So I recently switched jobs , and I went from acute care ( critical care and step down units) to long
term care but not your usual nursing home patients , these are Pts with mental and physical disabilities and considered young adults -ages 18-50 being oldest. The majority have CP and a few traumatic brain injuries. I have two patients that require prn nurse intervention one being str8 cath as needed per his request and one that has a trach. Requiring suctioning. Let's address first dude ... He will request that you straight cath him numerous times a shift despite timing between last cath times. Request we'll over what I think you would need to cath someone who is not able to urinate without nursing intervention ... Is there a limit to this the order states as needed within no limits and I have asked staff and they say they just do it when ever and how many ever times he request... Now here's the trach dudes story .... He request suctioning numerous times a shift. He request prior to neb tx , then after and then will request again in between the last neb and then again prior to ha neb and after and then again .. Each suctioning you hardly get anything but a scant amount of clear secretions , he wants you to hold the suction catheter down until he nods to pull it out. Is there a limit to this and how can I approach the fact that this seems to me as a behavior problem almost a stimulation type thing because he is a quad that doesn't feel anything from shoulders down. Any suggestions ???