help needed

[sheilab]

i am a community nurse and we are about to change the way we work. we will be loosing our twilight and night service and working an 8-8 shift pattern what i would like to know is 1; is anyone else out there doing a similar thing 2 if a patients catheter blocks after 8pm when we finish can they wait till the next morning or do they go to a&e 3 does anyone have any reaserch that will show how long a patient can be in a wet bed before tissue damage occurs. i need upto date info to present to our bosses before the end of jan.

[purplemania, BSN, RN]

If the patient is totally incapacitated should they remain at home?

[GingerSue]

sheilab - these are really good questions, and I hope someone knows

purplemania - about totally incapacitated patient remaining at home - people who are quads live alone with special telephone equipment and daily home nursing visits and several sevices - is this what you mean?

[meownsmile, BSN, RN]

I really dont know about your first 2 questions but with the 3rd. Amount of time is totally based on the individuals health status, nutritional status, and if they are completely and totally dependant. Try a wound/continence/ostomy clinic and see if they have the information or research you are looking for. I would think someone having to be in a wet bed for any longer than absolutely necissary would be unacceptable. Are they going to have people on call basis for some of these needs?

[sheilab]

the trouble is in england we manage alot of people at home they have carers usually visiting 3-4 times a day and also us and our twilight service which work from 6pm to 7am in the morning it usually works very well. people live in their own homes with this support and usually no relatives near by. i have a lady that has been in bed for the last 13years she is 94 she has no pressure sores eats and drinks when the girls come in. we visit to do catheter care and general problems that the carers may have we have key safes on the out side of the houses that we can gain access by and this works very well. thats why we are upset that they are going to cut our hours and our staff.