Dragging 'em out of bed

[SuesquatchRN]

Demented resident - we'll call her Mary - is always cold, often combative with care. She's freezing when she first wakes up. Incontinent of bladder. Her saturated chuck gets nice and warm.

She. will. not. get. up. The other nurse - I will NOT do this - tells the aides to get her up regardless. She's fighting and cursing and an aide ends up hurt and Mary ends up weeping in the nurses' station and asking me, "Why did you let them do this?"

She thinks she's been beaten up. Well, she kinda has been.

Now, I know she can't lie in her own waste all day and needs to get up. But how do we do this? (My co-nurse is pissed at me for suggesting that fragging her out of bed isn't the way to go. "They didn't DRAG her out of bed!" Of course they did, numnutz.)

Any suggestions?

[ayla2004, ASN, RN]

Good point Canoehead,we often just change them in bed( I assume a Chux is some sort of incontinence pad?)However they can be just as combative being changed in bed as getting up.The bottom line is they just want to be left alone and not fiddled about with by us young wippersnappers!:trout:

chux i think are the attends blue squares i think it would easiar to genlty roll the old one out clean and dry the lady and palce a new one under her

[nightmare, RN]

60 milimeters?

A UM must men unit manager. This American is guessing, too.

Where in Scotland are you?

60centimetres! in other words approx.24inches by 24.

I'm in Aberdeenshire which is the north-east of Scotland.

[SuesquatchRN, BSN, RN]

That's right! Centimeters (we spell funny here).

My paternal grandmother was from Aberdeen. Grandfather from Troon. But they never called themselves Brits.

[nightmare, RN]

My paternal grandmother was from Aberdeen. Grandfather from Troon. But they never called themselves Brits.

Neither do we!! I was trying to be PC! We are always Scots and proud of it.

[BoopetteRN]

today many things have changed in ltc, and some things remain the same. we are beginning the pioneer adventure at my facility, in other words, resident choice; we already have resident choice dinning. now we are working on resident's rising on their own and try to create a routine for them that is as close as what it was when they lived at home, well as much as possible. research shows that even demented residents can make consistent choices in regards to adls. getting them to get up sometimes is challenging. assess for pain, because many times they can not verbally express it, give them a time ( i will be back at 10 to get you up), then you will make sure they are kept warm with sweaters and blankets, tell them how long they will up and stick to it. find out what kind of activities they participated in when they were young and try to adapt them for the resident now. there is a video called bathing without a battle, creating a better bathing experience for persons with alzheimer's disease and related disorders by ann louise barrick phd, joanne rader ms, rn, and phillp sloane md, mph from the university of north carolina at chapel hill which provides a wealth of information to help deal with dementia and the problems it presents. keep the spirit up, we are living in a wonderful and adventurous time in long term care, we are changing the way elders are being cared for to make it better for all.

[nightmare, RN]

That sounds really good B but what is you staff to resident ratio?

[SuesquatchRN, BSN, RN]

there is a video called bathing without a battle, creating a better bathing experience for persons with alzheimer's disease and related disorders by ann louise barrick phd, joanne rader ms, rn, and phillp sloane md, mph from the university of north carolina at chapel hill which provides a wealth of information to help deal with dementia and the problems it presents.

hey, i just ordered the book through amazon.

[BoopetteRN]

Well not really that great because we have 7 residents who require one on one supervision because they have abused another resident, staff have to monitor them closely. Today on day shift we have 51 CNAs with a census of 237 residents. On pms we generally have 26 CNAs and on nocs we have 16 CNAs. Since we are just beginning our adventure with this movement we are still learning, from everything I have read, permanent assignments help the staff know the residents really well and retention and morale actually goes up, I hope so because we are short all the time.

[SuesquatchRN, BSN, RN]

Boopette, your staffing ratios are delicious, and seem like a dream to me.

[VivaLasViejas, ASN, RN]

Wow.....51 CNAs on day shift for 237 residents? That is some incredible staffing!!

Can I come work there?

[BoopetteRN]

we are currently not accepting any more residents because our staffing is so bad. we have the capacity for 304 residents. we have 1 and 1/2 halls closed down. the nursing situation is even worse. we are short 10 nurses and 17 cnas. we are had to resort to using agency staff. we are a county facility

[adrienurse, LPN]

can't you change her but not get her out of bed?