[jleski]

Hello everyone!
This website is so wonderful and I'm excited to be included. I've read so many of the postings that I finally decided to register and post. Here is a bit about me. . .I am a new graduate (May 04), worked on a Med. Surg floor for 5 months and was about to go crazy. Everyone said I was doing great but that isn't how I was feeling. I wanted to spend more time with my clients and I felt more like a nurse tech. than anything. I never felt safe, was physically sick before each report time, and even though I worked with GREAT staff I didn't feel as if I contributed much. (I know, I know, I am and was, way too hard on myself). I was given the opportunity to change jobs when offered one with DD. It sounded like the right fit and so far (knock-on-wood), it has been. I have a lot to learn yet, and even though I've had a bit of time on Med. Surg., there are still things I haven't had "hands on" experience with (example, changing G-tubes!). Other than that, I'm not sure what more you all would be interested in knowing, so I'll keep it short. Looking forward to the help, support, and postings

[nursebedlam]

hullo, welcome to allnurses..

[aj121]

Originally Posted by nursebedlam

hullo, welcome to allnurses..

Hello, thanks for welcoming me to allnurse.com. I hope that I can obtain some feedback from you on different areas of nursing. Although you live in Australia, nursing may be quite different overseas....but I am willing to listen to any suggestions in any area of expertise....How long have you been a nurse??? What type of nurse are you and what do you specialize in or do you specialize???

[Tweety]

Welcome. Good luck in all you do!

[akcarmean]

welcome

[Claver]

Hi Jleski,

I do hope that you enjoy your DD experience. I would like to offer some suggestions:

1.Subcribe to one of the nursing magazines that offer continuing education and articles in the med-surg area so that you keep abreast of what is happening in the field.

2.Always have your nurses drug reference on hand for instructing the staff on medication especially over the telephone and when they are medication changes.

3.Buy yourself a handbook on medical-surgical nursing - one about the size of the nurses drug reference so that it is easy for you to take around.

4. Buy yourself a copy of Telephone Triage Protocols for Nurses - it will help you in giving staff instructions over the phone.

5. You can join the Disabilities Nurses Association -(I used to be a member - they have great conferences - but my membership lasped - I am reapplying). They also offer a certification in the field.
Here is their website:http://ddna.bluestep.net

Originally Posted by jleski

Hello everyone!
This website is so wonderful and I'm excited to be included. I've read so many of the postings that I finally decided to register and post. Here is a bit about me. . .I am a new graduate (May 04), worked on a Med. Surg floor for 5 months and was about to go crazy. Everyone said I was doing great but that isn't how I was feeling. I wanted to spend more time with my clients and I felt more like a nurse tech. than anything. I never felt safe, was physically sick before each report time, and even though I worked with GREAT staff I didn't feel as if I contributed much. (I know, I know, I am and was, way too hard on myself). I was given the opportunity to change jobs when offered one with DD. It sounded like the right fit and so far (knock-on-wood), it has been. I have a lot to learn yet, and even though I've had a bit of time on Med. Surg., there are still things I haven't had "hands on" experience with (example, changing G-tubes!). Other than that, I'm not sure what more you all would be interested in knowing, so I'll keep it short. Looking forward to the help, support, and postings

[LuvPerNrsng]

Congradulations jleski on your new found experience with DD nursing and welcome to the site. Something that has helped me greatly is the fact that not only does my son have disabilities but I had alot of books that gave me a better understanding not only of him, but they have helped me out alot with the clients I work with.
If you can purchase or lend from a library try to find books related to your clients disabilites. In working with DD children or adults you will find yourself also working with support people like speech therapists and occupational therapists and physical therapists, dietary specialists and such. You will be able to provide continuity of care if you knew techniques that the PT is using for muscle strength and flexability or help out on non OT days by doing a "brushing" protocol on your tactile defensive clients.
I have found certain books dealing with Sensory Integration Dysfunction that has helped me understand my clients with Autism better. Whether they have CP, Down's Syndrome, Autism, Mental Retardation, Wilsons Disease, Fragile X Syndrome etc... reading about non-nursing issues regarding these and more disabilities will give you an edge and really help you to understand your clients.
Let me give you an example:
One day, I came to work and found that one of our Autistic clients was still up at midnight..and continued to stay up and refused to go into his room, that, and his self stimming behaviors were worse. We were perplexed but not shocked (he has horrible sleeping habits). Anyway, I walked with him to his room. he stood by the door, grunted and left. As I looked in his room I saw that they had added a mattress to his bed. They apparently had done this that day. Did they do anything wrong. Not if this client hadn't had autism. People with Autism need and thrive on sameness. Their rigid thinking prevents them from accepting something new without help easing into a situation. I told the others that they cannot simply just change this young mans room and expect him to be ok with it. And that by doing this they were asking for behaviors. I simply took the extra mattress off and put his familiar dark sheets on the bed. Guess what? He immediately laid down and slept all night. Detailed charting was in order here because of what I knew about Autism and what I knew about the client and his behaviors before and his actions later. Till this day, there still is no double mattress on his bed. They are learning that you just can't spring something on a person with Autism and expect them to be adaptable.

Good Luck with your New Field.

[jleski]

Thank you Claver!

Originally Posted by Claver

Hi Jleski,

I do hope that you enjoy your DD experience. I would like to offer some suggestions: I'm always looking for good suggestions. . .thank you!

1.Subcribe to one of the nursing magazines that offer continuing education and articles in the med-surg area so that you keep abreast of what is happening in the field. Do you have any suggestions as to which? Right now I have AJN and Nursing made Incredibly Easy (both of which I like).

2.Always have your nurses drug reference on hand for instructing the staff on medication especially over the telephone and when they are medication changes. Wouldn't go anywhere without it!!! Thanks

3.Buy yourself a handbook on medical-surgical nursing - one about the size of the nurses drug reference so that it is easy for you to take around. Suggestions?

4. Buy yourself a copy of Telephone Triage Protocols for Nurses - it will help you in giving staff instructions over the phone. Haven't seen one of these. Any suggestinons on this one too?
5. You can join the Disabilities Nurses Association -(I used to be a member - they have great conferences - but my membership lasped - I am reapplying). They also offer a certification in the field. This I have already filled out the application for. The cert. is something I have to work on. It takes approx. 2 years of work experience before applying. I have a few friends that have the cert. and will be getting some help from them.
Thanks for all the great info. Look forward to any suggestions you may have. jleski
Here is their website:http://ddna.bluestep.net

[jleski]

Thank you for the suggestions. I will try and find some books. Your example of the client you worked with with Autism was very helpful. I have two clients in the home I work in that have Autism. I was very concerned about a recent Christmas party we attended with our clients. As it turned out, my concerns were very valid (although I'm not sure the support in maybe doing something different next year will be there). The one older gentleman became very aggressive and had behaviors that were very difficult to handle. At one point it took several people to redirect him and you could tell he was very disturbed/angry. I would have loved to have seen something done that was more appropriate for him. I guess that will be where I come in. Hopefully I can do enough education for the staff that we can come up with something more appropriate for him next Christmas.
jleski

Originally Posted by LuvPerNrsng

Congradulations jleski on your new found experience with DD nursing and welcome to the site. Something that has helped me greatly is the fact that not only does my son have disabilities but I had alot of books that gave me a better understanding not only of him, but they have helped me out alot with the clients I work with.
If you can purchase or lend from a library try to find books related to your clients disabilites. In working with DD children or adults you will find yourself also working with support people like speech therapists and occupational therapists and physical therapists, dietary specialists and such. You will be able to provide continuity of care if you knew techniques that the PT is using for muscle strength and flexability or help out on non OT days by doing a "brushing" protocol on your tactile defensive clients.
I have found certain books dealing with Sensory Integration Dysfunction that has helped me understand my clients with Autism better. Whether they have CP, Down's Syndrome, Autism, Mental Retardation, Wilsons Disease, Fragile X Syndrome etc... reading about non-nursing issues regarding these and more disabilities will give you an edge and really help you to understand your clients.
Let me give you an example:
One day, I came to work and found that one of our Autistic clients was still up at midnight..and continued to stay up and refused to go into his room, that, and his self stimming behaviors were worse. We were perplexed but not shocked (he has horrible sleeping habits). Anyway, I walked with him to his room. he stood by the door, grunted and left. As I looked in his room I saw that they had added a mattress to his bed. They apparently had done this that day. Did they do anything wrong. Not if this client hadn't had autism. People with Autism need and thrive on sameness. Their rigid thinking prevents them from accepting something new without help easing into a situation. I told the others that they cannot simply just change this young mans room and expect him to be ok with it. And that by doing this they were asking for behaviors. I simply took the extra mattress off and put his familiar dark sheets on the bed. Guess what? He immediately laid down and slept all night. Detailed charting was in order here because of what I knew about Autism and what I knew about the client and his behaviors before and his actions later. Till this day, there still is no double mattress on his bed. They are learning that you just can't spring something on a person with Autism and expect them to be adaptable.

Good Luck with your New Field.

[Claver]

Hi Jleski,

Those magazines are good ones, RN is also good. I am sending two suggestions for books - Handbook of Medical-Surgical Nursing, third edition published by SpringHouse - ( This is about the same size and weight as the nursing drug book) - and Telephone Triage Protocols for Nurses - Julie K. Briggs, published by Lippincott. Also check out this website - www.specialneedsnurse.org. I am also developing a web site but it is not up and running as yet, but I will give you the address also - www.h-bcommunications.com