your very own personal crusade - page 5

i think everyone has a personal little cause - that little thing that's really not a big deal, but is a huge deal to you - and i want to know what yours is. mine's pads. pads, not nappies. ... Read More

  1. by   AMARTIN1
    Quote from DusktilDawn
    I actually had one person tell me the reason they worked 3-11 was so they WOULND'T have to pt baths :angryfire :angryfire :angryfire
    That's so ridiculous!!! Baths can't always be done during the day, especially if you work on a primary nursing intermediate/tele floor. It should be done within a 24 hour shift by any RN,LVN or CNA. I can't stand finding a patient I had the previous day, lying in a filthy bed with dried stains all over their gown!
  2. by   DusktilDawn
    Quote from AMARTIN1
    That's so ridiculous!!! Baths can't always be done during the day, especially if you work on a primary nursing intermediate/tele floor. It should be done within a 24 hour shift by any RN,LVN or CNA. I can't stand finding a patient I had the previous day, lying in a filthy bed with dried stains all over their gown!
    I agree it's ridiculous, but unfortunately there are too many with exactly the attitude that baths should be done on days.
  3. by   Luv2BAnurse
    Quote from stidget99
    After moving from the north to the south, I have seen a huge cultural difference re: how to address other people. I once had a pt complain about me for being rude and "overly professional/abrupt". They complained that I never used the "terms of endearment" like honey, sweetie, etc and always referred to them as "Mr". I hail from the midwest and was taught that you always address someone as "Mr" or "Ms" until given permission to do otherwise by the patient. This particular pt never gave me express permission to call him by his first name. I have now started calling pts by those terms of endearment simply because it is an expectation down here in the south.

    I also was mildly offended when I first moved down here by being called honey and sweetie and dear. It took me a while to realize that no disrespect is intended. It is a way of the south.

    Being from the South too, I LIKE being called those. Gives me a sense (however false it may be) that someone cares. I also USE those endearments on occasion. More so at LTC than in M/S.
  4. by   lady_jezebel
    I had a clinical instructor that called them a pt's "special pads", which sounds just as silly & belittling to me.

    I agree with using the word "pad", though "diaper" sometimes comes out of my mouth in order to differentiate them from "chucks".
  5. by   lady_jezebel
    Quote from DusktilDawn
    I actually had one person tell me the reason they worked 3-11 was so they WOULND'T have to pt baths :angryfire :angryfire :angryfire
    I'm all for pt's being clean & bathed, but I honestly don't like to do them either. I enjoy the intellectual aspects of nursing, but not the personal grooming, giving meals, or toileting. I do them b/c I have to, but would love to work a shift where baths weren't my responsibility. A person can still inspect skin for breakdown without doing a bath.

    In fact, I hate some of these aspects of nursing. I'm still a compassionate person & a good nurse. When I'm emptying garbage or pushing a bed or cleaning a room or even giving a bath to a patient, sometimes I think "I went to school for this???". These are my true feelings, so please don't flame me (or anyone else) for being honest.
  6. by   lady_jezebel
    Quote: "I really get irritated when health care folks talk to the patients and tack, "Okay?" onto the end of whatever they're saying. "I need to check your blood pressure, okay?" "We're going to start you on a new med, okay?"


    I do this, but not b/c I'm feeling submissive. I want patients to know that they have a choice in any procedure, even the small ones. Patients can feel so powerless in a hospital, so even little choices (or perceived choices) can make them feel more empowered & respected.
  7. by   Marie_LPN, RN
    Quote from DusktilDawn
    I actually had one person tell me the reason they worked 3-11 was so they WOULND'T have to pt baths :angryfire :angryfire :angryfire
    They would have hated one facilty i worked at. We did some evening baths and showers.
  8. by   Wise Woman RN
    Quote from goats'r'us
    i think everyone has a personal little cause - that little thing that's really not a big deal, but is a huge deal to you - and i want to know what yours is.

    mine's pads. pads, not nappies.

    only babies wear nappies, and i think that saying an adult wears a nappy takes away so much dignity! it's not that hard to just call it a pad and let the person have that one little bit of dignity. i mean, heaven knows if you're in hospital in need of a great big pad, you probably don't feel that dignified, without being popped into a nappy like a little baby!

    i used to work in disabilities, where i helped out in a group home with some profoundly disabled teenagers. they basically needed full assistance for all care, but it was so important that we were support workers, not carers, and they wore pads, NOT NAPPIES!! it just makes sense to me. i mean, you play down stuff all the time to save people's feelings - the lady hurling up her guts is 'feeling a bit off', the man covered in poo is 'in a mess' and just needs 'help to clean up', people who die slow painful deaths miraculously 'pass on gently' when their family ask if they suffered. i don't care if the person in front of me needs a big-mama super absorbant nappy-type creation, i'll still say 'i'll just grab you a pad' every time.

    see - smallest thing to everyone else, huge deal for me! what's yours?
    It bugs me, too... I call them disposable underwear...
  9. by   rn/writer
    Quote from lady_jezebel
    Quote: "I really get irritated when health care folks talk to the patients and tack, "Okay?" onto the end of whatever they're saying. "I need to check your blood pressure, okay?" "We're going to start you on a new med, okay?"

    I do this, but not b/c I'm feeling submissive. I want patients to know that they have a choice in any procedure, even the small ones. Patients can feel so powerless in a hospital, so even little choices (or perceived choices) can make them feel more empowered & respected.
    I'm in agreement about giving choices and have been a constant advocate for our grandson in that respect. I'm talking about saying okay at the end of nearly every sentence to the point where it becomes automatic and pointless. And truly, it is misleading if there really isn't a choice. Instead of saying, "I'm going to check your blood pressure, okay?" when I know the patient needs to have it done, I'd rather offer a real choice. "I can check your blood pressure now or after I give you your meds. Which would you prefer?"

    One of the reasons the repetitive okay bothers me is because I don't believe it's a genuine question in many cases. It becomes almost like punctuation, something to tack onto the end of a sentence. Or it serves as filler. And often, I think it's done more for the practitioner's benefit, sort of leading the patient where you want them to go and coaxing them, one okay at a time, to follow.

    I'm not thinking terrible thoughts about anyone or ascribing evil motives. I just think this is a bad habit to get into and we'd do well to eliminate about 90% of it in favor of stating whatever the plan is in plain terms and then at the end, asking a real question and waiting for a real answer. That seems less like baby talk and more like speaking with someone whose opinion you want to respect.
  10. by   Tweety
    My personal crusade is Incentive Spiroment teaching. Almost every postop or trauma patient who needs an IS hasn't been taught properly. They take quick gasping breathes trying to get a high mark. Instead of the slow, full deep breath that's effective in preventing complications.

    It's my mission to educate every patient on proper use and I'm supposed to inservice the staff. Problem is the respiratory therapy dept. does the initial teaching. My boss expressed my concerns to their manager and he blew me off. But my crusade will not end.
  11. by   P_RN
    From a southern perspective.....I also like to use the Miss Susie and Mr Thomas.....it's how I knew them all my life. If it is somone new to me I just ask what they want to be called.....The older I get the less I like being called by my first name by someone in their 20s whom I have never seen before.
    Also we say Yes ma'am and Yes sir.....that's expected common courtesy. I don't care if they're 100 or 20.

    As far as diapers.....I don't like that term. I usually say Attends or Poise or underwear...to me briefs are those granny drawers with the big legs.....one person's opinion.

    Bibs ewwwwww......how about dinner napkin....
    I can't tell you how many times I have given out pre meal hot wash cloths and had someone say no one had ever done that before.


    My BIGGEST is patients not being given analgesics because "she never asked for it." My MIL had parkinson's and was aphasic the last 4 years of her life. Lying in the hospital the last illness a nurse told me that......

    I stayed and made sure the doctor wrote for ATC morphine. Good gracious she was 89, had sepsis, pneumonia, total renal failure, sat's in the mid 80s and the nurse actually said she would get respiratory depression from the 2 mg of morphine she'd had that week!!! At least I can say her last few days were very comfortable.
  12. by   rn/writer
    Quote from P_RN
    My BIGGEST is patients not being given analgesics because "she never asked for it." My MIL had parkinson's and was aphasic the last 4 years of her life. Lying in the hospital the last illness a nurse told me that......

    I stayed and made sure the doctor wrote for ATC morphine. Good gracious she was 89, had sepsis, pneumonia, total renal failure, sat's in the mid 80s and the nurse actually said she would get respiratory depression from the 2 mg of morphine she'd had that week!!! At least I can say her last few days were very comfortable.
    That is sooo wrong. I'm so glad you were able to advocate for her (not to mention for common sense) and were able to make her passing a bit more bearable.

    How about a cognitively delayed child of 5-8 years (my grandson with spina bifida) being put on a PCA pump for post-op nerve and bone pain. With no basal. He had at least a dozen sugeries in three years and many times my daughter and I were told to "just keep pushing the button if you think he needs it." We took turns staying with him to give each other breaks but we were both exhausted. We kept asking for a basal rate, at least at night so that he wouldn't suffer if we should fall asleep. The best we could do was keep after the nurses to bring in the PRN meds as soon as they could be given.

    My other complaint was that the P in PCA stands for patient. Where is there any benefit in using a PCA with a child who a) doesn't "get it," and b) thinks that if he admits to having pain, he won't be allowed to go home. Shouldn't there be some type of assessment to see if a patient, especially a child, is a suitable candidate for PCA?

    We were told having a PCA was part of the post-op protocol and had to scream bloody murder that one size does NOT fit all and it certainly didn't fit him. Finally, we found out the hospital had a pain team (by accident!) and insisted they be called in. Bottom line, in the future, post-op narcs will be written as PRN but given as if scheduled for a minimum of 24 hours and longer if the type of surgery warrants it.

    We had to teach some of the nurses how to assess for pain in a child who can't or won't speak about it (or even use the pain faces accurately because only the happy face gets to go home). Tachycardia, tachypnea, poor O2 sats r/t shallow breathing, guarding, grimacing, dull look to the eyes, inability to concentrate, poor appetite, irritability, etc. Finally, we convinced the staff that we didn't want him to have any more analgesia/sedation than necessary but we wanted him medicated enough to be able to heal without being in agony. We also had them document the situation during a few stays and had the pain team make some permanent changes in his protocol. The last few visits have been much better.

    I shudder to think of what kids go through when they live 200 miles away and their parents have to be away from the bedside for long stretches to work or care for other kids.
    Last edit by rn/writer on Sep 20, '05
  13. by   SharonH, RN
    Two pet peeves: 1)addressing patients of any age over 18 by their first names without their permission. I have never done it and yet, it happens frequently to me. Why?

    2)Dirty hands. Often patients get so much attention focused on their faces and their bottoms and when I walk into a patient's room they will reach out to me with these filthy hands. Lots of times the ones with dementia will stick their hands in their diapers. *shudder* So I will stop what I'm doing, grab a wash basin and stick their hands in some warm, soapy water and wash them and yes that includes under the nails.

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