2012-02-13

Nursing Home Transfers


Nursing home transfers can be very interesting and in some ways depressing.  You will often be going into the backs of the nursing homes and seeing what they are like.  But this can show how understaffed they often are.  The poor staff are genuinely trying their best in most cases and yet they are being run about like mad.  I remember one awkward moment at a nursing home where just after we have the body on the stretcher and are walking down the hall.  Suddenly someone starts calling out softly for help from a room with the door open.  So the we poke our heads into the room.  There we find a very old lady, obviously unable to leave her bed and connected to various tubes and life support equipment.  unable to speak properly she points to the other guy and starts asking him to flip the switch.  We stood there in silent shock as she asked him to turn off her life support machine.  Then suddenly we realised she just wanted him to turn off the light.  She had obviously been sitting there for quite a while alone and with the staff too busy to turn off her light for her.  The brings me to the other depressing thing about nursing homes, the patients.  The way some will just sit there and stair mindlessly at the TV unaware we are there or what we are doing.  Overall many nursing homes are just depressing dingy places to live.  Having said that there are many, mainly the religious ones, which are lively and would be a great place to live.

The tricky thing with nursing homes is the procedure.  Many will be at least somewhat strict and follow the rules.  Others just could not care less.  And all will have their own individual rules or procedures.  But here is a breakdown of general rules and guidelines to follow:
  1. Talk to the nurses or staff and find out the procedure before you begin.  You will need to know the location of the body, the way in and out and if they have any special rules or procedures.
  2. Get the papers and sign the book.  Always get something to have authority to remove before you start.  This is a legal and moral issue which can cause trouble later.  So be organised and get the appropriate papers.  Then ask about “the book” or registery.  This is basically a little book that you sign to say who you removed and when, who you are and if they had any valuables.  Clothing is not considered valuables for their records.  If there is no book for one reason or another do not worry.  As long as you have the appropriate papers then it is OK.
  3. The body cannot stay in a room for more than two hours if other people are also living in that room.  Not all places will follow this but it is the law.  Some nursing homes will have a ‘holding room’ near the car park to keep the deceased until they are transferred.
  4. The doors to residence rooms should be shut as you bring the stretcher in and out.  The better nursing homes will shut all the doors before you proceed down the hallway and remove any residence.  Again, this is not always done but does make the job nicer for you.  So just before you get the stretcher ask if they would like to shut the doors and are ready.
  5. Try not to go in or out the front door if possible with the stretcher.  People just do not like this.
  6. If he body is in a shared room and there are other people there be discrete.  Just be as quiet and soft as possible, pull the curtains and conceal what you are doing.  Remember that you have nothing to hide and it is not a secret or unsightly, but it is inappropriate to be watched.
  7. The family may be there, ask if they want to watch the process and delicately recommend against it.  Like with house transfers there is nothing wrong with them watching but some will find it disturbing.
  8. Try not to arrive around lunch time, dinner time or 03:00am/pm.  If you arrive at lunch or dinner then the staff will be busy and more importantly you will be unable to take the stretcher through the dinning rooms.  If your path is through the dinning room then you’ll just have to wait until they are done and have left.  At 3 is when they usually change shifts.  So if you arrive just before or after a shift change they will be busy and distracted.  Ask yourself what it’s like to be given work just 5 minutes before you are due to go home, or just after you start work.  It is irritating and difficult to focus.
Another thing to not  is that unlike house transfers the nurses almost always wash  the bodies, or at least give them a light and sterilising sponge bath.  So here you can usually expect a clean and presentable body.
Nursing homes do not provide gloves, well, they do, but never count on it.  Keep a pair discretely in your pocket.  But if you forget the body is washed and they usually have gloves withing reach somewhere, so ask the nearest nurse or cleaner and they will give you some.  If you use their body bag replace it.  Do not quibble, do not hesitate, just get a spare out of the car and give it to them.  That way next time the deceased might already be bagged for you.


You must also always check for valuables.  This is simple but very important.  Take each hand and inspect it for rings or if they are holding something; look at each ear for earrings/hearing aids/etc; check the neck for necklaces; check the arm (all the way to the shoulder) for bracelets; check the feet for shoes/socks/etc; check the chest for pacemakers or other valuables.  Remeber to not just look but to feel firmly.

With nursing homes the residents know who you are and what you are for and they will not always like it.  We are like the death bringer to them, and so many places have strict rules about having all residents out of the corridor and doors shut as you make your way along.  Just remember this, and make sure to ask if it is OK to head down before making your way.  It is also polite and the nurses will appreciate it.
Staff at nursing homes often have hesitation when dealing with the dead.  This is interesting as one would think it was a common or at least important part of their job.  And yet they will often ask as odd questions or not want to go near the bodies.  Most nurses are Asian (especially in nursing homes) and as such many obviously have superstitions compared to non-Asian nurses.  You need to be aware and understanding of this, do not force or expect them to help.
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