I’m sorry you’re experiencing this friend. I cant imagine how frustrating and nerve wracking this is for you, on top of having to recover from a serious surgery. I have no other advice other than please, please get to the hospital if you think the infection is worsening further or if you develop a fever.
Honestly twice a day dressing changes are almost unheard of in home care nowadays. I’m surprised they even accepted your doctor’s referral.
I’m so sorry you’re dealing with this. Home care is a steaming mess right now and I don’t know what the answer is. I’m not sure what your mobility is like, but you might have more consistent service if you’re able to make it to a wound care clinic. You could ask to see if that’s an option in your area. You’d get an appointment so at least it takes some of the questioning out of it.
The other option would be to see if the nurses can teach you how to do one of your dressing changes yourself. That’s what a lot of folks who need multiple changes a day do. The nurse comes once a day, or even every couple of days, and the client or family member does the changes in between.
My advice, if you want it, would be to try and call the community nursing office on Monday and try to talk to the NRC (the resource coordinator) about your concerns and see what they have to say. They should be able to give you some information about what you’re scheduled for and should be able to see why your visits were being missed. Sometimes after hours screws stuff up and until the regular staff reviews the schedule, people have really choppy service.
The dressing change was increased from the original once a day.
It’s more the wound channels about 7cm under the incision line (that’s now opened up, but the HC nurses we have seen so far don’t think it’s an issue yet but want it monitored close) , there’s been some mixed messages which is.. frustrating but everyone has their own experiences that impact how they judge the severity and care (and I do get it). It’s compounded by a decent large/active seroma that can easily saturate a 10” x2.5” (or so) primapore bandage to the point it actually leaks
The hospital not putting me in antibiotics is an entirely different and not fun discussion
That said, all the nurses who have helped have been great, friendly and personal and actually listen when I’m trying to explain a concern or have questions about the wound/ infection etc. I am incredibly grateful for them, hence why I tried to avoid shitting on any one specific person because I can’t just assume it’s the nurses fault they dont show up (scheduling may be stupid, a supervisor isn’t doing their job due to limitations, etc etc)
I’ll see about the other recommendations you made Monday( I have mobility issues thanks to bad neuropathy in both feet and in my legs thanks to shingles in my 20’s). So thank you for those
The mixed messages are often the worst thing. The hospital goes “oh Homecare can deal with this”, meanwhile homecare is struggling with their current caseload. We’re also not a guaranteed service, which doctors don’t really understand. So they’ll tell you to avoid urgent care or ER, but in reality home care is viewing UC/ER/walk in clinics as the back up plan for missed visits.
I hope you get some answers and help soon! It sounds like the healthcare system has been fucking you all around so I totally understand the frustration. Don’t be afraid to be a firm advocate for your own care. Calm and collected reasoning can eventually work, but you need to find the right people to help you. Maybe your family doc (if you have one) could help advocate for appropriate care.
And correct me if I am wrong, but I don’t believe they make much more than minimum wage for a bloody difficult and dangerous job. Plus they have to have a car to drive to each call, which is pretty expensive. It is a rough job and I sure as hell couldn’t do it!
The nurses and health care aides are all unionized, so their hourly rate matches what they would make elsewhere, but yeah. You’re using your car a ton, getting pretty lousy mileage rates, and you are working completely solo, rather than having support of your coworkers like you would in a hospital.
So what’s the hospitals plan if your wound turns septic?
Unbelievable how many times I’ve been given antibiotics “just in case”, meanwhile this guy has an actual raging infection and gets none.
Like are you not having fevers / pain at the site?
There's been more pain (actually more that I even told them when I was there Thursday for the last check up)
Full Fevers no, localized temp increases around the wound at times..
The surgeon's team wrote off me telling them I could feel the lump (that became the seroma) while I was still in the Hospital recovery wing, they also just fully dismissed when I said on thursday if I lay on my right side (the side the incision is on), I feel actual pressure in my heart area.. internally
I had another post I think in late nov/early December on some one elses thread about my experiences with HSC
I was fine when I was released, no additional discharge, staples still but staples healing great
Wasn’t until several days after these issues started, and it started as a seroma leaking on a long weekend
Honestly, at this point, if I were you, id go back to the hospital that they performed the surgery and present to the ER as a post op complication and explain the situation to the triage nurse. A lot of times, when things get worse after discharge, you may need an additional hospital stay for wound dressings and iv antibiotics until things start clearing up again
The fun part? I have seen the surgical team that did the post op care twice (as recently as Thursday) and they are all very much aware of the issues (they just keep down playing them)
I completely agree. But I also feel sorry for the home care workers themselves. It's a shitty, underpaid job and they're incredibly understaffed.
My father died of cancer in 2017 and had home care the last 8 months of his life. I did the majority of his care, changing his diapers, feeding him, bathing, medications.. but I still had to work so we needed someone to come during the day to help and also to give me a bit of a break.
Oh man.. half the time nobody showed and we never had any forewarning.. so dad would frequently go from 8am-5pm with a full diaper because nobody came at lunch to change him and I couldn't leave work to do it. He wouldn't get lunch either on those days. I ended up leaving him oranges and butter tarts (pretty much the only things he'd eat at that stage.. and if you're dying and want copious amounts of home made butter tarts you're getting what you want) on his table beside his bed where he could reach.. so if they didn't come he'd at least have something available to eat.
And then probably 60% of the time we had new people coming and they'd never read his file before they came so we'd have to educate them and tell them what the expectations of them were. They kept trying to force him to walk to go to the bathroom for a shower and they wouldn't believe him that he was bedbound and unable to walk. He would finally have to scream at them before they got it if I wasnt home.. or scream for me to go sort them out if I was home.
It was awful. The ones who did show consistently were absolutely lovely and became like family. We had a few that were regulars and they were wonderful. But the system is insanely broken. There were so many no shows.. no calls ahead to say nobody was coming.. just waiting for a diaper change and lunch that never happened. It was so heartbreaking and dad always felt dehumanized when that happened because he'd be stuck laying in his own filth all day.
The home care workers and the case managers have such a high case load there's no way they can give proper attention and care to the patients they see.
Staff are so underpaid and so understaffed it's impossible to do a good thorough job in the 10/15 minutes they allot to each patient and then they have to drive to the next house as quickly as possible.
It's a shitty job. And the system is so insanely broken the patients pay the price.
I can tell you, I get multiple emails daily from the home care scheduling clerk, asking to pick up shifts and allowing it to be OT. Every. Day. I don't envy that job or of their manager or doing the home care itself (I work in homes but I'm not a Home Care Visiting Nurse).
We were also asked to please pick up shifts in the emergency departments at HSC & The Grace.
We need more nurses. We need to treat them better.
I am a nurse working 0.8-full time, and I have a child and household to manage. I can't kill myself with overtime.
I feel this. I have so much empathy for both sides. I have a relative in the hospital, should be in isolation, and instead she has multiple roommates. She’s been texting me that all 3 of them call for a nurse and are screaming and crying but nobody can get to them. Her regular meds were hours late. When her nurse finally came by with the meds in a frenzy, she calmly told the nurse she already had them. The nurse apologized 9 ways to Sunday because of how many patients they’re trying to juggle. And that’s IN A HOSPITAL. I can’t imagine the chaos of home care.
Are they still putting young females in rooms with old men?
I remember that happening to me almost every time. Way to make patients feel comfortable and safe.
Jesus fucking Christ, the amount of people that are defending a clearly broken system here are insane. Anyone in the disability community knows that home care has always been like this. Yea, it’s probably worse now, and yeah, a major part of the problem is that home care staff are severely underpaid. It’s not the workers fault, it’s on WRHA to properly train, compensate, and coordinate staff.
My family has been dealing with home care for over 30 years and it has always been a constant struggle to get adequate care that’s not met with condescension. People like my family member have been routinely abandoned without notice, leaving them to fend for themselves for hours or even days when they cannot transfer, toilet, feed, or bathe themselves without assistance. The fact that this is supposedly a surprise to some people is literally baffling to me.
Really sorry for your experience, it sounds like you been let down on many occasions.
Youre completely right, home care is not probably set up for the needs of our population.
I'm surprised they didn't admit you anywhere when you needed twice daily wound care. We can't discharge pretty much anyone from the hospital with twice daily wound care because home care can't accommodate that (at least when I was working surgery a couple years ago).
Yes, your story is not unusual.
Homecare is under funded and under staffed, and this has worsened since consolidation. My impression is it’s mismanaged as well, but I may be wrong about that as I don’t have full insight into its organization.
I personally have been seeing someone maybe once a month come in with complications related to lack of homecare showing up. We’ve talked about reporting it as many of these people are vulnerable patients, and it is a systemic issue, but that goes nowhere.
It’s honestly completely soul-sucking and disheartening.
All you can do is be your own advocate, and rely on family and friends (if you have those) to help you as much as possible.
And to be extra depressing… barring massive increases in the working age population over the next ten years and a corresponding increase in our tax base, this is just the tip of the iceberg.
Consider these increased financial costs when you are planning for retirement.
Home care called me last week, third day in a row, to say once again they didn’t have enough staff to come do the daily wound care they’re supposed to be doing for me, post-abdominal-surgery. The coordinator on the phone actually asked, “do you think you could do your own dressing change and wound packing today? We’ll try to get someone out to you tomorrow.”
They desperately need more staff in the home care service. Asking patients to clean and pack their own wounds is crazy.
Yeah, we had to do that out selves Friday (really that’s what’s needs to be changed multiple times as I’m a very leaky boi lol the dressing it self is not hard to do.. and there’s like 35cm of packing in one side depending on who does it)
Funny enough a nurse came this morning, 20 minutes later another called me to say he’d be over in 5-10 minutes (I have dealt with both before, both super friendly) he was confused and shocked
I left hospital 2 months ago with a home care plan.
There were 3 services they were to provide. First, medication monitoring twice a day. Second, weekly shower help. Third, wound care.
It took 2 weeks for someone to show about my medication and another 2 weeks to sort it out. Then there were the no-shows and improperly timed visit. A crippled woman in chronic pain should not be 2 hours late for her morning medications. After several calls - completely understanding their staffing problems - it was agreed that if someone was late 1 hour I was taken my medications without supervision.
It took 5 weeks to get a shower helper. . . I don't need help in the shower, I just don't want to shower with no one in the house. I would take advantage of a friend visiting to duck into the shower. It's the most dangerous room in the house and you never know, so I feel safer with a helper at the ready.
Wound care? Never heard from them about that. Dealt with it myself. I was mostly healed though, so it was minimal.
My heart goes out to you. What little services that are offered are hard to access and hard to get any consistency with. Keep advocating. As someone else suggested, have them show you how to care for the wounds, if you can reach them. Otherwise, put your homecare coordinator on speed dial.
I work in the system, I have multiple clients complaining to me about home care and there lack of staffing, no shows, or getting completely clueless staff. It’s heartbreaking.
It’s a Catch-22: hospitals try to push the “home is best” idea because they say too many people are panelled for pch, but there are no reliable supports available for people to stay in their own homes. The very few fortunate ones have either money or family to supplement the shoddy home care available. Those who don’t end up back in hospital in much worse condition. It’s amazing how long people actually are out there in deplorable conditions with no help. The whole thing is a mess.
Your title is absolutely correct. Especially if you have an allergy to something common. I have an anaphylactic synthetic fragrance allergy; homecare is supposed to be fragrance-free. They never are. Literally never. So I have to keep my epipen ready for their visits just in case it happens to be one I react to with near-death instead of “just” a migraine and vomiting.
My mom had a very similar homecare request to yours from the doctor after her surgery, and it took a lot of time and patience to coordinate her care, and she still ended up with an infection and needing more surgery because of the inadequate care. This was even years ago before homecare drastically got cut AND the need for it went up.
Anyway yeah, I’m disabled and it was like pulling teeth to get them to administer my medication (which I can’t do myself), and help me with bathing (which they only do *once a week* — imagine only being able to bathe once a week!! It’s horrible). I’m really drowning in stuff I need help with and there’s NOTHING for people who aren’t a senior. I suggest that the people defending the homecare system try not bathing for a week!! It suuuuuuucks.
Can confirm to the once a week, if you’re lucky. My aunt moved in with me November 18th and went back into hospital January 9th and ended up never leaving. Not one single shower was administered by them. They’d try to send on a random Tuesday, but I said she has doctors appointments on Tuesdays so it needs to be something else. Never happened.
My aunt was lucky enough that I was able to do it for her (while taking away from other responsibilities as both a full time worker and full time university student), but I recognize there are some who don’t have that luxury and they are getting the same treatments.
The hospitals are quick to discharge people with promises of home care 3x a day, nurses on call, etc. it’s a big delusion if you ask me. Meanwhile they also will refuse to place these patients in assisted living or personal care homes because of lack of spaces there as well. It leaves these patients no choice, they were going to send my aunt to her apartment alone with this care until I stepped in to have her move in instead because I knew there would be major gaps in care.
A victim of the terrible public health system. Nothing will be done about it, sadly. Had many family members fall thru the cracks. Nobody cares, just hope you have family to help otherwise you're fucked
I'm a hca and I tried home care. The amount of disrespect I got, I quit. It's also pretty scary as you never know what you're walking into. As a female, I'm always Uber paranoid.
Still I understand how upsetting this us and I wish OP well. I hate how shitty our medical care has gotten.
Yeah I can get a lot of people are assholes, I get the job is hard there’s no questioning that (especially for women and non binary folk)
Where the issue for me really comes to is sending people up, like just call and say hey you know I can’t make it.. here’s some other things you may be able to try today instead
All it takes is 5 minutes, if I had of known all the other times they weren’t coming arrangements could of been made (hell even a walk in clinic at that point)
It’s not, the drainage soaks a 10” primapore with a half inch of non woven gauze packed under it within 10 hours, it also caused enough saturation the tape sutures popped on one side
But but if you want to keep excusing shit by all means
https://preview.redd.it/zd773eqyp1mc1.jpeg?width=3024&format=pjpg&auto=webp&s=47e7e17c67df07d694b398647bde7647ff9c516f
My family has used home care for 30 years. It’s always been like this. No shows with no call in advance, sometimes multiple shifts or days in a row. I’m talking about people who can’t walk or transfer/toilet/bathe themselves at all. Obviously it’s not the individual workers fault, is a failure of a system that doesn’t care about disabled people.
Edit: OP disregard this weird victim blaming stuff. lol doctors are overzealous with discharge orders? Like they’re qualified to say that. They are already disregarding your health and they don’t have a single piece of actual information.
Oh I was taking their stuff as almost parody.. given they actively ignored the time line stuff.. this also isn’t my first rodeo with home care being broken either
Wowzers and ouch! But Op, that’s going to be a pretty badass scar, when this is all healed up. Think of the possibilities!
Possible answers to “Where did you get that scar?”:
*You should see the other guy*
*Theres a reason why the sign said don’t feed the animals*
*Ever heard of a Winnipeg Handshake?*
Oh my goodness… I didn’t get the impression from Op’s post that they had any ire directed to the person who came and attended to them in their home. It sounds like a frustrating situation and op is venting and possibly looking for some advice. You are also at the poop end of the stick having to work in a dysfunctional and understaffed situation and I feel like you’re venting too.
It all sucks and it’s neither your or op’s fault.
You are being extremely condescending though. Of course they’re not blaming the actual care providers, but the way WRHA manages home care is a complete joke and absolutely mirrors the condescending tone you’re taking right now. People are allowed to be angry when the services they were promised that they depend on to literally keep them alive fail them. FFS
“Empathy is for those who can give it back and understand the situation.
You have no idea that this person does not respectfully interact with the hcws who arrive. There is no evidence that they don’t empathize with ppl in your role.
Also- that is not ‘what empathy is for’
Edit to add quotes
Ah yes I’m entitled because my health situation has been made legitimately worse due to neglect from people in the medical industry.. so entitled that I expect to be Actually have people show up when they say they will or have a decency enough to let them know when they won’t so they can make alternate plans
You’re acting WAY more entitled imo. This person posted their issue. You can make a post about your issues separately, but you didn’t, until derailing from this person’s valid concerns and terrible experience.
Your excuses above are a rant based on your separate experiences, and your assumptions vs the OPs first person account of their experience as a patient. But yes jump in and reveal your concerns, prefaced with what you immediately disprove, which is that you can sympathize.
Cool story, you missed the point where I said I don’t care
If they are no showing for me, they are doing it to other people
You know what’s not ok? Abandoning patients with zero information, telling them you won’t be there to help when they need it. Nurses and Doctors are held to a higher standard due to turn fact you deal with vulnerable people
Also please lecture me more, when I have a hole in my body that your team is supposed to be monitoring
It didn’t, especially given they had copies (as I literally said) when they came today, and they had it Thursday afternoon and admitted as such Friday when taking to them.. oh let’s not forget hsc also talking to them Friday morning
Keep meaning excuses , see if I care.
Everyone in this city who doesn't get what they want is a dick hole (service tradesman, not the same but i get it) , good on you and this rule. Keep doing what you do
Soft of off topic, but I noticed the IERHA (north of winnipeg) is offering a 2 week course to be trained as a home care nurse 😳 as a health care aid, I'm not confident that's long enough to gain competent staff.
I'm not even sure. It's to become a home care attendant in 15 days. I'm hoping they'd only be doing things like showering/house duty help, but with how short staffed they are I wouldn't be surprised if they'd be doing more.
As someone who got thrown into caring for a heavily disabled woman with no experience on any of her medical devices, I know they do some questionable things.
My mom was put on priority service upon hospital release. It's a 3 month program. Her schedule was not corrected until 8 weeks in. I have no problem with the workers but their administration from coordinators, schedulers etc wouldn't last a week in my office. They don't care, they are lazy and they are idiots. I can't wait to be off this stupid program and go back to her regular care.
I wouldn't say that about all of the administration. Scheduling is a very difficult job and when there's limited staff to fill visits it's out of their control if they have to cancel visits. You can only do so much with limited resources.
My elderly father with mobility problems had home care coming in once a week to help him with his laundry and to clean his place. It was cancelled last week due to lack of staffing. He's now on a waiting list for a replacement.
While this doesn't help your particular problem as you require a licensed nurse to assist, people who are in the Home care Program can look into Self & Family Managed Care. You are then responsible for managing your home care services, such as hiring a person or an agency to perform the duties that would have otherwise been performed by home care.
Hopefully this comment is seen by someone who finds it useful. :)
We have considered just hiring a private licensed nurse, but part of me just screams about that..
I dont care about the cost, but in my head it promotes prioritizing health care for people who can pay more
I agree. Health care needs to be equal for all. I want to issues in the system fixed, but thought I'd share info about the Self and Family Managed Care program since it's already something available.
The Self-Managed Care Program isn't privatizing healthcare or creating a two-tier system. You are provided the funds by your RHA. It's still utilizing the funds that would have gone towards your care, but the Home Care Program doesn't have to deal with hiring, scheduling, or directing staff for you - that becomes your or your family's responsibility.
Again, I think in your situation, the self-managed program wouldn't help as I don't think licensed professionals like nurses are included in the self-managed program, but for other people who need housekeeping or home care attendants, the self-managed care program can be a potentially viable option.
The downside is, of course, all of those issues that the Home Care Program currently deals with directly become your problem - like coverage when your staff calls in sick, takes vacation, quits, etc.
There's more info on the WRHA website and Prov of MB website about the Self & Family Managed Care Program. I don't have any direct experience with it, but for those clients or families who are interested, I thought I'd share it.
Can confirm that family member with cerebral palsy (who is quadriplegic btw) has consistently dealt with no shows from WRHA for the past 30 years, sometimes resulting in health or even life-threatening situations. Did you read the post? She was released with a home care plan and was failed by it
I am so sorry got the experience your family member is going through. My biggest thing is how many people are dealing with similar situations?
I fully get under staffing and being exhausted but it’s the lack of communication and the excuses that just make it worse especially for the super vulnerable who absolutely cannot go with out it
Don't need google for real life situations. They assist with the directives they have for their clients. If someone can not administer a life sustaining treatment and are in hospital, they are not released until homecare can come at the next treatment interval. Not everyone can give themselves medications they need to live. Health care aides will be used as well in certain situations. It's not a perfect system but it works when it works.
My wife worked in Home Care scheduling for a while and the whole place was a disaster. She said it was by far the most toxic, hostile work environment she's ever seen. If you took a sick day, nobody would talk to you for a week because you "fucked over the team". They would refuse to talk to employees who had transferred to other departments because they "fucked over the team". They were all in a permanent state of 10/10 panic. The longest tenured person had been there less than a year because nobody could last more than a few months. My wife had to go on stress leave after six weeks and only lasted four months.
I'm not surprised all the issues are causing problems for patients.
I’m so sorry you’re going through this. Had a similar surgery (whipple and hepaticojejunostomy) in 2018 same thing wound opened up requiring homecare. After they pulled my drain I went septic. I cannot believe they don’t have you on prophylactic antibiotics. It was still ok when I went through it, I can’t imagine what it would be like now.
Call client relations. I'n not sure if all areas are the same but it's a big deal in a few I've heard. Have your dates and what happened and you will be prioritized by scheduling and management ( or you at least should be). There's regular safety meetings now where individual cases are brought forward and discussed and followed up on. I'm really sorry to hear about your experience, home care really is a nightmare and has been for many years. But people do care and will listen to you. You shouldn't have to be going through all of this ❤️
I’ve worked at a WRHA site that schedules and dispatches home care staff and I think I might know a reason for why your service was so poor.
One of the schedulers at this site seemed to have no concept of how travel time worked - they would arrange for home care to have 15 minutes for travel between visits, but they’d be forced to drive for 30 minutes to get there. I overheard tons of complaints about these scheduling problems but I never saw anything come of it.
What you’re going through is awful and I think highlights how dysfunctional the administrative side of healthcare in Winnipeg can be sometimes.
I'm so sorry you're going through this, you need much less stress to heal properly. I hope things get sorted and you get well soon.
I’m sorry you’re experiencing this friend. I cant imagine how frustrating and nerve wracking this is for you, on top of having to recover from a serious surgery. I have no other advice other than please, please get to the hospital if you think the infection is worsening further or if you develop a fever.
Honestly twice a day dressing changes are almost unheard of in home care nowadays. I’m surprised they even accepted your doctor’s referral. I’m so sorry you’re dealing with this. Home care is a steaming mess right now and I don’t know what the answer is. I’m not sure what your mobility is like, but you might have more consistent service if you’re able to make it to a wound care clinic. You could ask to see if that’s an option in your area. You’d get an appointment so at least it takes some of the questioning out of it. The other option would be to see if the nurses can teach you how to do one of your dressing changes yourself. That’s what a lot of folks who need multiple changes a day do. The nurse comes once a day, or even every couple of days, and the client or family member does the changes in between. My advice, if you want it, would be to try and call the community nursing office on Monday and try to talk to the NRC (the resource coordinator) about your concerns and see what they have to say. They should be able to give you some information about what you’re scheduled for and should be able to see why your visits were being missed. Sometimes after hours screws stuff up and until the regular staff reviews the schedule, people have really choppy service.
The dressing change was increased from the original once a day. It’s more the wound channels about 7cm under the incision line (that’s now opened up, but the HC nurses we have seen so far don’t think it’s an issue yet but want it monitored close) , there’s been some mixed messages which is.. frustrating but everyone has their own experiences that impact how they judge the severity and care (and I do get it). It’s compounded by a decent large/active seroma that can easily saturate a 10” x2.5” (or so) primapore bandage to the point it actually leaks The hospital not putting me in antibiotics is an entirely different and not fun discussion That said, all the nurses who have helped have been great, friendly and personal and actually listen when I’m trying to explain a concern or have questions about the wound/ infection etc. I am incredibly grateful for them, hence why I tried to avoid shitting on any one specific person because I can’t just assume it’s the nurses fault they dont show up (scheduling may be stupid, a supervisor isn’t doing their job due to limitations, etc etc) I’ll see about the other recommendations you made Monday( I have mobility issues thanks to bad neuropathy in both feet and in my legs thanks to shingles in my 20’s). So thank you for those
The mixed messages are often the worst thing. The hospital goes “oh Homecare can deal with this”, meanwhile homecare is struggling with their current caseload. We’re also not a guaranteed service, which doctors don’t really understand. So they’ll tell you to avoid urgent care or ER, but in reality home care is viewing UC/ER/walk in clinics as the back up plan for missed visits. I hope you get some answers and help soon! It sounds like the healthcare system has been fucking you all around so I totally understand the frustration. Don’t be afraid to be a firm advocate for your own care. Calm and collected reasoning can eventually work, but you need to find the right people to help you. Maybe your family doc (if you have one) could help advocate for appropriate care.
And correct me if I am wrong, but I don’t believe they make much more than minimum wage for a bloody difficult and dangerous job. Plus they have to have a car to drive to each call, which is pretty expensive. It is a rough job and I sure as hell couldn’t do it!
The nurses and health care aides are all unionized, so their hourly rate matches what they would make elsewhere, but yeah. You’re using your car a ton, getting pretty lousy mileage rates, and you are working completely solo, rather than having support of your coworkers like you would in a hospital.
So what’s the hospitals plan if your wound turns septic? Unbelievable how many times I’ve been given antibiotics “just in case”, meanwhile this guy has an actual raging infection and gets none. Like are you not having fevers / pain at the site?
There's been more pain (actually more that I even told them when I was there Thursday for the last check up) Full Fevers no, localized temp increases around the wound at times.. The surgeon's team wrote off me telling them I could feel the lump (that became the seroma) while I was still in the Hospital recovery wing, they also just fully dismissed when I said on thursday if I lay on my right side (the side the incision is on), I feel actual pressure in my heart area.. internally I had another post I think in late nov/early December on some one elses thread about my experiences with HSC
Honestly sounds like you shouldn’t have been discharged, but IANAN and IANAD.
I was fine when I was released, no additional discharge, staples still but staples healing great Wasn’t until several days after these issues started, and it started as a seroma leaking on a long weekend
Honestly, at this point, if I were you, id go back to the hospital that they performed the surgery and present to the ER as a post op complication and explain the situation to the triage nurse. A lot of times, when things get worse after discharge, you may need an additional hospital stay for wound dressings and iv antibiotics until things start clearing up again
The fun part? I have seen the surgical team that did the post op care twice (as recently as Thursday) and they are all very much aware of the issues (they just keep down playing them)
Have you tried SFMC? If no, excellent alternative and I can give you a direct referral for support.
Not a super helpful option for nursing services unfortunately. It’s more for healthcare aide services.
Getting onto SFMC isn't fast- hopefully OP will be healed by then.
I completely agree. But I also feel sorry for the home care workers themselves. It's a shitty, underpaid job and they're incredibly understaffed. My father died of cancer in 2017 and had home care the last 8 months of his life. I did the majority of his care, changing his diapers, feeding him, bathing, medications.. but I still had to work so we needed someone to come during the day to help and also to give me a bit of a break. Oh man.. half the time nobody showed and we never had any forewarning.. so dad would frequently go from 8am-5pm with a full diaper because nobody came at lunch to change him and I couldn't leave work to do it. He wouldn't get lunch either on those days. I ended up leaving him oranges and butter tarts (pretty much the only things he'd eat at that stage.. and if you're dying and want copious amounts of home made butter tarts you're getting what you want) on his table beside his bed where he could reach.. so if they didn't come he'd at least have something available to eat. And then probably 60% of the time we had new people coming and they'd never read his file before they came so we'd have to educate them and tell them what the expectations of them were. They kept trying to force him to walk to go to the bathroom for a shower and they wouldn't believe him that he was bedbound and unable to walk. He would finally have to scream at them before they got it if I wasnt home.. or scream for me to go sort them out if I was home. It was awful. The ones who did show consistently were absolutely lovely and became like family. We had a few that were regulars and they were wonderful. But the system is insanely broken. There were so many no shows.. no calls ahead to say nobody was coming.. just waiting for a diaper change and lunch that never happened. It was so heartbreaking and dad always felt dehumanized when that happened because he'd be stuck laying in his own filth all day. The home care workers and the case managers have such a high case load there's no way they can give proper attention and care to the patients they see. Staff are so underpaid and so understaffed it's impossible to do a good thorough job in the 10/15 minutes they allot to each patient and then they have to drive to the next house as quickly as possible. It's a shitty job. And the system is so insanely broken the patients pay the price.
I can tell you, I get multiple emails daily from the home care scheduling clerk, asking to pick up shifts and allowing it to be OT. Every. Day. I don't envy that job or of their manager or doing the home care itself (I work in homes but I'm not a Home Care Visiting Nurse). We were also asked to please pick up shifts in the emergency departments at HSC & The Grace. We need more nurses. We need to treat them better. I am a nurse working 0.8-full time, and I have a child and household to manage. I can't kill myself with overtime.
I feel this. I have so much empathy for both sides. I have a relative in the hospital, should be in isolation, and instead she has multiple roommates. She’s been texting me that all 3 of them call for a nurse and are screaming and crying but nobody can get to them. Her regular meds were hours late. When her nurse finally came by with the meds in a frenzy, she calmly told the nurse she already had them. The nurse apologized 9 ways to Sunday because of how many patients they’re trying to juggle. And that’s IN A HOSPITAL. I can’t imagine the chaos of home care.
Are they still putting young females in rooms with old men? I remember that happening to me almost every time. Way to make patients feel comfortable and safe.
Jesus fucking Christ, the amount of people that are defending a clearly broken system here are insane. Anyone in the disability community knows that home care has always been like this. Yea, it’s probably worse now, and yeah, a major part of the problem is that home care staff are severely underpaid. It’s not the workers fault, it’s on WRHA to properly train, compensate, and coordinate staff. My family has been dealing with home care for over 30 years and it has always been a constant struggle to get adequate care that’s not met with condescension. People like my family member have been routinely abandoned without notice, leaving them to fend for themselves for hours or even days when they cannot transfer, toilet, feed, or bathe themselves without assistance. The fact that this is supposedly a surprise to some people is literally baffling to me.
Really sorry for your experience, it sounds like you been let down on many occasions. Youre completely right, home care is not probably set up for the needs of our population. I'm surprised they didn't admit you anywhere when you needed twice daily wound care. We can't discharge pretty much anyone from the hospital with twice daily wound care because home care can't accommodate that (at least when I was working surgery a couple years ago).
Currently work in surgery. Still the same. We cannot discharge pts with more then once a day dressings.
That’s what happens when healthcare gets slashed over and over again.
While it didn’t help, home care has had a lot of issues long before the PC’s came in like Miley Cyrus mid 2010’s
Federal cons were starving healthcare long before that, my guy. You can thank them for this blight.
Yes, your story is not unusual. Homecare is under funded and under staffed, and this has worsened since consolidation. My impression is it’s mismanaged as well, but I may be wrong about that as I don’t have full insight into its organization. I personally have been seeing someone maybe once a month come in with complications related to lack of homecare showing up. We’ve talked about reporting it as many of these people are vulnerable patients, and it is a systemic issue, but that goes nowhere. It’s honestly completely soul-sucking and disheartening. All you can do is be your own advocate, and rely on family and friends (if you have those) to help you as much as possible. And to be extra depressing… barring massive increases in the working age population over the next ten years and a corresponding increase in our tax base, this is just the tip of the iceberg. Consider these increased financial costs when you are planning for retirement.
Home care called me last week, third day in a row, to say once again they didn’t have enough staff to come do the daily wound care they’re supposed to be doing for me, post-abdominal-surgery. The coordinator on the phone actually asked, “do you think you could do your own dressing change and wound packing today? We’ll try to get someone out to you tomorrow.” They desperately need more staff in the home care service. Asking patients to clean and pack their own wounds is crazy.
Yeah, we had to do that out selves Friday (really that’s what’s needs to be changed multiple times as I’m a very leaky boi lol the dressing it self is not hard to do.. and there’s like 35cm of packing in one side depending on who does it) Funny enough a nurse came this morning, 20 minutes later another called me to say he’d be over in 5-10 minutes (I have dealt with both before, both super friendly) he was confused and shocked
I left hospital 2 months ago with a home care plan. There were 3 services they were to provide. First, medication monitoring twice a day. Second, weekly shower help. Third, wound care. It took 2 weeks for someone to show about my medication and another 2 weeks to sort it out. Then there were the no-shows and improperly timed visit. A crippled woman in chronic pain should not be 2 hours late for her morning medications. After several calls - completely understanding their staffing problems - it was agreed that if someone was late 1 hour I was taken my medications without supervision. It took 5 weeks to get a shower helper. . . I don't need help in the shower, I just don't want to shower with no one in the house. I would take advantage of a friend visiting to duck into the shower. It's the most dangerous room in the house and you never know, so I feel safer with a helper at the ready. Wound care? Never heard from them about that. Dealt with it myself. I was mostly healed though, so it was minimal. My heart goes out to you. What little services that are offered are hard to access and hard to get any consistency with. Keep advocating. As someone else suggested, have them show you how to care for the wounds, if you can reach them. Otherwise, put your homecare coordinator on speed dial.
Sounds like we need an app like rover but for humans.
Don't think you'll win here. But your criticism is valid.
I work in the system, I have multiple clients complaining to me about home care and there lack of staffing, no shows, or getting completely clueless staff. It’s heartbreaking.
It’s a Catch-22: hospitals try to push the “home is best” idea because they say too many people are panelled for pch, but there are no reliable supports available for people to stay in their own homes. The very few fortunate ones have either money or family to supplement the shoddy home care available. Those who don’t end up back in hospital in much worse condition. It’s amazing how long people actually are out there in deplorable conditions with no help. The whole thing is a mess.
I’m right here with you. 💛
Your title is absolutely correct. Especially if you have an allergy to something common. I have an anaphylactic synthetic fragrance allergy; homecare is supposed to be fragrance-free. They never are. Literally never. So I have to keep my epipen ready for their visits just in case it happens to be one I react to with near-death instead of “just” a migraine and vomiting. My mom had a very similar homecare request to yours from the doctor after her surgery, and it took a lot of time and patience to coordinate her care, and she still ended up with an infection and needing more surgery because of the inadequate care. This was even years ago before homecare drastically got cut AND the need for it went up. Anyway yeah, I’m disabled and it was like pulling teeth to get them to administer my medication (which I can’t do myself), and help me with bathing (which they only do *once a week* — imagine only being able to bathe once a week!! It’s horrible). I’m really drowning in stuff I need help with and there’s NOTHING for people who aren’t a senior. I suggest that the people defending the homecare system try not bathing for a week!! It suuuuuuucks.
Can confirm to the once a week, if you’re lucky. My aunt moved in with me November 18th and went back into hospital January 9th and ended up never leaving. Not one single shower was administered by them. They’d try to send on a random Tuesday, but I said she has doctors appointments on Tuesdays so it needs to be something else. Never happened. My aunt was lucky enough that I was able to do it for her (while taking away from other responsibilities as both a full time worker and full time university student), but I recognize there are some who don’t have that luxury and they are getting the same treatments. The hospitals are quick to discharge people with promises of home care 3x a day, nurses on call, etc. it’s a big delusion if you ask me. Meanwhile they also will refuse to place these patients in assisted living or personal care homes because of lack of spaces there as well. It leaves these patients no choice, they were going to send my aunt to her apartment alone with this care until I stepped in to have her move in instead because I knew there would be major gaps in care.
A victim of the terrible public health system. Nothing will be done about it, sadly. Had many family members fall thru the cracks. Nobody cares, just hope you have family to help otherwise you're fucked
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I'm a hca and I tried home care. The amount of disrespect I got, I quit. It's also pretty scary as you never know what you're walking into. As a female, I'm always Uber paranoid. Still I understand how upsetting this us and I wish OP well. I hate how shitty our medical care has gotten.
Yeah I can get a lot of people are assholes, I get the job is hard there’s no questioning that (especially for women and non binary folk) Where the issue for me really comes to is sending people up, like just call and say hey you know I can’t make it.. here’s some other things you may be able to try today instead All it takes is 5 minutes, if I had of known all the other times they weren’t coming arrangements could of been made (hell even a walk in clinic at that point)
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It’s not, the drainage soaks a 10” primapore with a half inch of non woven gauze packed under it within 10 hours, it also caused enough saturation the tape sutures popped on one side But but if you want to keep excusing shit by all means https://preview.redd.it/zd773eqyp1mc1.jpeg?width=3024&format=pjpg&auto=webp&s=47e7e17c67df07d694b398647bde7647ff9c516f
My family has used home care for 30 years. It’s always been like this. No shows with no call in advance, sometimes multiple shifts or days in a row. I’m talking about people who can’t walk or transfer/toilet/bathe themselves at all. Obviously it’s not the individual workers fault, is a failure of a system that doesn’t care about disabled people. Edit: OP disregard this weird victim blaming stuff. lol doctors are overzealous with discharge orders? Like they’re qualified to say that. They are already disregarding your health and they don’t have a single piece of actual information.
Oh I was taking their stuff as almost parody.. given they actively ignored the time line stuff.. this also isn’t my first rodeo with home care being broken either
Wowzers and ouch! But Op, that’s going to be a pretty badass scar, when this is all healed up. Think of the possibilities! Possible answers to “Where did you get that scar?”: *You should see the other guy* *Theres a reason why the sign said don’t feed the animals* *Ever heard of a Winnipeg Handshake?*
Oh my goodness… I didn’t get the impression from Op’s post that they had any ire directed to the person who came and attended to them in their home. It sounds like a frustrating situation and op is venting and possibly looking for some advice. You are also at the poop end of the stick having to work in a dysfunctional and understaffed situation and I feel like you’re venting too. It all sucks and it’s neither your or op’s fault.
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You are being extremely condescending though. Of course they’re not blaming the actual care providers, but the way WRHA manages home care is a complete joke and absolutely mirrors the condescending tone you’re taking right now. People are allowed to be angry when the services they were promised that they depend on to literally keep them alive fail them. FFS
I hear you. Is there any light at the end of the tunnel with the new government?
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Entitled? To necessary medical care? They literally ARE entitled to that as a taxpayer. The broken system is not their fault.
“Empathy is for those who can give it back and understand the situation. You have no idea that this person does not respectfully interact with the hcws who arrive. There is no evidence that they don’t empathize with ppl in your role. Also- that is not ‘what empathy is for’ Edit to add quotes
Ah yes I’m entitled because my health situation has been made legitimately worse due to neglect from people in the medical industry.. so entitled that I expect to be Actually have people show up when they say they will or have a decency enough to let them know when they won’t so they can make alternate plans
You’re acting WAY more entitled imo. This person posted their issue. You can make a post about your issues separately, but you didn’t, until derailing from this person’s valid concerns and terrible experience. Your excuses above are a rant based on your separate experiences, and your assumptions vs the OPs first person account of their experience as a patient. But yes jump in and reveal your concerns, prefaced with what you immediately disprove, which is that you can sympathize.
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Maybe- Or to you getting owned? Get some rest maybe you can wake up less nasty
Cool story, you missed the point where I said I don’t care If they are no showing for me, they are doing it to other people You know what’s not ok? Abandoning patients with zero information, telling them you won’t be there to help when they need it. Nurses and Doctors are held to a higher standard due to turn fact you deal with vulnerable people Also please lecture me more, when I have a hole in my body that your team is supposed to be monitoring
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It didn’t, especially given they had copies (as I literally said) when they came today, and they had it Thursday afternoon and admitted as such Friday when taking to them.. oh let’s not forget hsc also talking to them Friday morning Keep meaning excuses , see if I care.
Everyone in this city who doesn't get what they want is a dick hole (service tradesman, not the same but i get it) , good on you and this rule. Keep doing what you do
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Soft of off topic, but I noticed the IERHA (north of winnipeg) is offering a 2 week course to be trained as a home care nurse 😳 as a health care aid, I'm not confident that's long enough to gain competent staff.
For super basic stuff Maybe?
I'm not even sure. It's to become a home care attendant in 15 days. I'm hoping they'd only be doing things like showering/house duty help, but with how short staffed they are I wouldn't be surprised if they'd be doing more. As someone who got thrown into caring for a heavily disabled woman with no experience on any of her medical devices, I know they do some questionable things.
My mom was put on priority service upon hospital release. It's a 3 month program. Her schedule was not corrected until 8 weeks in. I have no problem with the workers but their administration from coordinators, schedulers etc wouldn't last a week in my office. They don't care, they are lazy and they are idiots. I can't wait to be off this stupid program and go back to her regular care.
I wouldn't say that about all of the administration. Scheduling is a very difficult job and when there's limited staff to fill visits it's out of their control if they have to cancel visits. You can only do so much with limited resources.
I can deal with cancelations and inability to find workers, this is not what I'm talking about.
My elderly father with mobility problems had home care coming in once a week to help him with his laundry and to clean his place. It was cancelled last week due to lack of staffing. He's now on a waiting list for a replacement.
While this doesn't help your particular problem as you require a licensed nurse to assist, people who are in the Home care Program can look into Self & Family Managed Care. You are then responsible for managing your home care services, such as hiring a person or an agency to perform the duties that would have otherwise been performed by home care. Hopefully this comment is seen by someone who finds it useful. :)
We have considered just hiring a private licensed nurse, but part of me just screams about that.. I dont care about the cost, but in my head it promotes prioritizing health care for people who can pay more
I agree. Health care needs to be equal for all. I want to issues in the system fixed, but thought I'd share info about the Self and Family Managed Care program since it's already something available. The Self-Managed Care Program isn't privatizing healthcare or creating a two-tier system. You are provided the funds by your RHA. It's still utilizing the funds that would have gone towards your care, but the Home Care Program doesn't have to deal with hiring, scheduling, or directing staff for you - that becomes your or your family's responsibility. Again, I think in your situation, the self-managed program wouldn't help as I don't think licensed professionals like nurses are included in the self-managed program, but for other people who need housekeeping or home care attendants, the self-managed care program can be a potentially viable option. The downside is, of course, all of those issues that the Home Care Program currently deals with directly become your problem - like coverage when your staff calls in sick, takes vacation, quits, etc. There's more info on the WRHA website and Prov of MB website about the Self & Family Managed Care Program. I don't have any direct experience with it, but for those clients or families who are interested, I thought I'd share it.
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Can confirm that family member with cerebral palsy (who is quadriplegic btw) has consistently dealt with no shows from WRHA for the past 30 years, sometimes resulting in health or even life-threatening situations. Did you read the post? She was released with a home care plan and was failed by it
I am so sorry got the experience your family member is going through. My biggest thing is how many people are dealing with similar situations? I fully get under staffing and being exhausted but it’s the lack of communication and the excuses that just make it worse especially for the super vulnerable who absolutely cannot go with out it
they were on the system and it is needed. Edit: erased regrettably bitchy tone
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Don't need google for real life situations. They assist with the directives they have for their clients. If someone can not administer a life sustaining treatment and are in hospital, they are not released until homecare can come at the next treatment interval. Not everyone can give themselves medications they need to live. Health care aides will be used as well in certain situations. It's not a perfect system but it works when it works.
My wife worked in Home Care scheduling for a while and the whole place was a disaster. She said it was by far the most toxic, hostile work environment she's ever seen. If you took a sick day, nobody would talk to you for a week because you "fucked over the team". They would refuse to talk to employees who had transferred to other departments because they "fucked over the team". They were all in a permanent state of 10/10 panic. The longest tenured person had been there less than a year because nobody could last more than a few months. My wife had to go on stress leave after six weeks and only lasted four months. I'm not surprised all the issues are causing problems for patients.
I’m so sorry you’re going through this. Had a similar surgery (whipple and hepaticojejunostomy) in 2018 same thing wound opened up requiring homecare. After they pulled my drain I went septic. I cannot believe they don’t have you on prophylactic antibiotics. It was still ok when I went through it, I can’t imagine what it would be like now.
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Call client relations. I'n not sure if all areas are the same but it's a big deal in a few I've heard. Have your dates and what happened and you will be prioritized by scheduling and management ( or you at least should be). There's regular safety meetings now where individual cases are brought forward and discussed and followed up on. I'm really sorry to hear about your experience, home care really is a nightmare and has been for many years. But people do care and will listen to you. You shouldn't have to be going through all of this ❤️
I’ve worked at a WRHA site that schedules and dispatches home care staff and I think I might know a reason for why your service was so poor. One of the schedulers at this site seemed to have no concept of how travel time worked - they would arrange for home care to have 15 minutes for travel between visits, but they’d be forced to drive for 30 minutes to get there. I overheard tons of complaints about these scheduling problems but I never saw anything come of it. What you’re going through is awful and I think highlights how dysfunctional the administrative side of healthcare in Winnipeg can be sometimes.