At Better Options in Vancouver, Washington, there are two multi-story homes side by side. A garden and gazebo separate the two living spaces and beckoning porches call people outside. While these two structures look like ordinary homes, they are anything but.
Instead, what you’ll find is a long-term care facility specifically catering to residents who require ventilator care.
The residents are accompanied by a full-time staff, which consists of highly skilled nurses and certified nursing assistants. And each day, these nurses spend one-on-one time with each resident as they encourage them to ambulate, bathe, and enjoy their lives in the most independent manner possible.
While this may sound simple enough, their skills are top-notch, as they are extremely attentive care experts. This is of utmost importance since ventilator patients are at high risk for unexpected airway emergencies, infections, and even falls.
Here are five ways our attentive care experts look after our live-in residents.
It’s customary for staff to check residents’ vital signs on a regular basis. This includes their heart rate, temperature, and blood pressure. They’re also going to be diligently monitoring patients’ breathing, listening to the sounds, noting any changes, and connecting with the physician as needed.
The nurses are also going to assess each ventilator machine to ensure it’s on the proper settings, which will include respiratory rate, fraction of inspired oxygen, tidal volume, and peak inspiratory pressure. They will also know how to hyperventilate and hyper-oxygenate patients, where a bag-valve mask is located if needed, how to use suction to open an occluded airway, and how to address a machine alarm.
Patients may also require various lung therapies, which nurses will confirm were performed and assist as needed.
Checking a setting sounds simple enough, but making sure that someone receives enough, but not too much, oxygen is more complicated than it sounds.
Anytime someone is dealing with an illness, they’re at an increased risk for secondary infections, as the immune system is already compromised. One issue that’s common among people using mechanical ventilators is ventilator-associated pneumonia (VAP). However, there are steps that can be taken to lower one’s risk.
According to American Nurse Today, which embodies practices we adhere to, there are five known steps that will help.
Residents who use ventilators cannot swallow normally. Especially if this is a new situation, this dramatic lifestyle change will greatly alter one’s mealtime routine. While those with tracheostomy tubes are able to swallow food and do so when allowed by their physicians, and under supervision by our staff, most others who live here will require a feeding tube. Liquid nutrition becomes their only source of energy.
While a resident in this new circumstance may feel appropriately perturbed by this change, our staff works with them one-on-one to help adjust to this new intake schedule and routine, as well as to deal with the emotional and physical toll it can take.
In some instances, family members were previously the primary caregivers before their loved ones moved into one of our homes. In these cases, they are intimately familiar with what it takes to properly care for someone with a ventilator. Stepping back from the caregiver role can be a challenge but also a blessing for both the families and our new residents. This is when we allow them to get back to just spending quality time with one another, rather than worrying that they aren’t doing enough or about the next thing that needs to be taken care of.
In other instances, a resident experienced a trauma and is now on a ventilator for the first time. They’re still adjusting to the new lifestyle and will need education on how to best care for themselves, especially if they’re still able to maintain their independence. The family might also want to learn more.
If, for example, the resident is unable to verbally communicate, we share how important it is to overcommunicate when you’re visiting. For example, immediately introduce yourself when you walk into the room and tell them what you are doing. While nurses might share that they’ve come to help the resident get out of bed and walk around, family members may say that they’ve just come from work and were missing the resident so came to visit for a while.
Our nursing staff spends more time with the residents than anyone else. They’re present 24/7, watching over them and adjusting to their needs as they arise. While many days the residents and the nurses settle into a routine and become very friendly, there are days when the nurses step into bigger shoes as they advocate for the residents’ needs.
This may be something that’s ongoing, like communicating between physicians and medical insurance providers to confirm that the wheelchair that’s needed is 100 percent covered, or there might be days when more urgent requests come through. Then it’s the nurses who connect with the proper doctors to decide which tests to run (many of which can be performed at Better Options), which medications to adjust, or if something more severe requires a visit to the local hospital.
Attentive care experts are always available for our residents and their families. They want Better Options to feel like home, while also ensuring the highest level of medical care is provided.