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My mother was very confused when I saw her four days ago. I had the nurse check her vitals after mom said she didnt feel well. She was found on the floor the next night and dry heaving the next day. I asked them to collect urine to test. "No, we cannot do that we have to wait three days" I replied so she has to suffer 3 days before you even TEST for UTI? "antibiotic over use blah blah blah" My dad suffered because of UTI's and developed sepsis - "gee sorry about that" . "Your mother doesnt have a temperature and we dont know where she hurts, but she is sleeping now nice and comfortable" Grrrr!!! Called last night to hear "Sheesh! I am busy, the head nurse saw her and left for the weekend, she said to keep an eye on her and to do "UTI protocol" your mother is sleeping on the couch "Called this morning = "She is nice and comfortable sleeping, we will call you if any changes" - I truly hate that they *like* it when the people are sleeping because they require less care. The head nurse refused to even test urine and left for the weekend. Sorry, had to vent somewhere.

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The 3 day wait misinterpreted and misunderstood!
A urine sample is taken
If positive, it is sent for a culture to determine the correct antibiotic.
The culture may take 3 days.
In the meantime, a broad spectrum antibiotic is started immediately to treat.

Anyone professional caring for elderly KNOWS that a urinary tract infection does not present or show the usual symptoms of fever, but instead, major behavior issues a n d illness.

Do not wait to get care. It can be life threatening when it rapidly turns to sepsis.
Go to the E.R.
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jeannegibbs Jun 2018
I wondered also, Sendhelp, if the 3 day wait referred to the lab results, not to drawing the blood and urine. Without knowing all the details it is hard to judge this situation. And I'll bet micalost doesn't know all the details because often care center personnel are not good at explaining things.

My sisters and I were very disturbed about what looked to us to be a very haphazard approach to Mom's new symptoms. Only after I had a uti myself, and had a doctor who could and did explain the whole process did I look back and understand what the NH was doing with our mom. If we'd understood it then we would have been a whole lot more patient and less disturbed.
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You need to go to the facility and see how Mom is doing. If she doesn't look well YOU call an ambulance. Mom is a resident not a patient. She has rights and you have a right to call an ambulance. And, an RN should be on duty in a NH all 3 shifts. An AL, they are on call 24/7. UTIs kill if not taken care of.
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I share your pain. Getting Moms old Nurse Practitioner to order a urine test was always a battle (actually brought me to tears once, and I’m usually a battle ax) and had to go over her head sometimes. But I never heard of the 3 day wait...they wanted a few symptoms to appear like delirium, fever, dark urine, etc. The new NP is a little more relaxed about ordering it and accompanying bloodwork. 3 times I have been right, once wrong and it turned out to be dehydration. If her symptoms don’t get worse or even improve while you’re waiting for the big blessing for the test, you may want to try to pump some fluids like pediayte into her just in case it’s dehydration. Just a thought.
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The world is upside down.
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Sendhelp, I like your explanation of the urine sample and the 3 days it takes to for urine culture results to processed.

JoAnn29, I agree with you that ''micalost" needs "to go to the facility and see how her Mom is doing. If she doesn't look well YOU call an ambulance. Mom is a resident not a patient. She has rights and you have a right to call an ambulance... UTIs kill if not taken care of."

In regards to the "RN should be on duty in a NH all 3 shifts", that is true. However, the RN does NOT have to be performing resident care, she/he can be doing office work while at the nursing home. .
FYI: The RULE is that there needs to be an "RN IN THE BUILDING" 24 hours a day /7 days a week. There were times that I was working in my office doing Medicare paperwork and not doing patient/resident care. I was counted as "the RN in the nursing home" during the hours that I worked.

micalost, Please go to the nursing home and visit your Mom. If she isn't feeling well, then CALL for an ambulance to take your Mom to ER Dept NOW.
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She seems to be rallying this evening, hopefully it isnt uti.... And yes, I cared 100% for my father till he passed and at the same time my mom. From their separate homes to nursing homes for over 10yr
My father died from UTI sepsis complications so i am really going to put my foot down about this.
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Micalost, your profile says you are caring for a friend who has diabetes. Are you also responsible for your mothers care? Wow.

Anyway, in my humble opinion, you are being blown off by your mother’s facility and you need to do something NOW. Facilities are open 24/7. My mom’s had a policy that people could visit all day and all night. Her care or lack thereof is not acceptable. This is not why you had her placed there. If she was on the floor dry-heaving and all they did was wipe her up and put her back in bed, that is not acceptable. How do they know “she is nice and comfortable “? I’m not a nurse, but I’ve never heard of a 3-day non-test rule.

You are your mother’s advocate. I know this is Saturday, but there still has to be a Charge Nurse on duty. Go to the facility and calmly but firmly ask, in person, whether the facility’s house doctor has been notified of what’s going on. How often are they checking on Mom? Ask them to check in with you on her condition every few hours. If they don’t, return in person and ask why you haven’t been called. No one, in a weakened and ill state, should be dry-heaving on the floor of their room. Do you know how long she was there? Had she rung for the nurse and no one showed? Is she eating? Communicating? How long is she awake? They can only blow you off if you let them. Don’t be afraid to speak up.
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Jeanne, your comment on explanations and understanding is so true, and I think perhaps is a function of the knowledge gap between medical professionals and patients and patients' families.

That's a very good reason for patients' families to learn as much as they can so they can converse as close to possible on the same level as the medical pros. The same knowledge gap occurs in law as well.
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Mica, I think an in person visit is in order, even though it's a weekend. I've never heard of waiting 3 days to do a UTI test. In my experience, it's done quickly so the antibiotics can be started.

Do you like this place otherwise? If not, you might hint at reconsidering the placement. If you mention contacting an ombudsperson, they'll circle the wagons.

You could mention that you're documenting though, or just take notes every time you go there. That usually raises the attention level and things improve.

Being found on the floor with dry heaves is to me a potential emergency and should have been addressed immediately. I get the impression this place doesn't have the best policies and that's reflected in the attitude of the staff. Anyone rude enough to tell you "I am busy" might not be very pleased with the facility, with her salary or with management. That's not an excuse though.

When you do get in touch with the DON or SW, ask for a care conference to discuss these issues AND develop alternate methods of dealing with them, methods that truly address your mother's health.
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sorry but no. The "three day UTI protocol " is that they observe them for three days after a person appears to be acting abnormal.  They said they could not take the urine, only the head nurse could- and she refused to
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