txwildflower57 2,501 Views
Joined: Oct 13, '06;
Posts: 36 (56% Liked)
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I dont even know you and I love you! I have worked with many nurses that thought helping me was beneath them. There was one time when it was all male CNAs in the building and there was a few residents that didnt want a male cleaning them up. and the nurses said they can either take you guys or nothing until the next shift let me remind you that it was 12 hour shifts too!! I thought How rediculas! then there was some nurses that didnt mind and the nurses that help me I help in return like geting the stuff ready to do treatments and helping them turn a resident. I used to worke with one nurse that was an aide for a long time and she even helped do bed checks with out even being asked to help. I love all nurses that arent afraid to get there hands dirty and whipe a little butt or answer a few call lights. I know that I cant wait to be done with nursing school and I havent even started yet because I want to be one of those nurses that arent afraid to do aide work. you give me hope and I dont blame you either for feeling like you could be doing somthing better with your training also and that the young LPN gets treated like the experienced one I think it should be shared equally.
It might help to research the difference between systolic and diastolic blood pressure. Systolic is the pressure in the arteries while the ventricles are contracting. Diastolic is the pressure while the ventricles are filling, or the heart is at rest. Most blood pressure medications that you are giving affect the contractions of the heart- either slowing the rate or decreasing how hard the heart contracts. Those would decrease systolic pressures (force during contraction of the ventricles) but affect the diastolic much less.
YOu need to be concerned about the diastolics when giving a medication that relaxes the smooth muscles of the arteries (like hydralizine). Med's that relax the arteries will decrease diastolic blood pressures as well.
Also consider whether the diastolic BP is the patients norm or if they are taking other meds that could be affecting it.
When you have a question like this, think about the action of the med you are giving. How does it affect the body in order to achieve results? Then consider whether or not that mechanism of action is likely to negatively affect the patient in some way.
It seems to me anybody and anybody can do nursing, doesnt matter if you are really interested or not, not important if you care about people or not, not relevent if you have a passion for nursing or not just come along we will train you and then you can look after our sick, eldery, frail, poor homeless, drug seekers.
Without passion, without caring, sometimes with little comprehension of what that poor sick person in the bed needs.
I am fed up with hearing about people seeing nursing as a quick route to money it is so much more and it offends me that nursing is used as a short cut to being employed. We should have stricter entry rules and by this I mean more screening to make sure the nurses coming into the profession actually want to be a nurse for the right reasons and employment not being one of them.
We all know nursing is a hard profession it takes from your soul sometimes but you know who has the passion because they ride the storms better than the nurses who dont have it.
I have had a passion for nursing most of my life and I am now struggling with some of the harsh realities-but give me a patient any patient and I come alive, I thrive. I forget why I am tired after all my years, I forget why I want a new job, I forget why the management make my life harder each day.
For me nursing is almost like acting I can be somebody else with a patient I can be who they need me to be for that person and their family, I have the ability to calm a tense situation, I can bring trust to the room, I can make that patient feel like they are the most special person in the hospital and that nothing is too much trouble for me. I have knowlege and can educate. I can make that person feel safe, I can make them laugh even when they dont want to, I can be their advocate, their confident, their friend, but also I can persuade them to take the shot, to take the medicine, to go for the test. I can hold their hand and I can be firm. I can predict their mood and can listen to their worries and woes. I can educate their families and friends and I can educate and train their future RN's.
It doesnt matter that outside that room chaos is happening, that 3 other pts need me as much if not more than the patient I am with. They at that moment are the most special important person in my working day.
In 20 years I have had this ability it has shone out of every bone in my body. I have smiled constantly even if my world is falling apart. I have the passion I can make somebodies life better, I know my 'stuff' and I care.
Although I came into this profession relatively late in life, I have been around healthcare long enough now to yearn for the "good old days", when nursing homes looked like hospitals and hospitals (and other care facilities) had squeaky-clean, shiny floors. I used to love walking down a hall where the tiles gleamed like pearls and no ugly stains could be seen to remind one of what sort of substances hit the deck on a regular basis. I miss the crisp, efficient sounds of rubber-soled shoes on freshly-waxed linoleum and the faint antiseptic smell of a well-scrubbed room. And while I'm sure walking on hard floors shortened my bedside-nursing career by several years due to the stress on my knees and back, it was certainly easier to push an occupied bed down to the ICU over a smooth surface than wall-to-wall carpeting.
The use of floor coverings in healthcare facilities---for all its cozy charm---has to be one of the worst trends ever invented. The stuff is everywhere now......in acute-care and skilled nursing facilities, clinics, doctors' offices, even long-term care. Yes, it makes the building seem more welcoming; yes, it's more "homey" than chilly, sterile tile. But I have to wonder what the powers that be were thinking when they decided to put carpeting in places where patients are incontinent of every possible bodily fluid, and where they drop food and liquids which produce stains that even the toughest industrial cleansers can't get out.......at least, not for long.
I didn't always loathe carpet in healthcare settings; in fact, for years I advocated it as an antidote to the cold and clinical appearance of most facilities. But the realities of working it are a "whole 'nother" matter entirely.
Take the one night when my son, the CNA, and I were working together on the LTC unit of a local nursing home. I'd gotten my med pass done and was charting my treatments when he came down the newly-carpeted hall with a resident perched on a shower chair, and he was hollering "MOM! I need you to come look at this!" Of course, I broke into a run because I thought someone had gotten hurt........but no, it was one of our two MR/DD residents, with poop trailing fifty feet behind her and the crowning achievement, a soft, extra-large BM, sitting right in the middle of the carpet like a comet with a long tail.
He did the best he could to pick up the mess, but after valiantly fighting his gag reflex for several minutes, he succumbed and gave it up, tossing his cookies unceremoniously in the nurses' station sink while both the resident and the rest of the staff howled with laughter. It would have been SO much simpler just to wipe things up with gloves and a few paper towels (well, OK, a lot of paper towels) and then mop the floor; but no........we've got to make things complicated and try to pick it out of carpeting with the texture of Astroturf.
Then there's the stain factor. Why is it that when something lands on a carpet in a healthcare facility, it keeps coming back to haunt you forever? Case in point: last winter, our company yanked out all the nice deep-maroon carpet that hid a multitude of sins and replaced it with a rough-napped, greenish-tan material that shows absolutely everything that's spilled, voided, evacuated, or otherwise deposited upon it. The maintenance staff extracts and shampoos it twice monthly, as well as spot-cleaning it PRN---which is sometimes every couple of hours---but those stains keep turning up like bad pennies. Housekeeping does the best they can; care staff tries to catch dribbles during meals; even the administrator has been seen standing over repeat offenders with a squirt bottle, muttering "Out, out, damned spot!"
When you're standing on the second-floor balcony overlooking the dining room, you can see every sip of soup, every spoonful of mashed beets, every overfilled glass of cranberry juice that's wound up on that carpet since it was installed.....from up there, it looks like a bad map of L.A.
Which is sooooo not-impressive when a prospective resident comes in to check out the facility. I'd been unaware of how bad the carpet really looked until a few weeks ago, when a tour came in and both my boss and the marketing rep were at some Chamber of Commerce deal. Since I was the only manager on duty, I was elected by default, which didn't thrill me because I'm a nurse, NOT a salesperson, and I couldn't sell a space heater to an Eskimo. But I digress.
I've always loved that upper-story view of the dining room with its lush appointments, its elegant chandeliers, and its generously proportioned picture windows; it's a gorgeous sight, and on the rare occasion when I do give a tour, I show it off, and most people comment very favorably on it. Unfortunately, this potential customer just happened to be a prominent state representative who was looking for a place for his mother......I still blame that stinking carpet for losing the "sale" to another assisted-living facility, which presumably made better choices when it came to flooring. Feh.
Now, if we had nice wood-grain floors, like another facility I worked for a couple of years ago, we'd have both form AND function---what a concept. So when the topic of changing the carpet came up last fall, I suggested this practical and attractive alternative....only to meet with utter disapproval on the part of Corporate. Actually, they pretty much laughed me out of the room when I mentioned it. "Our residents want a homelike environment," the "experts" reminded me. "Nobody wants bare floors and bleach smells in their home."
Ho-kaaay, well, it's hard for me to believe they want floor covering that looks (and smells) like 80 toddlers peed, drooled, and smooshed their strained carrots on it, either, but far be it from me to question marketing people!
I don't mind the carpet in the lobby and the hallways. It does make the building appear warmer and friendlier, and it muffles the institutional sounds of walker wheels and orthopedic shoes. I'm not as big a fan of carpet in the residents' apartments for the obvious sanitary reasons, but the rooms are their homes; and if they'd rather do their frequent face-plants on a nice cushioned rug than a hard floor that doesn't 'give', I'm all for it.
It's those ugly patches of black and brown stains that stretch from the med room to the mailboxes, the break room to the kitchen, the dining room to the patio out back that alternately fascinate and repel me. I wonder what, exactly, created those stains and what, if any, diseases they contain; and I avoid walking on them, thinking (as nurses are prone to do) that I don't want to take any of it home to my family and pets. If I start feeling nauseated, I automatically ask myself if I might have stepped in the area where RuthAnn horked up a plateful of chicken a la king earlier in the week; and when one of the staff tells me that Bobbie's catheter sprang a leak during lunch, I'll raise the maintenance man on the walkie-talkie and get him down there with the extractor before the yellow peril has a chance to do its damage.
Bottom line: The "eew" factor is very prominent in these misadventures, and to my mind carpeting serves mainly to reinforce the theory that the world is literally teeming with pestilence. But I have to confess that while I've been a germophobe by trade for many years, it's gratifying to hear residents and staff alike admit that they used to go by the 5-second rule for food and meds dropped on the floor, and now that they're here, they don't do it anymore. Hmm.......can't imagine why.
You know what really gets me about this stuff? Take the example the OP gave about one group that supposedly needs to have dirt under their bed. Let's face it, that's a folk superstition dating back from more primitive times. There is no scientific data that supports this, it sounds ridiculous, and probably the people who actually subscribe to that belief are uneducated people.
First of all, I'll bet that ethnic group consists of more than uneducated hillbillies that are following medieval beliefs. Yet these cultural diversity pundits paint these ethnic groups with broad strokes and stereotypes. They actually make non-white people from other countries (except for white hillbillies from Appalachia) sound like superstitious peasants.
Secondly, I see no reason for the healthcare system to indulge people's outrageous superstitions. These people sound like they have severe knowledge deficits. Why should healthcare workers be expected to guard dirt under the bed in a hospital? I think that's outrageous. Let these people put their dirt in a box and put a sign on it themselves not to touch it, just like other people leave their slippers under the bed.
This is a very loaded subject. :typing
Think about all of the different cultures outside of those medical walls and ask yourself how they culturally mingle. I would say, overall they do not, they remain cloistered to an extent. Point being, a care plan will not do much in enhancing cultural bridges. The care plan is always underutilized. I agree with the one poster that said one more piece of paper is a bad idea.
I think for what you are trying to study, I would apply to LTC --- there I believe it would be successful and the poster that said to study pharmacy/culture would be useful to the prescribing doctors moreso than the nurse, yet a good idea.
Good luck with the paper, interesting topic,
Also, when you said those in the United States should abide by our traditions, I have to ask, whose traditions are those? The European white majority? We have many traditions. The European white majority is going to become the minority as demographics change in the United States.
I don't know that it would work because even if a person identifies with a particular religious group, that doesn't mean their practices are the same. For example, if a person is Jewish, they don't necessarily keep Kosher. Those that keep kosher do so to different degrees. I know a rabbi who keeps Kosher, but will eat chicken with dairy because chicken is a bird, not meat. Other rabbis would freak out if you tried serving them chicken and milk. Other Jews consider themselves Kosher because they are vegetarians or vegans. Some Jews simply don't eat forbidden meats (pork or shellfish), and they consider that kosher-style.
I think an individual plan of care will be the most appropriate.
You could sum this "class" up in about 10 seconds. Treat others how you would want to be treated. There you go, A for the day.
You could sum this "class" up in about 10 seconds. Treat others how you would want to be treated. There you go, A for the day. Seriously, this kind of ****** is why new grads have to go through hospital orientation programs to learn how to be a nurse. If Nursing Educators really want to be teaching this cultural diversity crap then they should at least cover useful topics...such as pharmacokinetic/dynamic differences that are apparent among different races, why some classes of meds work on one group and not well on another. At least you could apply that to nursing. Actually, that would be a helpful database for you to put together. You could probably even get it written up in the ANA journal.
Tx, My opinion like a "smug sociologist" and nurse and closed to patient satisfaction, loooool, much more than MY own cushion job well paid, is YES, is a nice study, good to be applied if a open mind manager will see it. And I will tell why...
IF I will be your patient and if my cultural background and my etnicity will be respected by your facility and your employe know how to talk with me, knowing my background I will come back each time. If not, I truly belived that I will found somewhere else...
And I will give you an exemple, people who belong to one culture...... deaf culture like, LGBT culture, like gipsy culture, like punk subculture and many others has their own values (hided or not). Much more many of them could respond or not of the questions related of them culture. Many of them even not identify them self like part of that culture, are hided. But others are out of the box and is easy, to keep them contents.
If you will ever try to talk about heaven and confession with a gay what do you think that he/she will do next time when she will need medical care....loool.
Or if you will put a gipsy in isolation for MRSA, and not alowed any one in contact with him many days... what do you think that will be happen, next time.
Or if a old hippy one that usually smoke pot from his young times and you will try to keep him on ativan and pain meds just to make him helaty...lool
Or related etnicity...is the same...just nice, nice nice..very related to patient satisfaction
Is a soo nice study..... "five a clock tea" is another etnicity related one... sir, madame.. a lot, looooool. My opinion try it! If you will know how to expose your ideea, related to patient satisfaction, sure you will find a open mind for implementation!
Frankly, I think catering to every wacky, superstitious belief is opening up Pandora's box. If someone has an unusual need or belief, whether it's culturally based or not, they need to communicate it clearly to the staff and not expect the hospital to know every little cultural nuance under the sun. To expect every nurse to guard some dirt under the bed is going above and beyond the call of duty. And please don't give us another form to fill out to satisfy the smug sociologists who cook this stuff up from within the hallowed halls of academia.
i agree with karen.
i think you have a great idea to build on there.
as far as more paperwork, i am not a huge fan of that, but like she mentioned making it a part of the intranet system is a good idea.
that way nurses can pull it up at their discretion and see what cultural considerations are necessary when the patient informs you of any specific religious or ethnic backgrounds.
for example, i had a middle eastern patient who about knocked me out when i tried to start an IV in his left hand (with my left hand, mind you) he said the left hand is dirty and is reserved for wiping after the bathroom. that is something i never knew!
Cultural consideration is important in education, compliance and comfort.
It is part of treating the patient holistically.
I do not need another piece of paper to fill out or print out some "overall" considerations that may or may not apply to the individual in front of me.
Part of triage is asking "do you have any cultural or spiritual needs I need to be aware of?". Most people look at me like I'm crazy, but it is part of the mandatory questions on entry into the hospital system. If there is something they do or don't want done, that's the opportunity to say so. "Databases" can be misleading, wrong, or not applicable.
Beyond that, its up to me to know my community and its makeup. I know general things about Navajo, Pueblo, Northern Apache, Hispanic, Mexican and Deaf culture; because all of these peoples are my neighbors and patients.
And please don't give us another form to fill out to satisfy the smug sociologists who cook this stuff up from within the hallowed halls of academia.
It is not the responsibility of the American healthcare system to accommodate for the customs of each culture residing in the United States (unless a particular institution is trying to turn a profit adhering to a particular custom). If you are in America, then you should abide by our traditions. Want a vegan dinner tray, fine, eat the apple that is neatly place next to the tea.
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