Nursing Home Health Care Leadership Mission Discussion

Nursing Home Health Care Leadership Mission • • • • • Introduction Maplewood Rest Home Activity Medical Needs Area Conclusion Introduction Evacuating a medical facility is always a challenging endeavor, and one of the most difficult types of medical facilities to evacuate is a nursing home. Unfortunately, after a nearby chemical spill, the Maplewood Rest Home needs to be evacuated immediately. The majority of the residents are evacuated to the Medical Needs section of the Red Cross emergency shelter and stay there for three days. With the help of several firefighters, the evacuation goes well, with no fatalities and only a few unexpected problems. Go through the following scenes at the Maplewood Rest Home and the Red Cross Emergency Shelter from a health administration leadership perspective. Observe and evaluate the leadership skills displayed by various individuals. To what degree are the leaders successful, and can you offer any suggestions for improvement? Characters in this Mission • • • • • • • Michelle Coolidge – Administrator, Maplewood Rest Home Kimberley Fuller – Nurse, Caring Hands Clinic Justin Hoffman – Firefighter Rosemary James – Director of Nursing, Maplewood Rest Home Corey Lucas – Maintenance Director, Maplewood Rest Home Seth Morgan – Firefighter Arthur Smith – Resident, Maplewood Rest Home • Elizabeth Wu – Nurse, Maplewood Rest Home Maplewood Rest Home At the Maplewood Rest Home, staff members assemble quickly to enact their evacuation plan. Michelle Coolidge, Administrator of the Maplewood Rest Home, meets with Nursing Director Rosemary James and Maintenance director Corey Lucas to facilitate the evacuation of the nursing home. Michelle Coolidge: [Somewhat frantically] All right, I’m afraid our worst nightmare is here. There’s been a chemical spill and this whole area of the neighborhood is being evacuated. Maplewood needs to be evacuated immediately. Corey Lucas: Oh, geez! How long do we have? Michelle Coolidge: They’re saying an hour and a half. We’re supposed to have two buses from the city and lots of ambulances, but they’re not here yet. In the meantime, we need to follow the emergency evacuation plan.Nursing Home Health Care Leadership Mission Discussion

I want to stress how important it is to get everybody out of here as calmly as possible. There’s a terrible risk of heart attacks and other medical emergencies in stressful situations like this one. Rosemary James: We’ll make it happen, Michelle. Where are we moving the residents? Michelle Coolidge: There’s an emergency Red Cross shelter at Beck University. We may be there for several days. Rosemary James: Will the Beck University facility have everything we need for our residents? A 93-bed nursing facility is a tall order. Michelle Coolidge: I’m not sure yet if they’ll be able to accommodate all of our residents. Alzheimer’s patients may need to be moved to another location, but I don’t have that information yet. We’ll be working with the Public Health Department when we get to the shelter. Corey Lucas: But right now, the priority is to get everybody out of here safely, correct? Michelle Coolidge: Absolutely. Rosemary, what’s the staffing situation right now? Rosemary James: Short-staffed as usual. We’re short two nurses and four CNAs. Michelle Coolidge: [Sigh] Of course, we are. Well, we don’t have time to bring in anyone else. Rosemary, we need to organize the nurses and CNAs right away and coordinate the evacuation in an orderly manner. Nonambulatory and bedridden residents go first, then wheelchair residents, then ambulatory residents. Of course, all of this depends on the buses and the ambulances getting here. Corey Lucas: I’m sure they’ll be here soon. Do we need to get Medical Records down here? Michelle Coolidge: Yes. I’ll call Joan Parker right away. Medical records personnel are responsible for tagging and identifying all residents upon evacuation. Each patient needs their medical record transferred with them. That is crucial. Rosemary, do you know if the social worker is in… Kerry? Rosemary James: Yes, Kerry’s here. Isn’t she supposed to contact the families to tell them where the residents are being moved? Michelle Coolidge: Yes, but that will have to wait until we’re settled with the shelter. Kerry needs to keep an official roster of residents and staff. The roster will have information about each patient’s medications and records. Corey Lucas: So what now? Michelle Coolidge: Corey, you contact housekeeping and dietary and tell them to assemble emergency supplies.Nursing Home Health Care Leadership Mission Discussion

Then as soon as the buses and ambulances get here, I want you to coordinate transportation. Rosemary, locate the nurses and CNAs immediately and tell them to efficiently and calmly get the residents ready to leave. I’ll work with Joan on the medical records and Kerry on the patient roster. Corey Lucas: All right. We’re on it. Let’s get this place evacuated. Firefighters Justin Hoffman and Seth Morgan arrive at Maplewood Rest Home to help with the evacuation. Justin Hoffman: Ma’am, I’m Justin and this is Seth. We’re here to help you get evacuated. Michelle Coolidge: Well, thank goodness you’re here! Can you send us more ambulances? You finally sent us three, but there’re 93 patients in this facility, and we need more. Seth Morgan: I’ll put in a call right away. Unfortunately, the fire department doesn’t house ambulances in Riverbend City, but I’ll try to get more here as soon as possible. Michelle Coolidge: Well, can you help us get residents ready for evacuation? I don’t know what I can or can’t ask you to do. What is the role of the fire department in a situation like this? Justin Hoffman: Ma’am, the role of the fire department is to save lives and keep people safe. We’ll do whatever you need us to do to help you get your residents out of here safely. Michelle Coolidge: Oh, thank you so much! Elizabeth Wu: [Urgent] Excuse me, Michelle! We have an emergency. Mrs. Abelson had a heart attack. Colleen and Sarah are performing CPR. Seth Morgan: I’ll go grab the defibrillator from the truck. Justin Hoffman: I’ll take over the CPR, nurse—just take me to the patient. Michelle Coolidge: Oh, thank goodness you guys are here! Evacuating a nursing home is so risky, and I was afraid this was going to happen. The nurses begin to evacuate the patients. Nurse Elizabeth Wu stops in the room of 89-year old resident Arthur Smith, who is wheelchair-bound and has limited sight. Elizabeth Wu: Mr. Smith? It’s Elizabeth. Are you awake? Arthur Smith: Eh? Is that you, Lizzie? Elizabeth Wu: [Calmly] It is. Mr. Smith, I need you to listen carefully. There’s been a chemical accident down by the railroad tracks. The fumes from the chemicals are moving in this direction, so we need to evacuate Maplewood. Arthur Smith: [Alarmed] A chemical accident? Elizabeth Wu: Mr. Smith, there’s nothing to worry about. Just to be on the safe side, we’re moving everyone out of Maplewood for a few days. We’re going to be staying in a special shelter. Arthur Smith: What? I have to move? Elizabeth Wu: Just for a few days, Mr. Smith. But please, stay very calm and don’t worry. We’re going to take care of everything and you have nothing to worry about. Colleen will be here in just a few minutes, and she’s going to help you pack up the things you need. Arthur Smith: What about my medicine? I have diabetes and high blood pressure and sleep apnea. Elizabeth Wu: All of your medication is coming with you. Please don’t worry about a thing, Mr. Smith. We’re going to take good care of you. Arthur Smith: Well, I have to call my daughter Jeannie. She’s coming to visit me tomorrow, and she’s not going to know where I’m at. Elizabeth Wu: We’re going to call everyone’s relatives when we get to the shelter, Mr. Smith. Please don’t worry. Arthur Smith: But what about Harmony? Elizabeth Wu: Excuse me? Arthur Smith: Harmony. The nursing home cat here. We can’t leave her behind with the chemicals. She needs her food and water and litter and scratching post. [Cat meows] Elizabeth Wu: I’m sure someone will take care of the cat. I need to go talk to the other residents now, Mr. Smith. You just sit tight and Colleen will be here in a few minutes. And please don’t worry about anything. Arthur Smith: We can’t leave Harmony behind! I won’t leave her.Nursing Home Health Care Leadership Mission Discussion

Do you understand me? [Cat meows] Elizabeth Wu: Colleen will be right in, Mr. Smith. The firefighters help evacuate patients from the Maplewood Rest Home. Seth Morgan: All right, Justin, Mrs. Abelson is in an ambulance and on her way to the hospital. She’s stable. Justin Hoffman: Oh, good. What’s the status on the ambulances? Seth Morgan: A couple dozen just arrived. I think we’re set. What do we need to do now? Justin Hoffman: I’ve got a list of nonambulatory and wheelchair-bound residents that I’m wheeling out to the ambulances. Here’s one now. [Knocks on door] Mr. Smith! Hello, sir! Are you ready to go? Arthur Smith: Who’s there? I can’t see very well. Seth Morgan: We’re from the fire department, sir. Arthur Smith: [Alarmed] What? Is there a fire now? The nurse told me there was a chemical spill. Justin Hoffman: There’s no fire, sir. There’s been a chemical spill, and we’re moving you to an emergency shelter. Arthur Smith: Well, I have to bring my medications. I have diabetes and high blood pressure and sleep apnea. Justin Hoffman: That’s all been taken care of, sir. We’re here to take you to an ambulance so you can go to the shelter. Ready? Arthur Smith: Well, I’m taking Harmony with me. Justin Hoffman: Who? Arthur Smith: Harmony. The nursing home cat. The nurse said I couldn’t bring her, but I’m not leaving her to die in the chemicals. [Cat meows] Seth Morgan: Aw, what a cute little kitty. Justin Hoffman: Uh, sir, I don’t think you’re supposed to bring a cat to a shelter. Arthur Smith: Well, what am I supposed to do with her? I can’t let her die. Seth Morgan: I’m sure there’ll be a place in the shelter set aside for pets. Take her with you and they’ll find a place for her. Justin Hoffman: I don’t think that’s a good idea. Seth Morgan: Well, what are we supposed to do, Justin? Stand here and argue with this guy? Justin Hoffman: All right. I’ve got more rooms to evacuate. You go take Mr. Smith down to the ambulance. Arthur Smith: And Harmony too! Justin Hoffman: And Harmony too. Handout • Maplewood Rest Home Emergency Evacuation Sheet Activity Step 1 During the evacuation of the nursing home, a number of problems arose. With a limited amount of time to complete the evacuation, prioritization was essential. Rank the following problems in order from most urgent to least urgent.Nursing Home Health Care Leadership Mission Discussion

List to be ranked: • • • • • • • • • • Alzheimer’s patients need to be relocated to other nursing facilities. Ambulances are slow to arrive. Buses for ambulatory residents are slow to arrive. Medication for all residents needs to be collected. Mrs. Abelson has a heart attack. Nursing home is short-staffed. Other residents are fragile and could have cardiac emergencies. Relatives need to be contacted. Records for all residents need to be collected. Resident refuses to leave without cat. Step 2 Now that you’ve ranked the problems, indicate which of the following leaders is primarily responsible for resolving each problem. • • • • Michelle Coolidge, Administrator. Rosemary James, Nursing Director. Corey Lucas, Maintenance Director. Someone else. Medical Needs Area, Red Cross Shelter After the evacuation, the Maplewood Rest Home patients are relocated to the Red Cross emergency shelter. At the shelter, Maplewood Rest Home Director Michelle Coolidge meets with head of nursing Rosemary James and maintenance director Corey Lucas to discuss the situation. Michelle Coolidge: Rosemary, Corey, you two are lifesavers. I don’t know how I would have pulled off that evacuation without your help. Corey Lucas: You did a great job, Michelle! How are the residents? Michelle Coolidge: Disoriented. Uncomfortable. Just as you might expect. But no more medical emergencies, thank goodness. Rosemary, what’s the latest staffing situation? Rosemary James: Not good. Colleen just left. Michelle Coolidge: What? She left? Rosemary James: She said she wasn’t getting paid enough to work under these conditions, and she stormed out. Michelle Coolidge: Oh, that’s just peachy. Rosemary James: We do have some volunteer nurses from a local clinic helping us out. But we could use some more hands. Michelle Coolidge: I’ll talk with Rory Gilbert, the head of shelter about getting us some more volunteers. I have to say that he’s been very helpful at trying to get us whatever we need. Things have been going smoother here than I expected. Except I’m going to wring the neck of that witch from University Food Services. Corey Lucas: What happened? Michelle Coolidge: She met with me and the dietician to talk about the dietary needs of our residents. And when we told her about all our different dietary needs, she snapped at us! She told me that this wasn’t a full-service restaurant. Rosemary James: You’re kidding. What did she expect? Michelle Coolidge: I imagine she wants to feed our residents the same garbage she feeds college students. Chicken fingers and pizza for everyone! Fortunately, the food they’ve been sending us is sufficient, but I’m going to have to have a talk with Rory Gilbert about her. Corey Lucas: Well, I’ve got some good news. We’ve finished contacting the families of all the residents. Michelle Coolidge: Oh, thank you, Corey! And I’m happy to say that the Alzheimer’s and dialysis patients who couldn’t stay here are all settled in at other nursing facilities. Corey Lucas: Great! I also talked with someone from the university library. They were bringing over books to the shelter. I asked them to bring us some large print books. Michelle Coolidge: Good job, Corey. Let’s keep everyone as occupied as possible. Volunteer nurse Kimberley Fuller looks in on patient Arthur Smith, who has an unexpected companion. Kimberley Fuller: Excuse me? Sir? Arthur Smith: Who’s there? I don’t see very well. Kimberley Fuller: My name is Kimberley. I’m a volunteer nurse. What is that you have there, sir? Arthur Smith: I don’t know what you’re talking about. [Cat meows] Kimberley Fuller: Sir, you can’t have a cat here in the shelter. I’m going to need to take it out to the special kennel area we have set aside for pets. Arthur Smith: What? You’ll do no such thing! She’s not bothering anyone.Nursing Home Health Care Leadership Mission Discussion

Kimberley Fuller: Sir, you’re not allowed to bring pets to a shelter. Pets aren’t safe here, and other people might be allergic to them. Corey Lucas: Excuse me? What’s going on here? Kimberley Fuller: This gentleman snuck in his cat. Arthur Smith: You can’t take her! I’m not going to let her die in those chemicals. Corey Lucas: [To Kimberley] This is Harmony. She lives at the Maplewood Rest Home. As you can see, she takes very good care of our residents. Kimberley Fuller: Well, she can’t stay here. Arthur Smith: You can’t take her! Corey Lucas: Mr. Smith, I’ll tell you what. I’m going to give my wife a call and have her come down to the shelter. Harmony can stay with us until we’re ready to go back to Maplewood. Arthur Smith: Do you know how to take care of a cat? Corey Lucas: I sure do. We’ll take good care of you, Harmony, won’t we? [Cat meows] Conclusion Congratulations. You have completed the Nursing Home Health Care Leadership Mission. How well do you think the leaders handled the difficult task of the evacuation? What suggestions do you have for improvement? A few questions to consider: • • Which organization or leadership team is responsible for addressing the issues presented in this mission? Who is ultimately responsible for rectifying not only the situation that occurred, but the system in which in occurred? Back to top Licensed under a Creative Commons Attribution 3.0 License …Nursing Home Health Care Leadership Mission Discussion