schoedr

When I first started working as a nurse, I worked with a very nice gentleman with a neurological disorder that left him unable to move much of his body. One of the first days I worked with him, he requested the urinal while sitting in his wheelchair. While I was more than a little uncomfortable about unzipping this man's trousers an kneeling under his lap tray to hold his urinal for him, I put on a brave smile and did as requested. Unfortunately, his member was only about two inches long, if that. But, being the resourceful and helpful nurse that I am, I was intent on doing my best to help. OK, so there I am, holding the urinal with one hand, trying to get and keep his member into the urinal gently with the other. I had to readjust my grip a few times. Ok- I really had no idea what I was doing.... after a few minor readjustments, he grunts a little, then ejaculates.... we both were quiet for a couple of moments, then he says... uhhh, I lost the urge.... :imbar

How about public or community health? You still get to work with people, but it isn't really patient care. No life-or-death situations, for the most part. You usually work weekdays, regular hours. I am a family planning nurse for the local health dept. The pay is less than I was making at a hospital, but the stress level is also much less. Our health dept. also has nurses working in the WIC clinic, immunization clinics, maternal-child health, TB, STD, all sorts of different places. And seems everyone stays there for a long time.

Another suggestion- use the longest needle you can for IM injections- it hurts more when medications that are supposed to go IM wind up in the sq tissue- it doesn't sting or hurt nearly as much if it goes in way deep- and don't worry if you hit bone (ugh, I know...) just pull back a smidge then inject- people don't usually feel it at all. And our hospital no longer advises pulling back before injections- check with your facility first, though.

I asked my doctor the same thing. He said, in truth, we really need to worry about it when they start becoming interested in "sex, drugs, rock and roll"... I had to laugh. I chose not vaccinate any of my 3 kids until just before middle school (5th grade). One school nurse was quite upset with me, saying "don't you think your child can ever get molested or raped?". Sure, but I really wanted them to be protected when they really were at greatest risk - when the potential for them to engage in sexual activity and drug use was greatest (I hoped they would engage in neither during their early teen years, but I am somewhat realistic). I didn't feel comfortable vaccinating the kids at such an early age then having to test for immunity, and re-boost because surface antibodies had waned by the time they turned 10 or 11. I feel that I made the right decision, in spite of the "herd" theory. I do realize there are risks- like accidents requiring blood transfusions or rape, and did not take those possibilities lightly, but felt the risks were greater leaving them unprotected, or underprotected when they really were at highest risk- now that they are starting to like rock-n-roll....

I have worked in an RHC for the past 18 years. We never use bedrails as a restraint, but we do have clients who use bedrails for safety and positioning purposes. They are used only when we have approved them as part of a team, safety issues have been addressed, and modifications have been made where necessary. For those whose who have spasticity and may have limb injuries, we may use four-sided plexiglass around the rails to prevent injury or entrapment. For those who can climb, or are ambulatory at all, we do not use bedrails- we use floor pads with safety alarms instead. All their beds are low. For clients who are positioned in wedges and need the siderails for positioning (non-mobile clients), we have positioning guidelines written by ot and justification for use of bedrails (emphasizing, again, they are not for restraint, but for positioning). We also require all parents or guardians consent for bedrail use. I write a careplan for all our clients who need siderails adrressing areas of safety, comfort, etc.. Hope this helps!