derelys9

I don't work in ICU or acute care, but two things I find useful for pain management are Reiki and reflexology. Both methods can be taught to the patients and done on themselves and used at any time. I think it would be wonderful for more nurses (and everyone in general) to have some basic working knowledge in these areas, as they are not overly time consuming, they are effective, and most importantly (I think) they give the patient as sense of being in control of what is happening to them and a feeling of them being able to do something about it. Two very good webistes for more information: http://www.reflexology-usa.org http://www.reiki.org/

In the facility where I currently work, the nurses on 1st and 2nd shift have 28/25 residents. Night shift has 55 and 50 on the front and back halls respectively. I started out working second shift on a hall with 28 residents. It is certainly a challenge when you have so much to do, however, just remember to take your time and it'll work out. It took me about 3 months to get my own routine down pat: learning the residents likes/dislikes with how they take their meds, learning the doctors, families and co-workers. Once you get your own routine and "system of operating" it'll be a breeze. But, to answer your questions, no it isn't uncommon at all to have that many and even more patients. I did the same thing that "lindseylpn" did when I first started and made a list of all the things I had to get accomplished and then a time frame for getting them completed. I found that it also helped to make my list on a check off format, so I could check things off as I got them done. That also gave me a sense of seeing at the end of the shift all that I did do, so I didn't feel like I had not done something. I know that you have enough (and then some) of paperwork to do, but that is probably the most important thing that I did to help me get going and get into a routine. Also, it helps if you can jot down notes on your residents for yourself, such as who likes crush meds, who needs applesauce or pudding, who gets thickened liquids...etc. It takes time, but you can do it and will probably really enjoy it. Just be sure that when things seem overwhelming (as they can) take a moment to breathe and relax yourself.

Thanks for the links! I'll be sure and pass on the information to the HHP who is trying to help treat this child.

I wasn't quite sure where exactly to post this question, so if it's in the wrong spot I apologize. I am looking for any information at all about Horner's Syndrome. I've done an online search and found some really good and interesting information, however, if anyone here has any first hand information I would really appreciate it. I know of a one year old child who has been diagnosed with Horner's and am curious as to what can be done for it medically. I am in no way involved in this child's care (the child is being seen by a holistic practitioner in conjunction with a MD) and am quite interested in any information from someone who has seen patients with this before, or if anyone can point me to another place online to find more indepth information. Thanks

In the facility where I work, there are 3 floor nurses, the DON, ADON, and MDS who rotate being on call. As to if they come in, well, it depends on which one is on call and who is doing the calling.

Thanks a mint for the input, I do appreciate all of your thoughts. He has been moved to a neuro rehab clinic the other day. He is doing much better, still in a coma as far as I know (I live in another state and visit when I can) I was thinking that perhaps by using the term overstimulation the staff was mainly concerned about getting him in a state of agitation or anxiety (I know how detrimental that can be in any situation towards healing) I certainly understand wanting to keep things as quiet and relaxed as possible for him. I guess I mainly didn't quite grasp at the way some of the staff expressed the need for not overstimulating him without explaining the possible "whys" for it. As for the thought about the neuro changes occurring as a response to sleep deprivation, that is an interesting idea! Again, thanks for the information.

Right, I understand in relation to the ICP. When he arrived his ICP was>50 and it took about two weeks to get the pressure and drainage to a "normal" level. At that time, the drains were clamped and once it was deemed his body was actually processing the pressure and drainage flucuations normally the drains were removed after 24 hours. Some of the staff has continued with the 'overstimulation" bit since that time. When in the room, he tends to relax a great deal when talking to him and touching him: his body is less tense and rigid, he opens his eyes more, his BP, pulse, respirations are more even and steady and on occassion he will squeeze with his hand. But even with this (and it is only certain ones) some staff still basically make the family to feel like all they can do is stand at the door and peak inside while holding their breath.

Since a loved one has been in the NeuroICU for the past month (TBI, multiple broken bones and internal injuries due to motorcycle accident) I (as well as other family members) have been told off and on "oh don't talk to him, don't touch him, etc because it will overstimulate him and that isn't good" But yet no one has been able to explain just what "overstimulation" is and why it isn't good. I am a nurse(long term care) and I feel that I have a pretty good grasp of the siutation at hand, yet this whole concept of overstimulation is new to me and I can't seem to find much information on the subject that I can relate to. I asked one of the nurses at the hospital where I work and she said "well it can cause seizures in some patients" but didn't go into any further detail or explanation. So, if anyone could please shed some light on this for me I would greatly appreciate it. Also, while some of the staff are stern with the family about "overstimulation" and NOT talking, touching etc, others encourage the family to talk to him, touch him, etc and this has caused quite a bit of confusion between family and staff because the family isn't sure just what to do!