speti4

As the doc tells it-- An elderly lady went to him, as a checkup is manditory for keeping your drivers license at age 80. she mentioned that she had a "belly ache on and off, because she was constipated." On examination the doc felt a mass. An ultrasound followed by a CT revealed cancer. Because of her age it was determined she was not treatable. It was believed she had 6-12 months. the morning she was given the bad news, she left his office in shock with her blouse unbuttoned. The woman's husband had been waiting in the car for her. Shock left her unable to speak so he went to speak with the doc. It was determined that she would be admitted to the hospital until she was able to cope a bit better with her dx. This is where/when I met her. It was early in my 0700-1900 shift. She climbed into bed and refused everything.. pain meds, food, drink, etc, She cocked her head to the side and when spoken to repeated "Leave me alone I'm here to die." She was a strong woman who, her husband said was preparing food for the family reuinion weekend that was to take place starting that night. She made a turkey, ham, etc. As guests of the family reunion arrived, they were informed of her status. They were all very shocked she was in hospital as they had spoken with her before they started their journeys to our town. The woman's "Leave me alone- I want to die" got fainter as the afternoon progressed. Her head still cocked to the side.. she started chain stoking We moved her to a palliative suite where all her terribly confused reunion guests gathered round her bed. at around 1600 she took her last breath and was gone. How weird is that?

I hear you...been there, and do that too... Well--on occasion when I work 1100- 2200 PRN at a LTC facility. Then- I have 39 residents with 3 or 4 Care Aides. It is a tough job. I was referring to my regular nursing job on a M/S ward where the focus of care is on the acutely ill and is totally not equipped for the demented, but not sick senior. AND have four+ other acutely ill pts. I'll use whatever technique necessary to soothe an agitated senior. In addition to our place having many exits to the outdoors, we are at the top of a hill and any road a confused senior may take goes dowwwn.

I work in a med/surg ward in a rural hospital and we almost always have at least one geriatric/ALC pt on our cencus. They come through the ER because they have fallen, caregiver has burnout, etc. What ever the reason, they can no longer live at home and are waiting for placement. The unit is definitely not an environment conducive to utilizing the various philosophies of care I was taught. I personally have found the best way is to 'join' them in their reality. If they are agitated and "waiting for mom" -- I would never try to reorient them by telling them that their mom is dead.. I might however ask if they would like a clean gown or sweater while they wait. I would also use any other creative distraction technique. Even therapeutic lying. But--with open stairwells and exits, restraining them by using a gerichair has become necessary. Sometimes just parking the chair at the nursing station, reclining it and covering the agitated pt with a heated blanket is all they need. With four or more other pts on my assignment it's not for lack of desire, but for lack of time that such a restraint becomes necessary.

I also have benign familial tremors. I say go for it!! When I was a student I made sure I told each of my instructors that I have benign familial tremors. Not out of the blue, but rather at nursing arts and clinicals when the shakes become more obvious. I figured telling them straight out stops any speculation. I work in a med/surg ward and have found ways to help steady my hand as I fill syringes, etc. I am pretty matter-of-fact about my shakes ..with everyone. No apologies. It's part of who I am and doesn't impact the care I give. A few months ago I was learning a new wound care dressing technique and the nurse demonstrating had to be one of the most tremulous non-patient I have met. She eyeballed the wound and sissors in one shaky hand and large dressing in the other, she cut that dressing in the the exact shape of the irregular wound bed. I have never seen a steady hand accomplish what she had. I was duly impressed.

I have the hot pink happy face with hot pink tubing. I think it's ok... no better than my Littman. But my last two Littmans looked like everyone elses, so now I don't have them I like that it is unique and can be spotted easily. I don't find it gives a better listen to the lungs or heart compared to the Littman. When I bought mine they claimed that lungs could be heard through several layers of dressings/clothes.. Not with mine... at least no more so than with a Littman. Most of the doc's and nurses have used it and not one has commented either way. It is lighter that a Littman and hangs nicely around my neck. I would get another one because of the colors and light weight.

I work in a med/surg unit and occasionaly on call in Extended care where I have 39 residents. The med passes take most of the time..There are so many meds in that unit it boggles my mind. I have a few wounds to dress. I change the odd catheter. I do very few assessments per shift, sometimes none as they are in their homes, not the hospital. I communitcate via the fax for orders, etc. I don't like the environment, but I usually manage to get my work done by shift end. Some days it feels like I am running around putting out fires rather than being productive. Ah well... I have days like that on med/surg with 4 pts.

I'm sorry your family is going through this difficult time. What your father is experiencing is not uncommon. As a matter of fact, I recently had a pt with the same moods and he also voided in places other than the toilet. My recommendation is that your mother speak with his physician regarding these moods and behaviors. There are medications that can help with them. If one doesn't work try another. Best wishes to you and your family.

In spite of staying fit, using lifts and equipment to take the load off myself, and also watching my body mechanics, I still end up with shoulder tension which result in headaches. I always have. I have tried MDs, massage, stretching, narcotics, NSAIDs, analgesic rubs, hot/cold packs, showers, baths, yoga and plain waiting it out. One trip to the chiropractor and it's like magic. I go about once a month. As for the baby, I wouldn't do chiropractic unless she was symptomatic and we had explored all other possibilities. Maybe not even then. The swollen legs would get a trip to an MD as well. Chiropractic is a complimentary medicine, it isn't a cure all. But it sure has given me a better quality of life :)

I agree with you Miss Calculation....Clairol Natural Instincts is wonderful stuff. The first time I used it I applied it all over. Now I just apply it to the roots, put a plastic bag over it and leave it for an hour. I know the instructions read 15 minutes, but I leave it on for an hour. (I know...but I tried a test strip first) The last five minutes I apply it to the rest of my hair to brighten it up. I agree that the grey looks like goldish highlights.

It depends how low they are. If there is no sliding scale coverage ordered and they are really low, I melt some honey in the microwave and add some juice. If they are slightly low I give a snack. As a rule I dont find the glucase tablets handy. We have far too many patients with aphagia, bad teeth, or worse...no teeth. It takes a looong time to gum a glucose tablet, no to mention three of them. I had a pt break a tooth on one.

OWNK .....Out of Wedlock Not Keeping

I refuse to do any procedure for which I am not properly trained for. I keep in my work mailbox and also post on the wall in the nursing station a complete list of procedures that fall within my scope of practice. I get it from my licensing body and update as things change. Our Unit Clerks are also LPNs this is so handy for cosigning insulins and warfarin. But they do it as a favor as it is not part of their duty. They have no nursing procedures within their scope of practice. Their nursing history makes them awesome at their job.

Hi, it sounds like one of those difficult spots to keep covered. We use Friars balsam around (not on) the wound. It is so sticky that the duoderm sticks so much better. One thing that seems to get missed... is there adequate protien in their diet?

Wow Lindarn, You sound pretty sure of yourself.

We can have anything we want on our badges......well, almost anything. I have never seen any patient get overly impressed by a nurses badge. Just the quality of care they receive. If you want, you can have one made by an engraver.