A day in the life of a Daughterly Care private Registered Nurse for home
Since January 2015, Daughterly Care has had 2 private Registered Nurses (We’ve always had a team of part-time and full-time private in home Registered Nurses).
This is how they have been helping our private in home care clients (Welcome to the life of private inhome Registered Nurse).
Complex Wound Care (which other nursing agencies refused to return to)
This is a photo of a chronic vascular venous ulcer caused by poor circulation that Daughterly Care’s Private Nursing Services were engaged to treat. The wound required to be dressed 3 times a week after a number of private and public nursing agencies had refused to return to the private elderly client.
They had refused to treat the wound because the private care client had a mental illness, plus the adult child (who lived with the in home care client) had a mental illness as well.
We are fortunate that our private in home Registered Nurse, Jennifer (Jenny) Smith has a Masters of Social Work (so she is well versed in how to relate to people) and has an Advanced Diploma in Mental Health.
It’s a miracle this wound is healing at all, given that:
- the elderly client and adult child do not follow the medical advice of Registered Nurses or General Practitioners or Doctors;
- some days it is difficult, just to get into the home and then to be allowed to dress the ulcer;
- due to the private client’s mental illness, the client will not take antibiotics believing people are trying to kill the client;
- the elderly client scratches and picks the ulcer, and has poor hygiene which continually re-infects the wound;
- the wound is infected with Staphylococcus Aureus (a highly contagious, strongly resistant bacteria most prevalent in hospitals) making it even slower to heal;
- food is medicine and this client has a very poor diet;
- the in home client unwraps our dressings and re-dresses the ulcer on days we are not there because the client ‘knows all about wound care’; and
- the elder care client will not walk to improve circulation.
Yes, everything is working against this wound to heal. Everything except our private Registered Nurses, Jenny and Verlie’s determination for this wound to heal.
If we had our way the in home care client would be in hospital, on IV-antibiotics, eating nutritious, high protein with lots of vegetables type of meals and walking to improve blood circulation for faster healing.
Due to the client’s ‘non-compliance’, the ulcer started to break down, plus secondary and tertiary ulcers started underneath the main ulcer so our best in home care nurses, Verlie and Jenny decided to seek advice from the Wound Care Specialist at St Vincent’s Hospital. This allowed them to assess the wound in the private client’s home and give specialist advice on how we could hasten healing given the difficult circumstances.
A couple of months later Jenny requested a Case Management Review of the wound with the same Wound Specialist and the client’s doctor (GP). This home nursing care support enabled them to determine whether the in home private care client needed to go to hospital to receive IV-antibiotics and be in an environment where a better diet and infection control could be accomplished.
Facing the prospect of hospitalisation, the client promised to become more compliant with hygiene advice and since then the wound has started to heal, as you can see in the photo above. The wound still has some way to go… but it is finally healing.
Teaching our Caregiver to monitor blood pressure
Our Pay by the Hour private client lives happily alone and enjoys a good life including enjoyable outings with our carer companion. Her only child lives overseas.
Our private in home care Registered Nurse, Jenny popped in to teach our Hourly Carer how to take the client’s blood pressure on each service. The blood pressure machine sends the results to the private care client’s doctor electronically, each time it is taken so the doctor can monitor the client’s blood pressure too. Our private nurse, Jenny sends an email to inform the client’s daughter that our in home carer has been trained and the details of the blood pressure results for each visit.
Our private livein Care client was not feeling well, due to constipation caused by pain relief she had been taking. Constipation can make you feel really poor. It can be painful, make you sweat, shake and feel nauseous. Our private care Registered Nurse, Jenny drove to the client’s home and checked the client’s stomach to feel if she had a blocked bowel as this would require more aggressive treatment.
There was no blockage so Jenny massaged her stomach to encourage movement of the bowel and gave the private nursing care client some Movicol (a gentle bowel stimulant) which she had bought for the in home care client. Our client soon felt well again.
Removing stitches from the private care client
Our live-in Care client was due to return to the doctor to have stitches removed from his face. He was not feeling well that day (he is breathless and on oxygen so just getting to the doctor’s clinic required a big effort). To add to the difficulty, it was pouring rain so our in home care Registered Nurse, Jenny drove to his home and removed the stitches for him. This made his day, a lot easier and was very appreciative that our in home care Registered Nurse was able to treat his wound.
Assisting our private nursing carers to provide quality End of Life care
A private Pay by the Hour client who we have cared for over a number of years in Rose bay, on Sydney’s Eastern Suburbs was receiving End of Life care from Daughterly Care. To make our client more comfortable and our carer’s work safer, our private Registered Nurse, Jenny popped in to assist the client to prepare for bed, as well as to be bathed and turned. The private in home care client sleeps on the best airflow mattress to prevent pressure sores, which was recommended by our wonderful private Registered Nurse.
Registered Nurse & Clinical Management,
Jennifer (Jenny) Smith
Registered Nurse & Managing Director,
Client in hospital and refusing to eat
A Hourly in home care client was in hospital after an unusually rapid decline. Her daughter was very concerned that her mother had refused to open her eyes and to eat for a couple of days.
Our private Registered Nurse and Managing Director, Verlie visited the private nursing client in hospital. By talking about Forster which is where the client and Verlie had both lived, Verlie was able to connect with the client. The private nursing client opened her eyes, connected with Verlie and then began to eat with confidence.
Client returning home from rehabilitation therapy in the hospital
We receive a late afternoon phone call, requesting assistance with showering for the following morning. The gentleman is leaving the hospital, after being in rehabilitation. Rather than send a in home carer, Daughterly Care sent our private Registered Nurse and our Managing Director, Verlie to carry-out the service. This allows us to professionally assess the private nursing client’s mobility, Work Health and Safety (WH & S) risks and a thorough indication of their in home care needs.
When our Private Nurses start a new service, they write the Care Plan and choose the appropriate in home carer for the on-going services. If it takes a few days to “lock in” an on-going in home carer, our Registered Nurse does the first couple of services to provide consistency of care. We don’t charge the Registered Nurse fee, just the usual private carer rate.
Organise ACAT assessment and attend assessment
A new elderly client in her 90s does not have children living in Sydney and is legally blind. After visiting the private aged care client at her home, Verlie (Our Registered Nurse) offered to organise an assessment by the Aged Care Assessment Team (ACAT) and attended the ACAT Assessment to ensure the Assessor thoroughly understood her in home care needs.
The in home nursing care client asked the ACAT Assessor to send a copy of the ACAT Assessment to Nurse Verlie so she could read it to the client over the phone. A copy wasn’t sent to Nurse Verlie so she visited the private nursing care client and read the assessment to the elderly client. The next step forward was Daughterly Care organising a Government Subsidised In Home Care Package.
First visit for prospective clients
In between clinical nursing visits for our existing elderly clients, our private care Registered Nurses now visits potential clients. They answer questions about the way Daughterly Care works and whether we are the right aged care provider for them or their loved one.
Other roles Daughterly Care Registered Nurses do:
- Transport the private care client to equipment hire / buy shop and help select appropriate home assistance equipment to make living at home safer and easier; and
- Provide personal clinical or general in home care advice on incontinent pads that will work better for the private aged care client.
Why we have introduced private aged care Registered Nurses
We studied an evidence-based model of nursing care overseas and have found that when you combine professional Nurses with exceptional in home carers, the proven outcome is a higher quality of health for elderly clients. This means, a reduced number of hospital admissions and a healthy, improved lifestyle.
We don’t change existing elderly private care clients who require one-off in home aged care nursing services
Daughterly Care recommends private care or Government funded elderly clients continue working with the free and low cost Nursing Services already in place for them such as DVA Nursing, Community Nursing Services and Palliative Care Nursing Services. This approach is the most cost effective and maintains consistency of in home nurse care.
In the event, in home services cannot be accessed in a sufficiently timely manner then Daughterly Care’s Registered Nurses are available to provide private in home nurse care.