Hospital Bed Evaluation: Fill & Download for Free

I was doing home visits. I had a referral on a young mentally challenged patient. He had uncontrollable seizures and decubitus ulcers (bed sores). The mother was a very strange person. She had eye problems and I could not make eye to eye contact. She was very uneducated and always complaining about something.Our communication was good because I was very patient with her. She needed to vent most of the time and I never took it personally. I was doing a visit to the home at a later date and I could hear someone moaning. I asked about the sound.It was her granddaughter that she had adopted. She proceeded to take me to her room. She was a 12-year-old that looked about 4 or 5 years old. She was lying in feces in an old hospital bed that looked like a cage. She had no communication skills. She had decubitus, too. Her body was so contorted it was difficult to recognize her as a human. She looked like the most uncomfortable child I had ever encountered. Her hair was matted and neglected.My mind just started racing. I had a million thoughts going through my head. I looked over on the wall was a picture of the caregiver’s dead husband in a casket.I thought I was having a horrible out-of-body experience. The house looked like a disaster area. A retarded son in a hospital bed in the living room, a granddaughter in a bed looking like a cage. So malnourished and emaciated. In her bed was a bowl of food that resembled Alpo dog food and had the same smell as dog food. I was thinking how did this happen, how did this get so out of control? Why, why, why was going thorough my mind.I asked the mother who fed the child. She said she feeds herself. OMG what was I going to do first or next? She was not a homecare patient but, at the risk of getting myself in trouble, I asked the mother if she wanted me to clean the child and put a clean diaper on her. She verbally consented to letting me help the child. I knew I could not leave her there that way. I could not sleep that night for reliving seeing a child living in such neglect.I gave her a bath and the decubitus ulcer was to the bone. Put a diaper on her and clean linens for the bed. My heart was breaking in a million pieces. My mind was still racing. I had to try and reach this child. She needed love and comfort, food and more than I could comprehend at the time.I got her in a blanket and got her out of the bed just to hold her. She was starved for love and was a failure to thrive. Her arms and legs were so deformed she did not resemble a human.I had no history on her and the grandmother told me she had adopted this child. Her mother was on drugs when the child was born causing her deformities from birth the best I could understand. The biological mother did not want the child and was still using drugs. The father died of an overdose. Obviously she had not be cared for and this was a social services case. When I got her little distorted body in my arms it was like holding a dead person. I got no response except the moans got louder.I was concerned I was hurting her and put her back in the bed. I asked the grandmother if I could call her pediatrician and ask to admit her to homecare or a possible hospital visit. Grandmother refused to take her to the hospital.I was trying really hard not to offend her. There had been numerous nurses to this home and different homecare agencies. This woman did not trust nurses and, according to her, had bad experiences with them. It was like walking on eggshells.She did like me but I had to build some trust. I was given the referral because I worked well with difficult situations and complicated cases. This was definitely one that I did not expect to encounter.She agreed to a call to the doctor. I had to leave the child in that condition. She had been that way for a long time. It was still very difficult to do. As I was driving to my office I was trying to wrap my head around the situation. I kept thinking about that picture of her dead husband. That was blowing my mind.I called the doctor and discussed the situation. He was aware of the move and thought that the move might help. He said social services was involved in the case. He agreed to homecare so I did admit her to our services the next day. He said the family was very defensive and rude to the nurses and they would not go back to the home.I contacted social services and they said there was nothing that could be done. I wanted to scream. This was child neglect and endangerment. All I could do at this point was document the conversation and hope for the best.This is life working in rural health. The poor and uneducated suffer and it is very difficult. It seems like people don’t care but I think they just don’t have any recourse to help.Social services had contacted the grandmother about the food the child was supposed to feed herself. The only thing that changed was the grandmother wanted to know why I contacted social services. I was speechless for a few minutes trying to find the right words.I explained to her, very kindly, that as a nurse I had to report her health status. I could be liable if I did not. I explained to her that I was there to help her. I was very sincere in what I was saying to her. I wanted to cry but I tried to just chit chat with her to relieve some tension.She started to talk about her husband — he had died a couple of weeks prior to the admission of the son. She was grieving the loss of her husband and trying to care for two unhealthy children. I understood it was difficult for her.She proceeded to take me to the room to show me his picture. This room was morbid and different than anything I had encountered. I let her talk; she was hurting on the inside and taking out her pain on the nurses. The more I listened to her I could see a difference in how she responded to me.I continued daily visits and would bathe and feed the child. She would not allow a nurse's aide to come to her home and do the personal care. Her son would get an erection when I would visit and that was a little uncomfortable. I had to put a Texas Catheter (external condom catheter) on him. He was incontinent making his bed sores worse. The catheter kept him dry and helped the sores to heal.I had a heavy schedule and was spending excessive time in this home. It was difficult with the grandmother as she would talk and talk to me. I would work late and just not turn in the overtime. I would do this visit last so that I could be punctual with my other patients.The grandchild did not improve much. I gave her protein supplements trying to get the bed sores to heal. There was some progress but she was not doing well. By this time the grandmother was more trusting of me.She did take her for a pediatrician visit by ambulance. The doctor did not change any orders but he did agree to a physical therapy evaluation. The grandmother refused to let them visit.I knew I had tried but it seemed like I was just not making much progress. She seemed to groan less but appeared lifeless. It was as if she was dead but there was still some bodily function that had not ceased living.I returned to the home on a Monday and the child was gone. I thought she must be in the hospital. She had died.My knees were so weak and I had tears in my eyes. I had to get myself composed and keep doing my job. I never really knew what they determined as the cause of death. She was only existing but it was still painful knowing she had died. I wondered if she was alone.Her son progressed. I was able to teach her how to care for him but it was a very slow process. I was eventually able to discharge him. My work was done at that home but my life was forever changed.There is a thin line that separates pain and laughter. Tragedy and survival. Life and death. This was a tragedy for the poor. This was a devastating life lesson.In my reflection on the child, death was an escape. She went from darkness into the light. I felt like I had lived through a super storm and life just goes on. The world keeps turning and hearts keep beating. Even broken hearts beat as the time passes. The dying never stops.Loneliness and the feeling of being unwanted and unloved must be the hardest part of poverty.I realized no one ever becomes poor by giving. Even in my pain and disappointment. I made my life by giving. I had given it my best. It was time for me to get busy and move on. I could not live in sorrow and had to keep moving.I knew that angel was around the throne in heaven. She was in her heavenly home. I had become a better person because she was a part of my life. I found my peace in knowing my battle was lost but her battle was over. She had peace and I had other patients depending on me. “We may weep in the night, but joy comes with a new morning.”

New infections leveling off is a good start. It’s nowhere near enough.“Leveling off” the number of new cases a day would at least eventually allow everyone who gets sick enough to need one to get a vent, but we’d need to maintain social distancing for a year at that level while the vaccine gets created, 200,000 Americans would still die, and we’d have 30,000 hospital beds full of COVID-19 patients for most of the time.If you want the country “opened up” again, that means not just leveling off new cases, but squashing the number down to the point where our health infrastructure can test and track anyone with COVID-19 symptoms. We’re nowhere near that point yet. I also don’t see how we will be able to be, when the national response’s effectiveness is limited to the effectiveness of the worst state’s response.The United States had months of warnings, which our national (and some state) leadership ignored, was woefully underprepared, and is seeing 35,000 new cases a day.Many thousands of individual Americans have responded to the crisis with utmost gallantry, and quite a few of them have gotten sick and died as a result of staying at work in America’s grocery stores, utility companies, emergency rooms, and police and fire departments. But there is no way to classify the response of the United States as a national organization as any better than some place between “poor” and “woefully shambolic”.Original question:With new SARS-CoV-2 infections leveling off, and epidemiological models being revised for lower rates of infection, how do you evaluate The United States' response to the pandemic?

I had been misdiagnosed with MDD, major depressive disorder. I was placed on an array of SSRI antidepressants in various combinations and strengths. Rather than feeling less depressed or better, I became obsessed with suicide ideology and self harm. I didn't even think there was anything wrong with that. I just figured I was reaching the end of rope, everything was hopeless, and the end by my own hand inevitable.That day came June 23, 2008. After another round of tried and failed antidepressant episode, my physician told me he didn't know what more he could do for me. Well, alrighty then. Time to put the plan into motion. I guess that's the news I was waiting for. A knock down, drag out with the wife the same day, an unexpected bill in the mail I couldn't pay, and a raft of shit from my boss and I said, “Fuck y'all. I'm outa here!”I awoke several days later strapped to a hospital bed in the ICU and placed on around the clock suicide watch.If every cloud has a silver lining mine was this. A full psyche workup and evaluation by two prominent psychiatrists, one of whom specialized in bipolar disorder, revealed I wasn't MDD, but bipolar. She also went on to tell me prescribing SSRI antidepressants, especially in the combination and amount I was taking, to someone who is bipolar, was like throwing gasoline on a smoldering fire. It can and does produce manic episodes which I was in the throngs of when I attempted to shuffle off my mortal coil.That suicide attempt was inarguably the biggest mistake of my life and a regret I will never be able to reconcile. Between lost wages and medical bills I ran the money clock up well into the six figure bracket and as a result, I'll never be able to retire. The financial repercussions are ongoing almost 11 years after the fact.