I am an RN (management) in a medium sized sub-acute care facility. We have a patient that was transferred to us two years ago, 53 year old male that collapsed at a Harley dealership (cause of collapse unknown), struck his head, resulting in brain injury. He has limited use of right upper extremity, very limited use of right lower extremity and is aphasic. He is completely oriented and has very active family involvement. He is generally very healthy from a medical standpoint. He was transferred to us when his Medicare days ran out for "further follow up rehab therapy". Of course, he is only in restorative nursing ambulation programming. The problem is this: he was seeing in our facility, a SLP that he developed trust in. She, before she quit due to politics, obtained for him a lingraphica. Since she quit there have been a couple of SLP's that our facility has employed that refuse to work with him due to his wife (she can be overbearing at times, really it is out of concern), they do not have "the time", they are unfamiliar with the lingraphica, etc. We now have a part time SLP, a fairly new grad. I have approached the Therapy Director sooooo many times about working with him, however she refuses to assign this case to her, and very bluntly told me, "She is tooooo new, the wife is overbearing, and I do not want to scare her away". I feel for the patient. He can occasionally get out a few appropriate responses verbally due to this aphasia, and what we are seeing is a major loss of independence and a deepening depression. I know that it has been a major struggle for the facility due to a shortage of SLP to obtain and retain one on staff, however, how in the world are we, the nursing staff, supposed to help him? The Therapy Director also stated, "Let the wife work with him with the lingraphica". I was so shocked and appalled I nearly quit right then and there. Additionally, we are attempting to locate a psychiatrist to work with him on his depression issue, however, that in itself is a major feat as his expressive aphasia limits his ability to interact with the psychiatrist. His payor source is Illinois Medicaid, SLP would be covered under Med B. If anyone can help, please, please, please, point me in the right direction. I would be grateful and our patient would have hope! Thank you for reading!
Salli, RN
work phone (708) 354-4660