Is TLC(=tender loving care) causing you more trouble?

[sarahrain]

i took care a ventilated, 74 year old, patient today. he came in unconscious with opening eyes and motor response to pain only. due to high pco2, he was intubated and sedated. as his thyroid function was corrected. he was more alert. and predictable, his fist reaction was anxious and disoriented. i explained to him and gave reassurance to him from time to time. and it happened that he was a christian, i talked to him and read him a few interesting passage of my christian book. he was obviously calm down. spiritual encouragement did help him as it seemed.

the trouble was he kept knocking at the cot-side after that for more attention. and my colleague said because of my tlc, the patient would start to give us trouble..

and i would say she is no different than just a management-centered staff nurse as if she doesn't know that anxious and knowledge deficit are nursing diagnosis.

is tender loving care causing you more touble?

[nightmare, RN]

TLC is always labour intensive and always worth it!

[Dolce, RN]

TLC is always labour intensive and always worth it!

I agree. TLC builds a positive nurse-patient relationship. If the patient feels that they can trust their nurse and that their nurse has the patient's best interest in mind they will be more cooperative with cares. Also, they are much more willing to forgive you for the times you may appear rushed or busy. If they know that you really care about them they can feel more confident in their care.

[SuesquatchRN, BSN, RN]

I hope that if I'm on a vent and frightened that some kind nurse will show me the kindness and attention you did.

[Ms Kylee]

I love giving my patients the attention and care they deserve. I really hate it when nurses tell me I'm spending too much time in a patient's room. Some are really sick, some are really scared, some just need someone to listen. I've also found most of the PITA patients settle down and don't spend as much time ringing if I spend a few extra minutes just listening to them.

You did the right thing. Don't listen to that other nurse.

[RedCell]

Sounds like this Christian dude could have benefited from a healthy bolus and gtt of dexmeditomidine....a different yet superior form of "TLC". This concoction of snake oil will quickly resolve any knowledge deficit or anxious thought process.

[NRSKarenRN, BSN, RN]

Sounds like this Christian dude could have benefited from a healthy bolus and gtt of dexmeditomidine....a different yet superior form of "TLC". This concoction of snake oil will quickly resolve any knowledge deficit or anxious thought process.

From YOUR perspective.....

The comments I've received fron the hundreds of vented patients I've cared over 20+ years, is that they felt trapped. Calm soothing voice, possitive words of encouragement along with human touch and personal presence what they craved--and made the difference helping them get OFF the vent.

[prmenrs, RN]

Before you hit them w/the Etomidate, might want to read the side effects section of this Wikipedia entry: http://en.wikipedia.org/wiki/Etomidate

[RedCell]

I am aware of the adverse effects of etomidate, but who mentioned etomidate. I suggested dexmeditomidine as a smooth way to wean the dude from mechanical ventilation.

[sasha1224]

I am aware of the adverse effects of etomidate, but who mentioned etomidate. I suggested dexmeditomidine as a smooth way to wean the dude from mechanical ventilation.

Yeah, Precedex. Maybe this is a great drug in some instances but not in all. In one patient, touch and talk were more effective than this drug. And for the chronic vent pt trying to wean it may not be feasible. Nowadays, longterm vent pts are moved from acute care to other facilities for weaning. I work for such a place, an LTAC. Most of my pt are trach/vent pt for weaning. We do not have Precedex on site, or can justify it. We have to rely on other means. And the concept of TLC has gone a long way here. Our wean rate is above the national average. With a combination of care from each specialty(resp, nursing, pharm, pt, ot, dietary, aides and MD) a good portion of our pt go on to functionality. So my point is that TLC can make an impact on the pt life. You don't just need to drug them.

[racing-mom4, BSN, RN]

I treat my patients like I treated my babies in the sense that the more I held them the less they ultimately cried.

In other words if I spend 5 precious minutes sitting next to someone on the edge of their bed rubbing their back and listening to them, in the long run they will require less of my attention.

[Penny8611]

I am aware of the adverse effects of etomidate, but who mentioned etomidate. I suggested dexmeditomidine as a smooth way to wean the dude from mechanical ventilation.

The......."dude"?