Roboapple

I work on a 27 bed unit taking care of people on long term ventilation in a long term care setting. Most of the people I take care of have neuromuscular diseases or spinal cord injuries. I'm an RN. There don't seem to be very many of these places in canada where I live so it's hard to do research on patient care standards. Facilities are either acute care or nursing homes and not many blends between the two. I didn't realize they were so common in the US. The term skilled nursing facility doesn't seem to exist here.

Are the meds better off being given every day or every 2nd or 3rd day? if enemas or supps are given, is manual disimpaction necessary?

This is the area that I have been working in for the last few years. It's very specialized and not very common. Does anyone else work in this area?

Not being the most glamorous subject to research, there's not a wealth of information out there about this subject. Is manual disempaction a necessary evil or is it old school. Just to be clear, theses are people who lack the necessary motility to evacuate their bowel on their own. They must have assistance to empty their bowel in order to prevent obstruction or autonomic dysreflexia. Are drugs the way to go or should a specific procedure be used as maintenance.

So I work in a place that defies description, mostly because there don't seem to be any more places like it or people who relate to it. I work in a 25 bed long term care unit that takes care of the complex needs of people on ventilators. They live there permanently, they are not bed bound and for the most part they are not critically ill, but have very complex medical needs. We're kind of working like an annex of a tertiary care hospital and share medical staff, but we're located in a long term care facility. The people who live there are independent, go off in their own directions and try the patience of saints.

you get over it. I used to gag at the sight of phlegm, now I work up to my elbows in it on a respiratory unit.