Getting my feet wet...

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Hey y'all.

I hope everyone's day has been blessed and exciting. We had our second orientation/clinical day today at a rehabilitation center. We couldn't do much, but we did vitals and gave baths and showers, changed linens, that sort of thing. Anyway, it was fun (scary and new, but fun), and some of the students (not me, though :o ) got to see a cleaning and dressing on a 6x6 cm stage 4 decubitus ulcer :eek: One of the girls watching said she nearly passed out, but I was sad I missed it. (Only in nursing can you make a statement like that and not be thought of a freak. :chuckle )

Anyway, I just wanted to share that with y'all. We have checkoffs on PO, topical, and optic meds Fri., and actual clinicals (for me) start the 21st, so pray for me!

:nurse:

aimee

God bless y'all!!!

Good luck with those checkoffs!

Hey sounds like you are definitely getting your feet wet. Good luck on your check offs!

Your first experience sounds similar to mine. We went to a Long Term Care facility and basically gave a bed bath to a stroke patient and changed her bed, practicing physical assessment of heart and lungs in between.

I did get to see a similar stage 4 ulcer on a patient's sacrum. It was wild. I was distressed by the woman changing her dressing. I think she was a CNA or something, but she didn't keep the procedure sterile *at all*. She said, "Oh, if the state were here, I would do it that way, but I'm in a rush today." No wonder half the patients in there have severe ulcers!

All I have to say about the experience is that it steered me clear from LTC nursing.

-Julie in NYC

Originally posted by julieK

I think she was a CNA or something, but she didn't keep the procedure sterile *at all*. She said, "Oh, if the state were here, I would do it that way, but I'm in a rush today." No wonder half the patients in there have severe ulcers!

Sad...but true! And I find it disgusting...she did this in front of you, can you imagine what happens when there aren't people there to witness it?? My CNA instructor warned us that we would see things on clinical (in LTC) that would make us cringe. She said that we can only change OUR behavior, not someone else's and to learn from their mistakes.

The nurse that was showing some of us around and finding things for us to observe was dressing blisters on an elderly lady and couldn't get the adhesive backing off with the gloves she was wearing. They were really crappy gloves--she couldn't even get her fingers all the way to the tips, so they were just hanging there! Anyway, she took the gloves off so she could get the backing off, and she said to the 5 or 6 of us in the room, "I know y'all aren't supposed to do this, but....." We all just looked at each other with big eyes. I mean, what else would you do in a situation like that? The blisters were intact and the woman was post-op hip surgery, so she couldn't just leave her lying there on her side in pain while she went and found better gloves, could she? See, these are the scenarios they don't teach you about in class!

:nurse:

aimee

Originally posted by NurseChic81

The nurse that was showing some of us around and finding things for us to observe was dressing blisters on an elderly lady and couldn't get the adhesive backing off with the gloves she was wearing. They were really crappy gloves--she couldn't even get her fingers all the way to the tips, so they were just hanging there! Anyway, she took the gloves off so she could get the backing off, and she said to the 5 or 6 of us in the room, "I know y'all aren't supposed to do this, but....." We all just looked at each other with big eyes. I mean, what else would you do in a situation like that? The blisters were intact and the woman was post-op hip surgery, so she couldn't just leave her lying there on her side in pain while she went and found better gloves, could she? See, these are the scenarios they don't teach you about in class!

:nurse:

aimee

Okay, I know that my not being in the clinical setting yet means there is A LOT I DON"T KNOW, But...I do see a couple of different remedies to this that to take off the glove. I mean, the biggest thing IMHO would be to make sure that I do have whatever supplies I needed before taking off the dressing (correct size gloves, sterilized forceps to pull off the backing). Am I wrong? I mean, I definitely wouldn't want the patient to be in excruciating pain, but if by not using sterile measures, wouldn't an infection be even more painful over a longer period of time. Could she (the teaching nurse) ask one of the student nurses to run and find a smaller sized glove?

Please forgive my niativity (sp?).

Kris

You will be absolutely shocked by what does NOT bother you as you progress in clinicals...I thought there was NO WAY I'd be able to handle a 'code brown" yet, I did, no problem. I "followed" the doctor into my patient's room to "observe" a dressing change and was greeted by a NASTY to the bone diabetic ulcer - didn't even phase me!! I was shocked!! I pulled out tubes - no big deal....stuff I would think was not doable - and I do it without gagging...so far...suctioning is yet to come and seriously doubt I'll survive that !!!

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