Teamwork At Its Best

  1. And now for something completely POSITIVE (for once)..........

    You ever have one of those days when everything goes right for a change? A day when every IV just slides right in.......every patient's pain is controlled.......every family member is happy with their loved one's care.......and when you need help, you actually get it?

    Today was just such a day, and I'm still smiling even as I savor the fact that it's the weekend and I'm off for two days.

    At 3 PM I went from PRNing the floor, as I normally do from 11-3, to a team of patients, which is also the usual thing. I'd been in these particular rooms quite a bit during the earlier part of the day, so assuming these patients' care was no big deal.......they were busy, and three of them were heavy care, but the main problem was my 5th patient, who was coming in from her home to have her Foley catheter changed.

    Now, before you ask why home health wasn't involved, or why she had a catheter in the first place, let me share this: This woman weighs 475 pounds. She has a catheter because she cannot get out of bed to toilet herself, and she has such a loooooooong history of physical AND mental problems that none of the home health agencies will touch her with a ten-foot pole. So she comes to the hospital once a month to have her catheter changed.......and the crud cleaned out from places most of us don't even have, and her skin assessed, and a full bed bath given. :uhoh21:

    Complicating things is her chronic need for oxygen, her quickness to panic, her diabetes, and her perilous home situation (her 80-year-old father and a woman who must be 70 if she's a day are her primary caregivers). There is no small amount of odor, which is dealt with by wearing masks with wintergreen oil sprinkled on them (I'm serious.......otherwise it's truly enough to gag a mortician). Getting her into the bed with our special lift, rounding up enough hands and equipment to do the job, and actually performing it usually takes at least 90 minutes, sometimes even up to 3 hours, so I wasn't sure how I was going to handle her PLUS my other patients.

    So I put a call in to the assistant department manager.......suddenly she remembered a meeting she had to attend (yeah, SURE ). Called a nurse who was extra in the critical care unit......oh, sorry, she was just getting an admission. Okee-dokee.........then all of a sudden, my co-workers gathered round and we brainstormed how we were going to attack the problem. One nurse went for the supplies, three aides and a student went in to get the patient out of the Hoyer, another nurse grabbed a handful of bath packets, I got the wintergreen oil, the masks, and the gowns, and then we all went in to do battle.

    Now, I'm a stickler for dignity, so I directed preparations while making sure the curtains AND the door were closed, and explained to the patient how we were going to do this. I'd gotten an inspiration and thought we probably ought to leave the old catheter in as a guide until we inserted the new one, and by golly, it worked! Two workers on each side holding the labia and the stomach out of the way, one at the foot of the bed supporting her legs, and one other nurse and I coordinated the cleaning and cath insertion process. VOILA! The new cath was in and functioning, the old one was out, the patient hardly even panicked.......and we got it done in 30 minutes.

    That, my friends, was teamwork at its finest. We not only set a record for getting this task done in short order, we actually kept the patient calm and preserved her dignity in the bargain. She even hugged us and thanked us for making what was ordinarily a humiliating and painful process as pleasant as possible (we'd even gotten her laughing a few times during the procedure), and we sent her on her way........all of us feeling good about the work we'd done, and proud of the manner in which we'd worked together to bring about a positive outcome for all concerned.
  2. Visit VivaLasViejas profile page

    About VivaLasViejas, ASN, RN Guide

    Joined: Sep '02; Posts: 26,920; Likes: 44,499
    RN and blogger extraordinaire; from OR , US
    Specialty: 20 year(s) of experience in LTC, assisted living, med-surg, psych


  3. by   stidget99
    Purely inspirational!! Thanks for sharing!
  4. by   night owl
    Excellent Job!
  5. by   Tweety
  6. by   ValerieB
    Kudos to that staff! Bariatric patients pose unique challenges. It's sad that home nursing can't be provided. At least for that day, the staff made her feel dignified and that her privacy was important. These are true caring professionals at work and it makes me happy when I hear stuff like this. :Melody:
  7. by   Spidey's mom
    Marla - to answer your question YES there are times when I just want to kiss my co-workers. The team spirit is awesome to behold.

    I agree with Valerie - too bad there isn't home care. It must be very degrading for that poor woman.

    You guys did good!

  8. by   NRSKarenRN
    great example of teamwork and preserving patient dignity. marla!

    Quote from valerieb
    it's sad that home nursing can't be provided.
    let's look at the facts here:

    Quote from mjlrn97
    perilous home situation (her 80-year-old father and a woman who must be 70 if she's a day are her primary caregivers).
    2 elderly caregivers to assist one homecare rn and maybe one aide in cath change = 4 persons ...

    Quote from mjlrn97
    two workers on each side holding the labia and the stomach out of the way, one at the foot of the bed supporting her legs, and one other nurse and i coordinated the cleaning and cath insertion process
    four persons needed just for holding stomach and labia: total of seven staff members in the hospital to change a catheter and bathe patient.
    not available in homecare.

    keeping old cath in as a landmark a must or insert long handled sterile q-tip into place, remove old, insert new along qtip then remove it once cath draining urine.

    toss in a fractured l femur that our agency patient had. unable to breathe lying on back, unwilling to turn herself off of her side and skin beneath started sloughing. weight estimated by pt over 500 lbs. she too was sent to the hospital this week and computer marked referral clearance: homecare will not accept client back as inapropriate. no lift in patients home: we can not safely meet patient needs due to lack of adequate caregivers.
  9. by   MryRose
    Way to go!!!!!:hatparty:

    A total inspiration for the nurses to be too!


  10. by   VivaLasViejas
    Thank you all..........this was one of those moments when I come out of the room thinking "Yep, THAT'S why I do this!" Moments that remind me that I'm a member of the greatest profession on earth........NURSING!!!