# Tipping the nurses



## Moneytoo (Mar 26, 2014)

I'm posting this in a General Discussion because I need an advice, but apologies in advance if it's more of a Hot Button topic. Last week my mom was diagnosed with a terminal brain cancer and is currently undergoing radiation treatment. I think we're still in denial about the prognosis (as she went from a healthy independent woman in her late 60's to a half-paralyzed invalid in a matter of 3 weeks), so are focusing on how to make whatever time she has left as comfortable as possible while saving her dignity.

In over 20 years in Canada this is our first close encounter with the health system, so I don't have any personal experience - and whomever I asked (starting with my daughter, who's the first year medical student), the answer was no, the nurses are not allowed to take cash or gifts. Yet I gave a $20 to ER nurse (after my mom was admitted and moved to the hospital room) and a box of chocolates to the nicest hospital nurse (who said that she'll share it "with the girls") The first nurse said I shouldn't do it, but accepted (we hugged and thanked each other), and I heard the second one saying, "Score! I got chocolates!" at the nursing station.

Now, we have a nasty night nurse. Last night she turned off the heat (and it was a rather cold night), and when my mom and her neighbour (who's got about 3 weeks to live) got cold, woke up and called her - told them that it's warm enough, and since it's just her on the whole floor - she won't be taking them pee or give them bedpans, so they peed themselves. And laid there wet and cold until the morning nurse changed them. They complained to the other nurses and their doctor, and were offered diapers for this night (same night nurse's shift)

Back home I would just give every nurse some cash and wouldn't worry about such a silly thing while my mom is fighting for her life. And I won't even ask how come I was able to learn in a day how to get my mom in the wheelchair, to the washroom and out of the wheelchair - by myself - yet they need 2-3 people to do the same at the hospital. They do have some nice and compassionate (and mostly professional) people there, and I understand that they're understaffed and overworked. So the questions are:

- Is it expected by night shift nurses to be paid for every washroom visit? (I.e. was turning off the heat some kind of a hint?)
- What's a customary "thank you" tip or present? (other than chocolates - I'll get a few boxes tomorrow, but there's one male nurse there, dunno what to get him...)

(And yes, I did find a PCW to help out on the first brutal night - she just didn't show up; and no, I'm not ready to take more time off work just yet to do it myself - I'm sure we haven't seen the worst yet, so coming every night after work for a couple hours for now...)


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## indexxx (Oct 31, 2011)

I think the chocolates are a nice touch, but cash seems kind of inappropriate to give a nurse. I've never heard of it happening and I'm sure the hospital administration as well as the provincial health authorities would deem it not appropriate also.


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## Moneytoo (Mar 26, 2014)

I forgot to mention that I also did some googling, found this old US thread, with the opinion that made me question "the common knowledge":

"*Always tip the nursing staff. Remember, they are under no obligation to make your mother comfortable. 

Only a cheap jerk wouldn't tip a nurse.*"

(I.e. I wouldn't want my mom suffer 'cause I was a cheap jerk who didn't tip a nurse for the extra care that she needs...)


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## sags (May 15, 2010)

My wife worked in hospitals for decades as nurse. The staff wouldn't even consider accepting a "gift" from a patient or their family.

To do so would be very unprofessional and it would be grounds for dismissal.

What you are encountering is the end result of squeezed hospital budgets. 

When my wife worked they had full staff working 12 hours shifts........7 to 7. They had several nurses, RNAs, and an orderly on the shift.

Now they have one nurse, and they often have to decide which patient needs their attention more.

I don't know why they can't supply a bedpan or perhaps consider a catheter though. 

I would suggest taking in a heavy warm blanket for your mom, maybe an Ipod so she can listen to her favorite music and a picture of the family. 

My dad suffered a brain tumor and the cancer had spread. It happens quickly and the prognosis is not good.

He spent time in the hospital, radiation therapy and rehab workouts...........but suffered continual strokes and then they talked to us about a hospice.

The hospice was a special kind of place The staff are there to specifically look after the patient needs. It is a much more comfortable setting for everyone.

Dad had a private room, much like a nice bedroom with a patio door that overlooked the countryside. He had a tv, radio and volunteers who came in to talk and read with him.

Almost to the end he enjoyed his Blue Jay baseball games and CNN and he became close to a Salvation Army lady who read the Bible with him a couple nights a week

When he passed in the middle of the night, the staff formed an honor guard along the hallway as he was brought out. Some of the volunteers attended his memorial service, where I was able to thank them for all they had done for Dad and for our family.

God Bless the volunteers...........

The nursing staff were excellent, and they cater the meals to the patient. Dad couldn't swallow very well, so they made his favorite soups and puddings for him from a regular kitchen area.

I would suggest you investigate a hospice in your area to see which would be the best one.

It is going to be a trying time for you and you will need some help. 

I wish you the best.


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## Moneytoo (Mar 26, 2014)

sags said:


> I would suggest you investigate a hospice in your area to see which would be the best one.
> 
> It is going to be a trying time for you and I wish you the best.


The oncologist told us right off the bat that if radiology doesn't work (since the cancer is too agressive and might keep spreading - and it's inoperable since it's too deep), we'll need "palliative care". But my mom said she prefers to die at home, so I made arrangements at work to take an unpaid leave on a short notice - and hopefully will be able to find two or three reliable private nurses... I'll think about it next week (if it's doable) - when her 10 radiation sessions are over and we know if it worked or not... This week we're hoping for the best - at least she stopped getting worse every day...

Thank you... I wasn't prepared for this at all - but I hear nobody is...


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## heyjude (May 16, 2009)

I'm so sorry to hear about your mother. If her prognosis is poor, ask for a consultation with Palliative Care as soon as possible. In some cities, the Palliative Care department can provide services at home. 

Nurses receive edible gifts all the time, but tipping them is not culturally appropriate in Canada. Giving a monetary gift to an individual nurse would create an ethical dilemma for him or her, which (s)he would likely need to discuss with his/her supervisor. 

Your mother's nursing care seems to be inconsistent. My suggestion would be to ask to speak with the Nurse Manager of the unit. Explain how grateful you are for the good care (and mention names) and tactfully mention that there are some areas where improvement is needed. A good Nurse Manager will value your input and act on your concerns. If you wish to show appreciation, ask the Nurse Manager what would be most appreciated by the nursing staff. It's very likely that he or she might suggest a contribution to the nurses' education fund. Maybe your favourite nurse might get chosen to attend a conference.

BTW, I am a retired physician.


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## Eclectic12 (Oct 20, 2010)

Moneytoo said:


> ... In over 20 years in Canada this is our first close encounter with the health system, so I don't have any personal experience - and whomever I asked (starting with my daughter, who's the first year medical student), the answer was no, the nurses are not allowed to take cash or gifts.


The nurses taking care of my mom in London refused cash but gratefully accepted the donations of things like flashlights and stuff the ward was short of. It was all added to the rooms on the wards and after leaving the hospital then returning about a year later, my sister noticed everything was still in use.

Food donations (oranges or chocolates) were accepted/shared.


The local hospital might have a different policy though.




Moneytoo said:


> ... They complained to the other nurses and their doctor, and were offered diapers for this night (same night nurse's shift)


The doctor was okay with this? Bizarre

If the doctor is okay with it, I suspect it is more than a "nurse issue".




Moneytoo said:


> ... - Is it expected by night shift nurses to be paid for every washroom visit? (I.e. was turning off the heat some kind of a hint?)


Not that I have heard of or seen ... I also haven't seen money accepted but other items.


Cheers


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## Userkare (Nov 17, 2014)

Once I spent a few days in the hospital for a gallbladder operation; the nursing staff was fantastic. I had a roommate who was a real joker, so the nurses spent a lot of their break-time in our room chatting with us. After I was discharged, I sent a bouquet of flowers to the nursing station on the floor. I didn't see any problem with that; I was already gone, so no chance of it being perceived as a bribe, or tip for better service. It was simply a thank-you.

Sorry to hear about your mom. I went through something similar when my mom had a stroke; it's hard on the whole family. Nurses are people; some are in good or bad moods some of the time, some are in good moods all of the time, and some are in bad moods all of the time. You have enough to deal with without the added stress. As sags says, bring things from home to make your mom more comfortable.

Hang in there!


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## tygrus (Mar 13, 2012)

I have had a couple close encounters with the health care system in canada and there is good and some bad. The good news is because its socialized, everybody has access  The bad news is because its socialized everybody has access. Which means you have a lot of staff dedicated to dealing with people who arent that sick or are doing it to themselves, like drinking drugs and daredevil escapades. I feel for nurses and doctors having to deal with that stuff. Some nurses have gotten pretty gruff over the years. Some are still very nice. 

If your mom is terminal, why are they treating her at all.

If you are doing radiation anyway, go get proton beam in toronto or ask for the same drug Jimmy Carter had. (Keytruda) It cured his brain cancer and he is 20 years older. If you are going to make a stab to save her, use the cutting edge stuff.


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## Moneytoo (Mar 26, 2014)

Thank you all. I think I should clarify that the ER nurse whom I "tipped" was an orderly or a nurse helper - I don't know a proper term, someone who does all the dirty work - and I assume is paid the least. She helped us out when no one else was around (we spent two days in ER - yes, with some "Aw man I parted so hard and took a bit more of the stuff that I usually take" druggies), so when I saw her in the hallway the following day - a $20 was all that I had on me, so it was an impulse decision...

I read or heard from someone that it's ok to tip those who bring food. Since my mom lost the use of her right arm and needs someone to open everything for her (and pre-cut large pieces), it's an extra duty that I would gladly pay for. I help her with dinners in the evenings, but somebody else is helping her with breakfasts and lunches, usually different people, so I'm not sure what's a proper thing to do? 

Just got a call from a social worker who suggested to organize a meeting with my mom's doctor to discuss the treatment plan and our post-hospital options, so I guess it's time to start getting ready for the next chapter...


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## Davis (Nov 11, 2014)

So sorry to hear what you are going through. It's an awful time. It had never occurred to me to tip in a hospital. I would be really uncomfortable with that. Tipping medical staff like nurses would seem really wrong. Non-medical staff it just seems weird, not not as objectionable. If you are concerned about the care your mother is getting at night, you could consider hiring a "sitter". We hired one through the hospital to make sure that (a) my father stayed in bed and (b) could get to the bathroom when he wanted to. If you have the money, it could make a big difference for you mother's comfort. Ask the social worker or head nurse. I would position it as being just about your mother's comfort, and not because the care is lacking. A sitter is a low-skill, low-wage position.


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## heyjude (May 16, 2009)

tygrus said:


> If your mom is terminal, why are they treating her at all.


That is a rather abrasive comment. If the OP's mother's condition is terminal, it is time for a team meeting to plan the next steps. If her condition is indeed terminal, palliative care is the best type of treatment. Nobody is going to suggest "not treating her at all".

Edited to add: I see that a family meeting is being arranged. This is an important step, one step in a process of decision making. Sometimes several meetings are needed as the situation evolves. Bring a support person, if you wish. They should supply Kleenex....


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## tygrus (Mar 13, 2012)

heyjude said:


> That is a rather abrasive comment. If the OP's mother's condition is terminal, it is time for a team meeting to plan the next steps. If her condition is indeed terminal, palliative care is the best type of treatment. Nobody is going to suggest "not treating her at all"


It wasnt meant to be abrasive at all, just a question. I find doctors sometimes evasive. If there is no hope, why make her suffer through some hopeless treatment.

Canadian health care is good for about 65% of your ailments but the cutting edge research is not done here and we are behind the world. Many doctors are still treating people like its the 50s. 

I had an uncle travel to the states to save his own life from prostate cancer. He would have waited up 12 months for surgery here. He was in inside a month in the US. I dont condone the US system, but if you have the means they will try everything to save you if you want. And if they cant do it, they know someone who can. 

My own dad was diagnosed with stage 2 or 3 colon cancer a few years ago and he pushed the system hard to get his treatment before it had a chance to spread. He had some initial scans booked and they would take 3 months to get in. Instead he went to a private clinic and had them in a week. The doctors were then able to start his treatment months earlier.


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## Moneytoo (Mar 26, 2014)

Davis said:


> If you are concerned about the care your mother is getting at night, you could consider hiring a "sitter". We hired one through the hospital to make sure that (a) my father stayed in bed and (b) could get to the bathroom when he wanted to.


Thank you, didn't know it was an option (to hire through the hospital) Although she might refuse it as nobody visits her dying ward-mate, and they developed some kind of a camaraderie - frankly, I'm afraid that fighting against "the evil night nurse" just gave them some kind of a purpose  But will see how last night went - and maybe will hire someone who'd help them both...


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## Moneytoo (Mar 26, 2014)

heyjude said:


> Edited to add: I see that a family meeting is being arranged. This is an important step, one step in a process of decision making. Sometimes several meetings are needed as the situation evolves. Bring a support person, if you wish. They should supply Kleenex....


We had one last week, and a volunteer with a Kleenex (I shed a tear once I realized that they can't cure my mom - and begged to give her a chance anyway...) I don't think they planned to treat my mom as the first surgeon-oncologist whom we met prescribed her steroids and sent us home, the follow up meeting with her was supposed to be yesterday. If I didn't drag my mom to ER a few days later, and we didn't end up at the best cancer center in Toronto last week (as luck would have it, my daughter met with a doctor who runs it a month ago - and he was there at the initial appointment) - I think yesterday would have been too late... But for now she at least stopped getting worse, and I won't be blaming myself for the rest of my life for listening to the "doctor's orders"...


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## Moneytoo (Mar 26, 2014)

tygrus said:


> It wasnt meant to be abrasive at all, just a question. I find doctors sometimes evasive. If there is no hope, why make her suffer through some hopeless treatment.


I'm not sure if they were evasive - or just didn't know for sure (our first diagnosis last month was a mild stroke, then tumour maybe lymphoma, then glioma - as they explained, it's too dangerous to do the biopsy, so this may not be the final one, either...) And we are hopeful that at least her right arm might come back to life - but they did tell us that it's not a guarantee, and even if the cancer shrinks now - it'll come back "eventually"... Anyways, if nothing else - it's a great real-life experience for our daughter (who had neuroscience as a major in undergrad and neuro-oncology as one of the top choices for future residency - but had her doubts as those doctors are called "diagnose and adios" for a reason...)


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## tygrus (Mar 13, 2012)

That drug that Carter took has walked people back from terminal conditions with cancers that spread to multiple systems. It charges your immune system to go after it. Some have been cancer free for 4-5 years. The response is long lasting. Its been use mostly on melanoma but now its being tried in other cancers with success. Its available in Canada now too.


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## Moneytoo (Mar 26, 2014)

tygrus said:


> That drug that Carter took has walked people back from terminal conditions with cancers that spread to multiple systems.


Thank you, I'll research some more, and will ask my mom's doctor, but from the first link that popped up:



> So, the bottom line is that 18/81 subjects in this clinical trial had a response (partial or total) that lasted from 6 to 36 weeks. Seventy-six percent did not respond. The results that Mr. Carter has achieved, unfortunately, are not necessarily representative of what the typical patient can expect.
> 
> What’s more, as NBC pointed out in its coverage, there’s no way of knowing whether it’s the drug or the radiation therapy and surgery that cleared all detectable traces of President Carter’s cancer.


What the media got wrong about Jimmy Carter’s cancer “cure”

(Sorry for being sceptical, but as a smoker with 30+ years of experience - I swore to myself long time ago that if/when I get cancer, I won't become one of those crazies who run around looking for a magic cure... but maybe I'll make an exception for my mom )


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## heyjude (May 16, 2009)

Moneytoo, I'm glad you are taking a look at the evidence for yourself. Every week there is news hype about this or that "cure" and when you look a bit deeper, you find that it was simply encouraging results from a small study, or a study in mice, or that many other variables could have influenced the outcome. What's important here is respecting your mother's values and wishes, if she is able to express herself, and her advance care directive if she is not.


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## humble_pie (Jun 7, 2009)

chocolates, bouquets of flowers & $20 bills are well-intentioned but in today's medical crisis they are a bit off the mark, imho.

sags has the point: our medical systems have run down from decades of financial & social neglect. Not neglect from the medical professionals themselves, whose dedication always amazes me, but neglect from all those who should be offering the funds that medicine needs. What nurses, hospitals, medical clinics & doctors all require is massive, heavy, permanent financial support from governments & from private donors.

many cmffers are comparatively well-off. Those who have benefited from the excellent care still being offered by public health care professionals should donate to the particular hospital that helped them.

sorry, but chocolates & bouquets of flowers don't cut this biscuit. I don't mean a few dollars, i'm suggesting hundreds, in some cases thousands of $$. Any household grossing $60-70k should be able to donate at least $500 each year to a local hospital. These should be annual commitments, imho.

what i do is specifiy that the funds be divided between the nurses on the general surgical floor - where i once was a patient - & whatever research or operating projects the hospital shall choose. It's a teaching hospital - interns, residents & specialists from all over the world are trained there - so the funds benefit the medical faculties as well. 

in my city, nursing is still a highly respected profession. It's up to us - the citizens - to make sure that the profession will be able to keep its standards up, now & in the future. To put matters bluntly, nurses should be paid more. It's beyond shocking how US hospitals send recruiters up here to the annual employment fairs for new graduating nurses & these american recruiters are able to immediately attract most of a canadian graduating nursing class with their higher US salaries.

all the hospitals in my city were built & are still run to a certain extent by philanthropic donors, so there is a strong tradition here that dates back hundreds of years. Governments only joined the financial support train in the last century.

IMHO the first order of duty is to start those annual donations to the local hospital foundation, or to the nearest university medical faculty or school of nursing.

next order to to find out what your elected provincial & federal representatives are doing to ensure that quality health care be given a top priority. Make your voice known! but first, i think, each citizen has to do his or her bit to donate.

after all, it's in all of our interests, right? sooner or later, we are all going to be there, right?


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## OhGreatGuru (May 24, 2009)

To OP: you indicate your mother is in a hospital setting. Staff in hospitals in Canada are generally unionized, and the registered nurses reasonably well paid. Personal care workers and personal service workers (which you may be mistaking for "nurses") get paid a lot less. But in a hospital it would still be unusual to be expected to tip them. Perhaps in other care facilities.

If your mother is being treated badly at night, complaining to management is the solution, not deciding whether to tip or not.


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## Moneytoo (Mar 26, 2014)

OhGreatGuru said:


> If your mother is being treated badly at night, complaining to management is the solution, not deciding whether to tip or not.


Yeah I love the saying "If the problem can be solved with money - it's not a problem, it's expenses" for a reason  And I hate complaining, especially in this case - 'cause the management won't be there at night, but the night nurse will... And if she's overworked like the other guy (who was nice when my mom arrived, but became cranky a few days later - when my mom asked, somebody told her that he's just tired because he had to cover two shifts over the long weekend...) - I'll see how I can make it easier for her (by either convincing my mom to wear diapers overnight - or paying for the sitter...) Just wanted to make sure that I'm not missing the unspoken signs (it's Toronto, so the stuff is as multi-cultural as the patients - and I'm sure some of them came from the countries where it was customary to pay for extra help...)


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## Eclectic12 (Oct 20, 2010)

humble_pie said:


> ... sags has the point: our medical systems have run down from decades of financial & social neglect. Not neglect from the medical professionals themselves, whose dedication always amazes me, but neglect from all those who should be offering the funds that medicine needs.


Sorry but I don't think it is that simple.

Wasted dollars include ...
doctors billing for non-existent patients or services not delivered (among the examples I can find one who admitted to just under $1 million ... no license revoking, 100 hours of community service, and ordered him to repay the balance of the money within 10 years),

doctors providing unnecessary referrals or treatment,

doctors not willing to arrange coverage have told their patients to go to emergency while they are on vacation,

nurses have been charged with a range of offenses including steroid trafficking,

a Canadian nurse whose California license was revoked for over-medicating / failing to monitor a patient yet it took the US public lawsuit getting into the news after two years of working in a Toronto hospital before the Nurses College took notice/investigated,

hospital procurement staff driving up costs by circumventing the bidding process for kickbacks,

hospital fund raising hiring a telemarketing firm to ask potential donors for their bank account and credit card numbers (what could go wrong here?),

hospital or and non-hospital clinics informing patients that over years, infection prevention and cleaning protocols weren't followed resulting in possible exposure to viral issues, hepatitis and/or HIV,


I forget the numbers of fraudulent OHIP cards that lead Ontario to switch to a photo id version. I suspect the numbers are not that much different for issues in the medical arena between the US, Canada and Europe.

Interestingly ...


> SEATTLE - A Quebec doctor practicing in Texas and the manager of his medical practice were arrested Tuesday and charged with allegedly defrauding the U.S. government of $375 million


http://cnews.canoe.com/CNEWS/Crime/2012/02/28/19437286.html





humble_pie said:


> ... What nurses, hospitals, medical clinics & doctors all require is massive, heavy, permanent financial support from governments & from private donors.


Where it makes sense ... yes. There seems to be a lot of places that would provide funds if abuses/fraud/effective planning were dealt with.


As I say ... the nurses in London, ON seemed far more touched that they no longer had to run around to find flash lights versus the awkwardness offered cash and the appreciative but at times "more chocolate? ugh".




humble_pie said:


> ... I don't mean a few dollars, i'm suggesting hundreds, in some cases thousands of $$. Any household grossing $60-70k should be able to donate at least $500 each year to a local hospital. These should be annual commitments, imho.


Lead the way ... personally, I want the problems/waste cleaned up as I see no point in having donations line someone's pocket. 




humble_pie said:


> ... To put matters bluntly, nurses should be paid more. It's beyond shocking how US hospitals send recruiters up here to the annual employment fairs for new graduating nurses & these american recruiters are able to immediately attract most of a canadian graduating nursing class with their higher US salaries.


Is this any different than the MBa's or engineers or computer types or doctors who bluntly say either there is too few challenging jobs in Canada's major centers or based on the job offers, they can't afford to stay in Canada?


It strikes me as a Canadian problem ... not a nursing/medical problem.


Cheers


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## sags (May 15, 2010)

There is abuse in any system when money is involved, but focusing on that doesn't solve the problem for a patient in a hospital bed in distress, while the lone nurse is assisting a patient at the other end of the ward.

Consider what appears the simple matter of assisting patients to the washroom.

There used to be male orderlies on wards that helped the nurses assist the patient. That job function was eliminated and the nursing staff had to deal with it.

So many 110 pound nurses got hurt trying to assist 250 pound patients, that the hospitals introduced lift mechanisms to help patients in and out of wheelchairs etc.

Fine........except it takes a lot longer to move the machine into the room, set it up and use it, at the same time nursing staff was reduced and further reducing the time nurses have to deal with other patients.

There are also hospital insurance liability issues regarding family members performing functions in the hospital. They aren't trained or recognized to be performing such functions.


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## humble_pie (Jun 7, 2009)

Eclectic12 said:


> Sorry but I don't think it is that simple.
> 
> Wasted dollars include ...
> doctors billing for non-existent patients or services not delivered (among the examples I can find one who admitted to just under $1 million ... no license revoking, 100 hours of community service, and ordered him to repay the balance of the money within 10 years),
> ...



eclectic there's a medical crisis going on now in canada. IMHO we need constructive, solution-seeking approaches. I can't see any value in throwing together as many verbal assaults on nurses & doctors as one can scramble together, when in fact the vast majority of medical practitioners are spotlessly ethical.

the medical system does need sustained funding. It needs far more than a few haphazard dollars tossed at it in the form of flashlights & other trinkets.

one alternative would be to go to a private non-universal health care system. I'm probably out of date, but i imagine even a basic hospital bed is running at least $1,000 per diem these days? a hip or knee replacement would be well north of $100,000?

would you be happy with that, eclectic? or would you prefer to toss flashlights at a broken system while - inexplicably - accusing doctors & nurses of cheating & fraud.


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## Eclectic12 (Oct 20, 2010)

sags said:


> There is abuse in any system when money is involved, but focusing on that doesn't solve the problem for a patient in a hospital bed in distress, while the lone nurse is assisting a patient at the other end of the ward.


Where significant $$$ are not adding nurses as the money is funneled elsewhere inappropriately ... what confidence do you have that throwing more money "at the problem" will hire additional nurses?




sags said:


> Consider what appears the simple matter of assisting patients to the washroom.


I prefer to remember what I did to assist my mother, while in the hospital ... which there wasn't anyone to object to as the nurses/doctors/PSWs were occupied elsewhere.


Cheers


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## lonewolf (Jun 12, 2012)

My doctor told me half of his time was spent on filling out forms sick notes for people that need them to return back to work, insurance forms for people to get paid while off work which were becoming increasingly long & complicated to fill out. I know someone in the medical field that was paid 30,000 for moving expenses to move to BC within a couple of years they were paid moving expenses to move back to Ontario. The helicopters are getting a lot of extra use from people faking they have chest pain to get free transportation into some cities & towns by some that live in the wilderness. This type of waist needs to be stopped. I have a very strong opinion that tipping in hospitals is in very poor taste anyone caught accepting tips should be fired & lose their pension.


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## Eclectic12 (Oct 20, 2010)

humble_pie said:


> eclectic there's a medical crisis going on now in canada.


I would have argued it was already in force in 2000 when my uncle was discharged from the hospital, over his doctor's objections. The "home care" didn't start up until he was home three days, despite being on morphine for the pain.




humble_pie said:


> IMHO we need constructive, solution-seeking approaches. I can't see any value in throwing together as many verbal assaults on nurses & doctors as one can scramble together, when in fact the vast majority of medical practitioners are spotlessly ethical.


In what way is summarizing media reports quoting gov't, police and court judgments or personal experience a "verbal assault"?
The medical profession is just as human/corruptible as the rest of us.


To recap, the suggested solution seems to be "donate ... it is time to invest". My point is that significant money that *should* be addressing the problem is not making it there. 

I personally find the "no license revocation, 100 hours community service and repay the stolen $1 million on a schedule" for a fraudster insulting. I suspect that if my employer caught me doing similar, continued employment as well as what seems like a light punishment would not be in the cards.




humble_pie said:


> ... the medical system does need sustained funding.


So why is it a problem to want the tax dollars spent provide the services they are targeted for?
Why is it a "verbal attack" to note that significant $$$ intended for the medical system has gone into boats, personal companies, jobs at contractors for family members where allegedly the hospital had to pay a second salary to the family member etc.?





humble_pie said:


> ... It needs far more than a few haphazard dollars tossed at it in the form of flashlights & other trinkets.


Trinkets aren't enough but at least I know they were used.

What the $500K paid for phantom work was used for is not clear to me. At the same time, the paying hospital laid off hundreds of employees ... $500K wouldn't be enough to save any jobs or do something about services provided, right?

Or I guess paying half or a third the cost for a generator from a different supplier could not have help with staffing costs or services provided, eh?

How long does it take to pay back $800K+ from one's salary and what impact did not having that money have on the medical system?




humble_pie said:


> would you be happy with that, eclectic? or would you prefer to toss flashlights at a broken system while - inexplicably - accusing doctors & nurses of cheating & fraud.


$500K here, $1 million there ... naw - that could not possibly help improve the system.


I have been enlightened ... let us happily hope for the best as donations are increased, despite what is being published, is in the courts or is a court judgement.


Cheers


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## Moneytoo (Mar 26, 2014)

Eclectic12 said:


> I prefer to remember what I did to assist my mother, while in the hospital ... which there wasn't anyone to object to as the nurses/doctors/PSWs were occupied elsewhere.


My favorite so far was the ICU nurse. After spending two days in ER (and a few days before that at my mom's), I was happy to finally get a break and decided to go to work. So I stop by in the morning to make sure everything's OK, and the first thing my mom says is to take her pee. Yes, I know, it shouldn't be such a big deal, but after taking her pee every couple hours in the wheelchair, fully dressed, both of us with bags and in winter jackets, into a single use ER washroom, with unusable handles, and people knocking on the door a minute we're in... I was hoping that at least in ICU she'll have someone to do their job while I go and do mine (to pay the taxes that pay for theirs) Yep, silly me - I became much more humble since then 

Anyways, so I tell my mom that my back is really sore after what I called "a weekend from hell" and ask her to press a button. Ten or so minutes later the nurse shows up. My mom tells her that she needs to go to the washroom. The nurse leaves... and comes back with a diaper. We both look incredulous and she explains that she's all alone for two (!) patients - and the nurse from ER left a note that my mom needs two people to assist her. I go ok, let me show you how I do it - after all, my mom can still use her left arm and leg, and I didn't drop her once since the very first time we tried it.

So we do it. There's a commode, so it's much easier. Sit up on the bed - stand up - turn - pants down - sit down on the commode. Easy-peasy. The nurse leaves, comes back with the wipes - and hands them to me. I looked at her, like, seriously, *****? Would you like to go and do my job for me in the meantime?

But, to be fair, it took the three of us (my husband, neighbour and me) to give my mom a bath before we took her to ER. And on Monday, a week later, the three of us came to the hospital to do it there (I saw that there's a shower in the shared washroom) To my surprise, my mom got washed before we came. By one nurse who did it single-handedly. So we spent a few hours of the Family Day talking - and I was really greatful...

As for the night nurse, last night my mom tried the diaper - and slept like a baby. So even though tonight her favorite male helper is back, she said she'll ask for the diaper. I understand that (not) tipping the nurses is just the tip of the iceberg, and, as my mom said, hopefully we will laugh about (some of) it one day... sorry, I'm just too tired - and thank you all again...


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## Karen (Jul 24, 2010)

Moneytoo said:


> The oncologist told us... we'll need "palliative care". But my mom said she prefers to die at home, so I made arrangements at work to take an unpaid leave on a short notice - and hopefully will be able to find two or three reliable private nurses...


I don't know anything about home palliative care in Ontario, but I had a truly wonderful experience with it in BC. My late husband was diagnosed with late-stage pancreatic cancer while we were visiting in his home state of Alaska. It was a complete shock because he had no symptoms except a sore back and had always seemed extremely healthy for a man in his sixties. I brought him home to Vancouver, together with the paperwork giving the details of his biopsy and diagnosis. Our family doctor agreed with the oncologist in Anchorage that there was nothing that could be done except to "let nature take its course," and he referred him to the palliative care providers of our local health unit. We were given the choice of admitting him to a hospice or having palliative care nurses attend to him at home, and he chose the latter. I was so impressed with the loving and yet practical care he received, and I would highly recommend your going that route if home care is available to you. Bill lived for just five weeks after he was diagnosed, but the nurses (and a male orderly who came to give him a bath) did everything possible to make those weeks bearable and I don't know what I would have done without them.


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## Moneytoo (Mar 26, 2014)

Karen said:


> I don't know anything about home palliative care in Ontario, but I had a truly wonderful experience with it in BC.


I obviously had no idea what palliative care means - now I see that I was confusing it with hospice... From not too old article:



> While access to palliative care is poor in Ontario, it is actually better than in much of the rest of Canada.
> 
> According to the Canadian Hospice Palliative Care Association, between 16 and 30 per cent of patients have access to palliative care, and while the overwhelming majority of people want to die at home, about 70 per cent actually die in hospital.


Well, hopefully the social worker (who hasn't called me back yet so don't know when our meeting is) and the doctor will be able to recommend the best course of action... I'm concerned that my mom thinks she's going home next week - as two physiotherapists were teaching her how to use a wheelchair yesterday... I made her call her friend (who's been leaving messages on her answering machine), she called, but didn't tell her about cancer... When I asked why, she said that she doesn't think she has cancer - 'cause she's not in pain... I'm afraid that while I'm facing the reality, she stays too positive - and will be crashed if the news are not good... And we were usually the opposite - she was imagining the worst while I was hoping for the best... But, then again, one of the tumour symptoms is "Personality or memory changes", so if she's turning into me - it's not the worst that can happen 



> My late husband was diagnosed with late-stage pancreatic cancer while we were visiting in his home state of Alaska. It was a complete shock because he had no symptoms except a sore back and had always seemed extremely health for a man in his sixties.


I would be devastated if it happened to my husband - thank you for your post, you give me courage...


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## OhGreatGuru (May 24, 2009)

To OP: reading between the lines of your original post, and leaping to some conclusions, it sounds to me like your mother is in a mis-named "palliative care" ward of a hospital, which the administration has decided to leave in charge of a single underpaid, under-trained personal care worker at night, in order to save money. I don't think tipping/bribing "Nurse Ratched" is going to help. But I can understand that you have more important priorities during your mother's remaining time than to begin a protracted and possibly futile fight with hospital management over their quality of palliative care. 

Keep notes. Maybe writing a letter to the Hospital's Board of Directors afterward will help you work through your grief.


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## Moneytoo (Mar 26, 2014)

OhGreatGuru said:


> To OP: reading between the lines of your original post, and leaping to some conclusions, it sounds to me like your mother is in a mis-named "palliative care" ward of a hospital


Technically, the Palliative Care Unit is on another floor (just googled it), and this one is called Radiation Oncology Inpatient Unit, but the lines can be blurred I guess... I was glad to learn that mom's wardmate was offered a surgery - the surgeon was there last night, discussing the details with her, while I was chatting with my mom. It's her (wardmate's) 4th time there, and many of the stuff remember her and greet her and ask her how she's doing. And now that I'm witnessing my mom forgetting or imagining things (my daughter who's there just texted me, puzzled), I think her mind is playing tricks on her and I shouldn't believe everything she says... sigh


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## marina628 (Dec 14, 2010)

My brother spent 7 weeks on the cancer ward in a semi private room ,very quickly we seen the nurses seemed to have little time for basic patient care beyond medications ,IV monitoring etc.We paid PSW from our own pockets along with family to care for him and keep him comfortable.I would never tip a nurse ever ,we always brought in coffee and treats though 2-3 times a week and left at nurses station and couple times we bought laura secord chocolates for them. They wanted to put my brother in Palliative care which is where terminal patients go and they do not do any life saving measures .My brother was still hoping to get well enough to go back to Princess Margaret so we never gave that option a thought despite knowing he was indeed terminally ill.


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## Moneytoo (Mar 26, 2014)

marina628 said:


> My brother spent 7 weeks on the cancer ward in a semi private room ,very quickly we seen the nurses seemed to have little time for basic patient care beyond medications ,IV monitoring etc. We paid PSW from our own pockets along with family to care for him and keep him comfortable.


Now that I've spent more time there (and met some amazing nurses, from both night and day shifts), I try to help out more while I'm there, especially before the shift change, as I can see how tired they are... Today's nurse was so great - I felt emberassed thanking her with chocolates, and she was refusing profusely to take them, but I convinced her to leave them for the night shift... And of course my mom called late at night that she threw up and thinks she has ulcer but the nurses won't do anything - as in, they cleaned her up, but won't call the doctor... It took us a while to convince her that she threw up because of the radiation, and should tell her doctor in the morning, as he's been asking about it every day... I called the nursing station afterwards anyway, the nurse said don't worry about it, we'll keep an eye on her.... I think that we had it relatively easy so far, yet I already feel exhausted, i don't know how they do it...



> My brother was still hoping to get well enough to go back to Princess Margaret so we never gave that option a thought despite knowing he was indeed terminally ill.


That's where my mom is, Princess Margaret, I hear it's the best cancer center... But I guess they won't keep her there after the radiation treatment is over?.. Our meeting with her doctor and social worker is tentatively on Tuesday, dreading the thought what happens next...


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## marina628 (Dec 14, 2010)

My brother was never a in patient there except for day surgery to put a stent in ,he spent last 7 weeks at Oshawa Cancer Center which was close to our home ,they put a feeding tube in and he was too sick to resume any chemo treatments until his weight got better .He actually died from a blood transfusion in Oshawa ,it was too much for him in the end.


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## Moneytoo (Mar 26, 2014)

Took another stab at finding the PSW. The hospital referred me to their care center who apparently only help out with in-home patients. A very nice woman explained to me that they can't help inside the hospital as it would be dipping into the same funds. But if you're willing to pay... Yes-yes, I am! She gave me three numbers of Toronto agencies, and advised to say magic words "private care" when I call.

Called the first one, explained what I need (take mom for a walk in the wheelchair, give her a shower, help with food and washroom). The rate is $30.50/hr with two hour minimum. I said sure, let's give it a try tomorrow. An hour or so later they called me back with a name - hope she shows up as I really need a break at least for a day...

Went to the hospital, talked to the head nurse - thanked her for everything they're doing, asked if it's ok if the PSW comes over tomorrow to take mom for a walk and give her a shower. And she was like sure, as we don't have anyone for walking, but we already washed her... (I really hope they make more than $30 per hour, otherwise it's really unfair...)

Got mom dressed, in the wheelchair and outside. Beautiful weather, warm and sunny, feels like spring. After two weeks inside the happy look on her face... I took a picture, we rolled around for more than an hour - and the nurses cheered us when we came back 

My sincere sympathies to all who went through this... And I think I can see the positives now. The whole ordeal brought us closer together - and it definitely gives a deeper perspective on life...


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## Eclectic12 (Oct 20, 2010)

*HP:*

From the passionate plea for donations that presumably means a high degree of confidence for what the donation will be used for, it would seem Quebec deserves kudos for avoiding the problems other provinces have faced.

Between the Conservative and Liberal gov'ts in Ontario, the good idea of electronic health records has, over a ten year period ... given Ontario a bunch of under-used computers, less than thirty civil servants having a job, more than three hundred consultants having a job (a lot at $2700 a day and up) and little progress in exchange for one billion dollars spent. 

Then there is allegation of publicly funded air ambulance service has been under fire for almost two years over sky-high salaries, financial irregularities and corruption allegations. The Liberal gov't has indicated that it went rogue with a web of for-profit companies and questionable business deals, as well as exorbitant salaries and lavish expenses.

BC has had it's own electronic records scandal where it is alleged thirty invoices totaling $251K were fraudulently submitted and approved. Like Ontario, a lack of appropriate controls/interest/oversight have been alleged.


It seems the UK also launched an investigation into why their one billion dollar electronic records system was under used.



Cheers


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## s123 (May 3, 2015)

After I've read about the case of about 100 seniors death naturally at the seniors house, 
It's convinced me the calm & peace event. 
Then.... I found this article that makes me more clear view of the wonderful human abilities.

- Is this proof near-death experiences ARE real? Extraordinary new book by intensive care nurse reveals dramatic evidence she says should banish our fear of dying
http://www.dailymail.co.uk/news/art...dramatic-evidence-says-banish-fear-dying.html

….Shortly after that, he told me, ‘I was floating backwards and went back into my body on the bed.’

His pain was excruciating, but he could still vividly recall how peaceful he had felt in that pink room. ‘Pen,’ he told me, ‘if that’s death, it’s wonderful.’
This near-death experience had two significant effects on his life. First, Tom says, it completely removed any fear of dying.
Even more extraordinary is what happened to his right hand, which had been frozen since birth into a claw-like position.
(This had been noted on his hospital admission form, and his sister has since signed a statement confirming it.)
Yet, in front of me, soon after his near-death experience, Tom opened and flexed that same hand. 
This should not have been physiologically possible, as the tendons had permanently contracted. What had caused this sudden, seemingly spontaneous healing? Even now, science has* no answers.



…..Indeed, when I analysed my research, I found that pain-killing and sedative drugs, particularly at high levels,* seem to make it less likely that a patient will have an NDE. 


In other words, well-meaning doctors who over-sedate dying patients may be denying them a natural and comforting final vision.


Furthermore, I also interviewed 12 patients who’d had drug-induced hallucinations. These were random and often frightening — such as being chased and stabbed with needles by drug dealers — but they bore absolutely no relation to NDEs.


...Regardless of what they believe, though, they generally become more considerate of others.


Extracted from The Wisdom Of Near-Death Experiences by Dr Penny Sartori, to be published by Watkins Publishing on February 6 at £10.99. © 2014 Dr Penny Sartori.


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## s123 (May 3, 2015)

additional info...


-Instinct to Die
http://serendip.brynmawr.edu/exchange/node/3909

* I found an interesting fact, which had been broadcasted by BBC.* They say at the moment of dying, we feel good.* When humans die, the beating of the heart stops which eventually ceases the blood flow into the brain.* Then the brain perceives it as a sign of death. In response, the brain 
releases endorphins at maximum levels throughout the body.


We are familiar with this hormone called endorphin.* It is a neurotransmitter that is commonly generated when we laugh.* Endorphins act like morphine relieving pain in human body.

* Why the brain releases maximum amount of endorphin at human’s last moment has not yet been resolved. But in point-of-view of evolutionary psychology’s, it might be a phenomenon of human’s instinct to overcome the fear of death. 

Along the same lines, we can find other examples of the brain’s use of endorphin sometimes to reduce pain and sometimes to increase pleasure. For example, endorphin levels are high for both mother and baby to reduce pain during labor and delivery. (2) It is surprising to know that herbivores bit in the neck by carnivores cannot feel any pain for the same reason.* They are called ‘god’s gift.’ *When we immerse our hand into hot water, our brain releases endorphin to offset our pain.* 

**In addition to reducing pain, endorphins increase pleasure. During the act of masturbation, it is reported that holding of breath intentionally or an infrequent breathing rate will cause orgasm sooner.* 

This implies that the *lack of oxygen* in our brain releases a large amount of pleasure hormones.


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## carverman (Nov 8, 2010)

Moneytoo said:


> - Is it expected by night shift nurses to be paid for every washroom visit? (I.e. was turning off the heat some kind of a hint?)
> - What's a customary "thank you" tip or present? (other than chocolates - I'll get a few boxes tomorrow, but there's one male nurse there, dunno what to get him...)
> 
> (And yes, I did find a PCW to help out on the first brutal night - she just didn't show up; and no, I'm not ready to take more time off work just yet to do it myself - I'm sure we haven't seen the worst yet, so coming every night after work for a couple hours for now...)


After spending 10 days in the cardiac wing of the Ottawa Hospital, *receiving excellent care by the CCU nurses*, I believe you are setting a dangerous precedent by attempting to bribe/tip the nurses on shift there.

First of all it is against their nursing tradition to accept cash bribes for "extras" and they could get fired if thy accepted it.

These are trained professionals, not taxi drivers or waiters. You can do a lot of harm to their career in nursing.
maybe an anonomous box of choclates, or a nice thank you card to the nursing station may be acceptable...but no not tipping! 

Please don't do this and ruin our health care system, (for profit) like it is in the US.


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## carverman (Nov 8, 2010)

OhGreatGuru said:


> To OP: reading between the lines of your original post, and leaping to some conclusions, it sounds to me like your mother is in a mis-named "palliative care" ward of a hospital, which the administration has decided to leave in charge of a single underpaid, under-trained personal care worker at night, in order to save money. I don't think tipping/bribing "Nurse Ratched" is going to help. But I can understand that you have more important priorities during your mother's remaining time than to begin a protracted and possibly futile fight with hospital management over their quality of palliative care.
> 
> Keep notes. Maybe writing a letter to the Hospital's Board of Directors afterward will help you work through your grief.


 In the Ottawa HospitaL, the nurses work 12 hr shifts. The shift changes occur at 7pm with the incoming (usually university nurse in training) is updated by the regular experienced day shift qualified nurse.
Some times the trainees are slow to respond to your call button at 2am-5am, but they do make their rounds to check up on you.


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## carverman (Nov 8, 2010)

Moneytoo said:


> Thank you all. I think I should clarify that the ER nurse whom I "tipped" was an orderly or a nurse helper - I don't know a proper term, someone who does all the dirty work - and I assume is paid the least. She helped us out when no one else was around (we spent two days in ER - yes, with some "Aw man I parted so hard and took a bit more of the stuff that I usually take" druggies), so when I saw her in the hallway the following day - a $20 was all that I had on me, so it was an impulse decision...
> Usually its a male orderly that handles patient with commodes or bedpans in the worse case. If no orderly is available on night shift (or occupied) then a student nurse has to handle the bedpan.
> 
> I read or heard from someone that it's ok to tip those who bring food.
> ...


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## marina628 (Dec 14, 2010)

Glad I am not the only one disturbed by this 'tipping ' Carverman.


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## Moneytoo (Mar 26, 2014)

carverman said:


> [NO! NO! No! They are paid workers.


How much do they make?



> besides..what would you expect from a tip?..a steak dinner instead of hospital food?


Huh? Why would I expect a steak dinner for someone who doesn't have the strength to cut the meatloaf?!



> Food delivery carts do not spend any time at your bedside cutting up portions of your dinner..only a family member, or worse case a kind nurse (if not too busy) can do that.


First, they do. Second, I don't see why it's better that my daughter should keep skipping classes and me work (I already switched to part time and taking an unpaid leave of absence in April - there goes my recent promotion and a raise...) or rely on an unpaid extra kindness of already overworked nurses, but god forbid I left my mom a bunch of 5 dollar bills for tips for extra help...
____________

At any rate, I found the solution to our problem (by hiring a registered nurse - and paying her cash) As usually, I don't know whether to laugh at, pity or envy "true Canadians" who have fond memories of the way things were or grand delusions of how they're supposed to be. I'm sorry for single-handedly "ruining the health system", but I'm a pragmatist who lives in reality, looks at the way things are, and does what must be done - "whatever works"...


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## carverman (Nov 8, 2010)

sags said:


> There used to be male orderlies on wards that helped the nurses assist the patient. That job function was eliminated and the nursing staff had to deal with it.


There still are. I used a few different ones at the Ottawa Hospital, but they generally work day shift. If you need to be lifted off your bed onto a commode, then the student nurses on night shift generally have to deal with it...sometimes it requires two of these to grab your arms and support you.

The beds are adjustable in height, so the patient sitting up on the edge of the bed can slide over
to the commode at the same height with a minimal of having the nurses lift the patient. 



> So many 110 pound nurses got hurt trying to assist 250 pound patients, that the hospitals introduced lift mechanisms to help patients in and out of wheelchairs etc.]
> 
> Fine........except it takes a lot longer to move the machine into the room, set it up and use it, at the same time nursing staff was reduced and further reducing the time nurses have to deal with other patients.


Yes, but these lifts are in short supply and in some cases used more by some patients over others.



> There are also hospital insurance liability issues regarding family members performing functions in the hospital. They aren't trained or recognized to be performing such functions.


Some times the family members have to, but usually a nurse is involved to supervise.


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## Moneytoo (Mar 26, 2014)

Palliative Care Unit at Princess Margaret Hospital is amazing - from floors and ambiance to atmosphere (more relaxed and compassionate than upstairs) Too bad my mom is only there for two days (getting moved to St. Michael's hospice tomorrow morning) The nurses don't look as tired even before the shift change - hopefully they have less patients per nurse.

Our today's nurse was older - and I guess "old school" (didn't let me help her change my mom, called the student nurse; and had such a proud yet nice demeanour about her - for the first time I realized what some of you meant that the nurses might get insulted even by chocolates; wouldn't dare to offer her a box) I became so good at helping out that can do most of the stuff myself now (two of the nurses from upstairs told me that they appreciate the help more than chocolates - and I kept telling them that I understand that they have a lot of patients, and I only have one mom... I did send the flowers after we got transferred downstairs, but wished I could do more... 

I felt bad that we're moving again so soon (my mom finally was able to sleep well - in a private room, with a beautiful view of the city - enjoyed watching the sunset with her tonight). But the nurse told me that she worked at St. Michael's for years, and we're gonna like it there. Her words: "The nurses there are older and better, and the atmosphere is like home." I hope she's right...

Our private nurse (whom I found via kijiji - she worked with terminally ill patients for more than 10 years) is truly a godsent. Today was her day off from work (she works at another hospital), she came and spent more time with my mom - and gave her a shower. I'm paying her per visit, not by the hour, but she so genuinely cares - I don't feel awkward (as I usually do when getting a "free service") She's the main reason (I think) my mom agreed to move to the hospice (instead of going home as she wanted originally) So our angel can keep visiting her there...


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## carverman (Nov 8, 2010)

Moneytoo said:


> Our private nurse (whom I found via kijiji - she worked with terminally ill patients for more than 10 years) is truly a godsent. *Today was her day off from work (she works at another hospital), she came and spent more time with my mom - and gave her a shower. I'm paying her per visit, not by the hour, but she so genuinely cares *- I don't feel awkward (as I usually do when getting a "free service") She's the main reason (I think) my mom agreed to move to the hospice (instead of going home as she wanted originally) So our angel can keep visiting her there...


Good for you and your mom. Last fall when I got really sick and weak, I tried to use the CCAC OHIP paid) services...1 hr per visit, of which approx 20 minutes was wasted checking in with CCAC and filling out the paperwork. The PSW lasted only 8 days with me because he cheated, frilling out things that he never did for me in the 8 days he came to my place. 

I dismissed him and informed his supervisor as to why. He was employed by a PSW contractor. I didn't have PSW service again from frrst of Nov until I got out of the hospital on Feb 20th.
I hired a local personal services that schedule a PSW to help me with all my needs ($30 an hr x 3 hrs min per day.

Right now its 7 daysa week,but I will be cutting back to every other day starting (maybe) next week.

What a world of difference between gov't funded (CCAC) and when you pay out of your own pocket for a private service.


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## Beaver101 (Nov 14, 2011)

> *[s123]... additional info*...


what are the points of your 2 posts in this thread?


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## Moneytoo (Mar 26, 2014)

carverman said:


> Good for you and your mom. Last fall when I got really sick and weak, I tried to use the CCAC OHIP paid) services...1 hr per visit, of which approx 20 minutes was wasted checking in with CCAC and filling out the paperwork.


I guess this is what my mom would get if she insisted on going back to her apartment (which didn't seem like a plausible option by the time they finished the radiation treatment... sigh) I stumbled upon this article when looking for a PSW: Home care personal support workers used as cheap labour

«Premier Kathleen Wynne and the government people talk like they are the saviours of medicare because they are saving money by taking care of people in the home rather than in nursing homes or hospitals. But sometimes people are too sick to be home with only a few hours of home care a day. And there are so many frail clients who need more home care than they are given in a week. I wish the premier would understand this. Instead, she talks a lot about saving money.

On the wages home care personal support workers make, the government should be saving money. I make $15.57 per hour. Only half of the PSWs I work with at my agency are full-time employees. But few actually work a full 36- or 40-hour week, since 21 hours a week is what is considered full-time at my agency. Hours are irregular and inconsistent. So you never know how many hours you are working and how much you are going to make in any given week. It makes it very difficult to budget so that you have enough money for rent, food and unexpected expenses.

The average personal support worker at my agency makes $18,423 a year. On that wage, there is no room to put aside anything for extra savings or a pension. We are unionized and even though our wages would be considered poverty-level by many people we make a lot more than most other personal support workers.
...
Because my weekly earnings as a personal support worker are not enough, I also work as a home maker for the same agency. This is work that is funded differently by the province. So I actually make more when I do that — more for cleaning than for taking care of people. Our employer would like to pay personal support workers the same as home makers, but the government doesn’t fund it.

I keep hearing the health minister talk about how important and valuable the work of personal support workers is to the health system. But I and the women I work with don’t feel very valued. It seems to us we are being used by the government as cheap labour in a home care system that isn’t given enough funding so that clients get more care and supports, and personal support workers are respected with better pay and working conditions.»

____________________

I feel strangely more fulfilled when I'm with my mom than at work. Really enjoy spending time with her - and we both love it here at St. Michael's PCU. Seriously contemplating becoming a trained volunteer - or better yet a wheelchair walker for dying smokers...


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## Moneytoo (Mar 26, 2014)

Beaver101 said:


> what are the points of your 2 posts in this thread?


I remember reading somewhere a few years ago "an enlightened opinion" that inoperable aggressive cancer is a short-cut to the afterlife (maybe it said heaven or paradise but I'm not religious, so just liked the idea in general: you've completed your life program on earth sooner than was planned? Well say your goodbyes and c'mon up now!)

I don't remember why it was cancer (and not a sudden death from an accident for example), but the article definitely didn't mention that silly time between diagnosis and death when the lucky soul still needs to eat & **** - and, in my mom's case, is dying for a smoke..


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## sags (May 15, 2010)

Hopefully the hospice will have an area where the residents can be outside with family for a bit. Maybe she could have a smoke out there. 

My dad had a room with a balcony door that led to a covered private patio. We could walk away from the building down a path and look out over the countryside.

He loved having the door open a little and fresh air coming in a bit. It was like a suite in a grand bed and breakfast mansion........with a small refrigerator, television, and couches and chairs.

I don't know what all hospices are like, but thought the one where my dad was would make an ideal template for more across Canada. We are going to have to address the aging problem soon.


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## Beaver101 (Nov 14, 2011)

^^ What a POBS opinion that is ...


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## Moneytoo (Mar 26, 2014)

sags said:


> Hopefully the hospice will have an area where the residents can be outside with family for a bit. Maybe she could have a smoke out there.


It's not a separate building, just a small part (10 beds) of the 4th floor at St. Michael's hospital in downtown Toronto (halfway between my work and our nurse's work and walking distance from my daughter's school, so perfect location as we'll try to keep taking mom outside twice a day on weekdays - and she's got 3 hour day pass for longer walks on the weekends, it's gonna be very warm and sunny this Saturday) There's a construction and a non-smoking zone around the hospital, but there's a church next door with a tiny asylum for smokers (and while it was raining earlier today, we smoked with a homeless guy at the bus stop - hey, he started it, we just joined! lol), so we'll be fine 



> My dad had a room with a balcony door that led to a covered private patio. We could walk away from the building down a path and look out over the countryside.


Guess it wasn't covered by OHIP?  This place is covered ("poor people's choice" - so far I only saw immigrants in there, and was told that there's another Russian family there - a mother visiting her son...) Everybody seems very nice, and since my mom lived for 8 years in a tiny subsidized apartment - she doesn't feel out of her element (as she would at a more upscale place. I found one anyway not far from our house, but they have a waiting list about a month - she might not live that long...) And I worked downtown most of my life here, so feel comfortable among homeless, druggies, crazies and prostitutes (of both genders - we're close to Church St... ) - and don't mind dirty sidewalks with cigarette butts and empty coffee cups  I have pictures of my mom's smiling face all over the place (and now a video from a nearby McDonald's where our nurse took her after I left) - I guess at this point it's more important that we keep visiting her every day and she gets her filtered through a cigarette downtown fresh air than beautiful views...



> He loved having the door open a little and fresh air coming in a bit. It was like a suite in a grand bed and breakfast mansion........with a small refrigerator, television, and couches and chairs.


She likes it warm (so everything is closed with the thermostat set on high), the room is a decent size with a pullout chair and a TV (that she's probably not gonna watch much as she has her laptop with favorite shows and DVDs with old Russian movies - and she sleeps more and more now...) There's a common kitchen with coffee and fridge full of juices and snacks (for both patients and visitors) and an area to sit, a quiet room, small laundry - more than enough when you don't need much... She was the most happy that the room is private (as they have 4 private and 3 semi-private rooms there - and we didn't know which one she'll get until we got there...) But, really, what's really important is the atmosphere - I can't describe it, but it just feels good there...



> I don't know what all hospices are like, but thought the one where my dad was would make an ideal template for more across Canada. We are going to have to address the aging problem soon.


How much were you paying for it? (the ballpark if you don't feel comfortable answering..) Frankly, I'd prefer to keep vacationing at more expensive places instead - as I can see now that I'd be fine where my mom is if I were dying...


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## carverman (Nov 8, 2010)

Moneytoo said:


> I guess this is what my mom would get if she insisted on going back to her apartment (which didn't seem like a plausible option by the time they finished the radiation treatment... sigh) I stumbled upon this article when looking for a PSW: Home care personal support workers used as cheap labour


Speaking from first hand CCAC fundeed experience for 8 days last Octobert..it SUCKS! The PSW is not allowed to lift you in case they strain their back and get hurt. You only have one PSW assigned to you for about 1 hr each day or more like every 2-3 days. As mentioned in my previous posts, some of that 1hr is spent on paperwork and "micro-managing their day" using my phone, as they don't seem to afford their own cell phone or prefer not to use up their air time.

My PSW followed a sheet of tasks that his supervisor set up. he showed up at 10 am (I was already up by 7am and in my wheelchair), so the "bedside assistance" never happened for me, BUT HE MARKED IT DOWN ON THE SHEET ANYWAY!

«Premier Kathleen Wynne and the government people talk like they are the saviours of medicare because they are saving money by taking care of people in the home rather than in nursing homes or hospitals. But sometimes people are too sick to be home with only a few hours of home care a day. And there are so many frail clients who need more home care than they are given in a week. I wish the premier would understand this. Instead, she talks a lot about saving money.



> On the wages home care personal support workers make, the government should be saving money. I make $15.57 per hour. Only half of the PSWs I work with at my agency are full-time employees. But few actually work a full 36- or 40-hour week, since 21 hours a week is what is considered full-time at my agency. Hours are irregular and inconsistent. So you never know how many hours you are working and how much you are going to make in any given week. It makes it very difficult to budget so that you have enough money for rent, food and unexpected expenses.


I hear you. Currently I am paying my private at home care agency $29,95 an hour + HST (3 hr minimum). I was so weak coming out of the hospital, that I wasn't going to use the CCAC PSW, as they do NOT ASSIST YOU WITH TOILET FUNCTIONS. They just stare at you dumbly and say nothing. I had to struggle on my own in my weakened state to get off the wheelchair onto the toilet booster seat and then go into contortions to get off the toilet booster seat and clean up myself. They just stood around and "supervised' in case I fell trying to get up. This is the kind of personal service you get for "free" from CCAC.



> Because my weekly earnings as a personal support worker are not enough, I also work as a home maker for the same agency. This is work that is funded differently by the province. So I actually make more when I do that — more for cleaning than for taking care of people. Our employer would like to pay personal support workers the same as home makers, but the government doesn’t fund it.



Pretty sad for in home health care. You would think that looking after seniors or disabled would be a lot cheaper for funding than in hospices, but the gov't doesn't seem to understand that. 



> I keep hearing the health minister talk about how important and valuable the work of personal support workers is to the health system. But I and the women I work with don’t feel very valued. It seems to us we are being used by the government as cheap labour in a home care system that isn’t given enough funding so that clients get more care and supports, and personal support workers are respected with better pay and working conditions.»


PREMIER wYNNE and her health minister are clueless. Wynne doesn't understand anything about health care as she
is earnimng$100k plus in her elected role PLUS a lucrative Ontario teachers pension. She doesn't have to live on
poverty level as living costs keep rising each year.

CHEAP LABOUR...THAT IS ABOUT THE CRUX OF THE MATTER, AND THE FUNDING IS NOT GOING TO GET ANY BETTER EITHER. 
____________________


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## coptzr (Jan 18, 2013)

Sorry, I don't have the time at the moment to read through entire thread, but to answer the title and first post. Do not tip a nurse or any hospital staff with cash. Most of my family have worked for hospitals and long term care from deliveries to the OR. I know many doctors/surgeons as well as administrative staff to CEO. This is not acceptable. They are paid well, unionized and should be professionals. Most are not given the thanks they do deserve I will agree. They put through 100's of patients per year, do 5-10 surgeries per day, and fight for money and proper equipment constantly. Floor staff enjoy treats, baking, coffee and tea or even flowers to lighten the place up. The doctors and surgeons like respect, cooperation, and in turn can provide good communication. If cash is your thing, take time to research and understand where you want it to go. Over the past couple years, I understand how researchers do not see much, if any money left at the front door. Ask them directly how to help the best.


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