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Help...locked box / stroppy nurses and injections!

K

kerry1971

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3
HI...

my friends father is 82 and currently in hospital ..his yype 1 diabetes has been playing up so he has now been raised to two injections daily....he is slightly senile and has started telling the nurses he has HAD his insulin...when he has not. SO relasing him from hospital is proving awkward....the local nurse who used to give his insulin is refusing to pop in in case she is held responsible for him having the incorrect does when he says he has taken it....so they asked for a locked box...family got one...hospital now say not good enough your father could obtain some (!?) from another source ( tesco!?) and administer his own meds, then the nurse comes, gives more and bingo he is in trouble but she is liable.....so...they wont release him from hospital unless :

1. the family agree to take on this job ( but the senior nurse stressed : if they decide to take this option they ''cant just change your mind and ask for a nurse later'' ...they will NOT be allowed or given a health care visitor in future..( WHY?) .....

2. they come up with a locked box fool proof system they are happy with and as the nurse said '' cant work out a good idea for that''.... so helpful!

3. residentail care...not an option the family say...he was born in his house and wants to die in it and is adamant he wont budge.

So stale mate!

I was approached by the family last week and asked if i would 'babysit' him 9am till 1.30pm mon - sat...clean, make sure he eats propelry, cook and iron and basically keep one eye on him at all times as he tends to collapse very suddenly. Having met him he is a lovely man and I would very much enjoy wotrking for him. However, should the family take the only option that appears to be being forced on them! ( administering the insulin themselves ) it would be down to me to do this job. Im not a health care worker and although efficient in injecting sheep! I am sure i can easily learn and wont mind BUT how do I stand legally ?

Any advice to me and also to the family would be most gratefully accepted...ideally nurses would come daily and sign a book...i mean how hard can that be to sort out!!

EG>
start date : total insulin 50ml
date
time
signature
amount of insulin administered 5ml
amount left 45ml


etc etc

Surely in this day and age there is a proceedure for older clients with dementia with diabetes!

Please help if you can...thankou and I shall pass all info onto the family who do not have internet access.....

THANKYOU !!! X
 
Hi Kerry and welcome to the forum.You don't say which part of the country you are in,different areas probably have different rules.Surely the easiest option for the nurses is for them to have a key for the lock box,with another being held by next of kin,so there is not possibility of him self injecting.Let us know how you get on with this problem.
 
I agree and we asked this -the senior nurse said : no that wont work your father needs access to the insulin as well and therfore could take some insulin and not tell the nurse / and how can we be sure YOU wont give him an extra dose too? then your not around to tell the nurse when she comes....we dont want any liability....he must have said that phrase 20 times in our 15 minute chat it was so frustrating !

he was soooooo unhelpful !
 
I cannot believe that they do not have protocols for this!he cannot be the only insulin user in the place! Have the family spoken to his GP/local Health centre etc?
 
My experience of working in the eldery care for 15 years both community and residental, sadly this is a very grey area and is constantly changing!

Firstley if the family haven't got a socail working, then they should really get one, as the social worker will know local protocall and all the ins and outs concering the rights that 'dad' has and can call for meetings with dad, family, hospital and doctors etc to reslove issuses and concerns about 'dads' on going care needs and care plan...

Another source for information is the Care Standards Commision as they can also give informations about 'indiviudal rights, protocall with in care both at home and residental' the phone number for the local office can be found in the phone book or via the internet...

If it did come down to 'dad' needing residental care then the care commsions inspection report on all care homes can be found via there web site, which is very usefull when having to go through the process of choosing a suitable home...
 
There must be some way of tracking how much insulin is in the pen.
My husband as once nearly killed by a GP who asked him( when he was just short of Hyper coma) if he'd had his insulin. He sayd yes, I said no, but wasasn't believed and the doctor gave him some IV. That was in the days before meters. Doctor didn't have BM sticks with him. Husband spent next 4 weeks in ICU.Doctor departed and left me to cope until ambulance arrived. I tried to complain afterwards, but couldn't get past the barriers.
That eas also when syringes were used. Pens would be easier to track.
 
Hi

Social work wont have a protocol for this, as its a health problem. They can however look at general stuff like carers coming in to support with food at certain times etc. They are also of course responsible for long term care etc.
NHS has a DUTY OF CARE and as such refusal to give what is effectively life saving medication should and could be challenged. If the man has a cognitive impairment (Dementia) then its scandalous if they refuse. There are lots of people with this who live at home quite well- with support. If Dementia is becoming a real issues they need to consult a lawyer to consider legal powers - and this will include right to advocate on his behalf re medical issues.

The box idea is a fine and extremely sensible idea. Suggest to DN or GP that family will sign a disclaimer (cause at the end of the day it it litigation/registration that worries them IMHO, as opposed to real concern for mishaps). They wont/cant however hold keys as far as I am aware

Also, why not leave a supply of needles, monitor and the insulin in the fridge at his home and ask for the DN service to come with the syringe only. That way he wont have the all the tools to inject and there wont be mishaps. Its not beyond reason that they carry syringes about, though think there are limits to meds they can have on them.

Also, a record keeping book or diary can be kept both by DN and family. If this man doesnt get support to manage this then he risks serious hypo or hyper.

Grrr

Lib
 
lilibet

I'm not sure whether this is based on area or not, I know that in my area DN's are not allowed to carry syringes, that are not allowed to carry dressings!!! They can't even pick up perscriptions from the surgery, this has to be sorted all by the person/family and be available for them within the home... (this has been brought in since the Dr shipham incidents)

A key for a locked box wouldn't be allowed to be carried keys either, but now the use of a secure key box that is secured to a wall and locked with a complination lock which of cousre the DN or community carer will be given the code for to retrieve they keys they needed...

When I was working in the community, I could give a client medication that was in a nomad type dispensing sytem that had been either sorted by family or by the chemist, if a client ask me to give any tablets that were in a bottle, I could losen the lid for them, but nothing else if I took the lid fully off or even tipped contents on the table so that they could take the required amount it could have been seen as dispensing....

As you can see how what seems to be a simple situation becomes a real nightmare to put into place... The policies, legisations and regulations to help protect and ensure that there human rights are adhered to has made the giving and providing community and residental care full of problems trying to implement it all around all these and there are many grey areas on handling certain situations, I'm so glad that I got out about 6 months ago after working in it for 15 years....
 
It sounds like preserving a vulnerable patient's health has become secondary to nonsense!
 
hanadr said:
It sounds like preserving a vulnerable patient's health has become secondary to nonsense!
Click to expand...

The patient died but you can't blame me!

Story from just down the road, one of the local gardeners called to do some work for a centenarian neighbour and found her lying on the floor of her lounge.

He didn't dare pick her up himself and had to dial 999 and call out the ambulance, purely for insurance/liability reasons.

It's worse: apparently social services had previously found her on the floor. They *had* picked her up and put her back in her chair but hadn't dressed the cut on her head or even cleaned her up. Nor had they bothered to inform anyone. Undoubtedly they were Following Procedure and if she had died they would be blameless.
 
Hi Jopar
The combination lock cupboard is a good idea but TBH if people arent motivated they will find any excuse but again with family permission, no reason why it cant be on his notes. I still think GP and family need to find a way forward for this, its nonsense.

Trink, thats a horrible story. Theres no procedure as far as I know for what you described but if someone was on the floor with a cut head Im sure a call to GP or paramedic would be the COMMON SENSE thing to do. SW's arent medically trained and cant make that call as to whether someone needs treatment or not. Mind you, Ive had many a fight with a GP about whether they will come out or not, and then got chastised when they refused to do it and calling an ambulance. Hey ho.

Moving and handling a patient from the floor without equipment, or in fact at all, actually breaches health and safety rules and first rule of being unsure if someone is unwell is to leave them where they are until health comes.

The debate about social care versus health care has raged for years, to the detriment of the individual as far as I can see.
 
tbh i think it would be a difficult one for you to do kerry - you aren't a HP and therefore have no insurance etc . The nhs has a duty of care to this man.

You should get the family to pressure the staff to organise a case review which includes social workers - i asked my sister about this as she is an elderly care social worker and that is what she advised.
 
When a neighbour (90 +) fell down stairs & pressed her alarm, we went to help & call the ambulance. The most important question seemed to be, "how many stairs she had fallen?"

That was 10 pm. By 3 am she had recovered enough to send home! Not kept for observation.
 
Would Help the Aged or Mind be able to offer any useful info?
Or any other relevant charity? Have you asked DiabetesUK? I hesitate to say that because I know some people really don't like them!

I hope everything gets sorted soon,

take care
 
SilverAndEbony said:
Would Help the Aged or Mind be able to offer any useful info?
Or any other relevant charity? Have you asked DiabetesUK? I hesitate to say that because I know some people really don't like them!
Click to expand...

That may actually be a good plan, make them work for their money!

It's really only the dietary advice (and the fact that they talk down to everyone like naughty four year olds) that annoys
 
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