cognitivly impared patients

TonyaM73, ASN, RN · Feb 17, 2010

This is all very new to you. All it takes is time and experience. I feel somewhat akward when I have a new patient that I am unsure of their personal needs and history. I am still a very new nurse, but I know a lot of this will just take time and experience to work out. Good luck to you and don't put so much pressure on yourself. :balloons:

mustlovepoodles, RN · Feb 17, 2010

I understand. I was just like you when I started. I was so afraid to talk to patients that I would have panic attacks and throw up. I had to lean my head on the cool tile in the bathroom and try to come up with small talk that didn't sound stupid. I was a hot mess.

It got better as time went by. When I enter a client's room I always knock. I call them by Mr/Mrs LastName, never "sugar"or "Honey." With cognitively impaired people you want to tell them what you're going to do, then do it, with respect. Don't ask "Do you want to go to the bathroom/get a bath/ sit in the chairnow?" because they will say "NO!" Say "I'm going to give you a bath now and you'll smell so good when I'm done, you won't believe it! Come on, let's get up", then do it. I suspect because you are new that you are not quite comfortable with touching people's bodies. That will come with time. Remember that sometimes you have to do very personal , very necessary things for people when they can't do it for themselves. I know you would never want a person to suffer pain or embarrassment, so you try to keep them covered as much as you can. When you have to do very personal care don't apologize. Be matter-of-fact--it has to be done and the patient will benefit from your ministrations.

I remember a few years ago I had a lady, mid-40s, who was in with a spinal injury. She could walk but had a lot of difficulty with the bathroom stuff. She was mortified that someone had to come in and help her wipe up, but she couldn't do it herself. She had diarrhea all night long and that was the last straw for her--she wept and wept and apologized and wept. I calmly got her cleaned up and put her back to bed. Then I sat down and took her hand. I told her that I was never offended when people really needed me, that she should think of me as a trusted sister who would surely do the same for her if they could be there. After that she became very comfortable with me and never felt the need to be ashamed in my presense.

Give yourself time and know that you are performing a valuable service for these people. :nurse:

leslie :-D · Feb 17, 2010

I remember a few years ago I had a lady, mid-40s, who was in with a spinal injury. She could walk but had a lot of difficulty with the bathroom stuff. She was mortified that someone had to come in and help her wipe up, but she couldn't do it herself. She had diarrhea all night long and that was the last straw for her--she wept and wept and apologized and wept. I calmly got her cleaned up and put her back to bed. Then I sat down and took her hand. I told her that I was never offended when people really needed me, that she should think of me as a trusted sister who would surely do the same for her if they could be there. After that she became very comfortable with me and never felt the need to be ashamed in my presense.

exactly, mustlove.

when you toilet them or change them in bed, make certain they are covered to extent possible, and as stated, explain what you're doing every step of the way.

whether a pt has dementia or not, all pts recognize when they're being treated with sensitivity and dignity.

leslie

michelle_d · Feb 18, 2010

Thanks, I feel better after hearing some other people had similar problems when they just started out. I'm starting to feel more used to asking residents to do things. It helps that most of the residents on my wing don't have cognitive problems, so we can communicate with each other a lot easier.