out of the blue she was "unconscious".  The nurse and the rest of the staff were hysterical by the time we got there ( but no one had attempted to help her - go figure) I just had this weird feeling that something wasn't on the level, so I ran my finger along the lashes on the outside corner of her eye.  Lo and behold her eyes twitched.  My captain decided to load her up anyway and find out what the story was, so we get out to the truck and as soon as the doors shut she pops up off the cot.  Turns out she just wanted to be off work because she was having some sort of fight with her boyfriend.... We sort of got the last laugh though because here, when EMS is paged out, someone from PD responds as well.  The officer was not happy with the little performance needless to say so she got snapped into protective custody and got an ambulance ride for a mental health consult :-D


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## Walter McCracken (Feb 16, 2006)

sara567 said:
			
		

> 99 y/o female.
> 
> sent for choking in the dining room.
> 
> ...



I NEVER want to be a near code and see a nursing home nurse heading toward me with a bag.


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