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CompleteUnknown

CompleteUnknown

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  1. CompleteUnknown

    The patients you love working with.

    I actually like the more difficult ones, love it when I can turn them around, even if it's only a slight turn around. I think there's way too many patients that become difficult because of what we do or don't do, and often we don't even see our part in it. I understand how and why it happens and I understand that sometimes it can't be helped but I think it's such a shame. A wise old nurse told me many years ago 'Anyone can look after the easy patient'. That's a bit simplistic I guess, but I came to understand and appreciate what she meant.
  2. CompleteUnknown

    Please Help - I have no where else to turn

    That's absolutely horrible abbaking. Awful. No other way to describe it. Give yourself some time before you decide 'that's it' though. I wonder if, as horrible as it was, it was more that it was just the last straw that particular shift? Maybe you normally would have been outraged, furious, whatever, but been able to handle it? I sometimes secretly wish that I was able to have a meltdown at work, it's so tempting and oh, to be able to scream and shout and say what I really think! It's just not me though. I either keep it inside or take it out on my family or friends. Neither of those options is good either - maybe we all need a kick boxing session after work. A friend of mine works in an office and they have a 'quiet room' with a sofa, soft drinks and snacks. Anyone can go there for a break when they feel it's all getting to be a bit too much. I don't know, when the paperwork starts getting abusive or something. I'm kidding!!!! No disrespect to people who work in offices - I've done it myself and I know it can be extremely stressful. It's a different kind of stress though even when dealing with the public and even if we DID have a quiet room, we would never have time to go and sit in it! Hope you start to feel a bit better soon. :hug:
  3. CompleteUnknown

    Advice please? Dementia pt resisting necessary intervention

    If the catheter is occluded but urine is leaking around it and there's no distension, you have to wonder if it really is necessary. If it is, I'd try the side-lying idea first. For the resident, it's generally not a confronting position to be in while the traditional lying on the back with legs apart definitely is. Either way, undo the bedding from the bottom of the bed and double it over towards the top rather than pulling everything down, it feels much less exposing for the resident to have the bedding around the top of their body as normal when you're doing something 'down there'. We do this for all pad changes and incontinence clean-ups where I work and it makes such a difference with the ones who tend to resist or fight - works like magic. If you think about it from the point of the view of the person with dementia, someone is coming in, ripping their bedding off and then doing things to them, no wonder some of them fight.
  4. CompleteUnknown

    Is it possible.....

    I've seen this several times too. It's really not that unusual. I voided over 2 litres about six hours after I had my first child (vaginal delivery). I didn't feel I even needed to go; it's only that they said 'if you don't go soon we're going to have to put in a catheter' and it sounded like they meant it. Lol.
  5. CompleteUnknown

    Death

    This is a great post and I think that most nurses feel the same, that 'it is huge' to be present when someone dies. It's easier when it's an expected death (no matter what the age of the patient) because things are usually relatively calm. Codes and unexpected deaths are harder because there isn't that sense that something profound is happening, it's too 'busy', if that is the right word. It sounds ridiculous to say you will get used to it but there's not really another way to describe it. There will always be deaths that upset you far more than others and often it's hard to even know why this death in particular affected you so much more than that one. Back in the dark ages when I first became a nurse, most of us were very young and had little or no experience with death. We all learned to cope in our own way and in our own time and it's okay, I think you will too.
  6. CompleteUnknown

    Never Argue With Dementia (and Other Nuggets of Nursing Wisdom)

    I seem to spend a lot of time checking train timetables, planning trips, finding out why husbands are late home from work, making sure the baby is okay, reassuring people they don't have to worry about the cost of staying another night because the room is 'on the house' tonight, and agreeing that it's very irritating the way these meals are served at unsuitable times but suggesting we probably should all have something to eat while the food is there.
  7. CompleteUnknown

    Never Argue With Dementia (and Other Nuggets of Nursing Wisdom)

    Make a molehill out a mountain. I've never heard it said in quite those terms before, but what a wonderful way to describe what we should be doing!
  8. CompleteUnknown

    To resign early or risk getting fired?

    Many years ago, I was told by my boss that I always looked like I had the weight of the world on my shoulders and that I needed to lighten up a bit. Honestly, I was pretty hurt. I mean, I was new and there was so much to worry about and what if this happened and what if I didn't know enough and what if I forgot something and what if this and what if that and I DID feel like I had the weight of the world on my shoulders! Anyway, after I thought about it for a bit I realised she was right. Nurses don't have to swashbuckle around the ward with a devil-may-care attitude but not everything is an emergency, not everyone is going to die right this minute, and it won't be the end of the world if I don't know every single thing there is to know. I made a conscious effort to try to relax and smile a bit more and it really did help. It was an act at first but soon I was feeling more relaxed as well as looking more relaxed and I found I actually started to enjoy work and even sometimes have a bit of fun. There's plenty of terrifying moments to go around, it's good if you can smile and joke with your patients and colleagues when it's appropriate. You may not be thinking that you're too proud to ask for help but is it at least possible that you are giving that impression? If what you've said are the only things they found to criticise, I'd let it sink in for a day or so, think about it again without feeling that you're being judged, and then take it on board. It doesn't sound like bad advice to me, and it doesn't sound like a reason for resigning either. :)
  9. CompleteUnknown

    Behaviors and Failing to Chart Them

    We only chart behaviours if there is an increase in frequency or severity of existing behaviour, if there is a new behaviour observed or noticed, during an assessment period, or during a review period such as when there's a trial of reduction in medication. Otherwise we'd have pages and pages of notes or charts on each resident each shift. However, we can't chart 'no behaviours this shift' (as that is rarely that the case) although we could chart something like 'current interventions for challenging behaviours remain effective' with a more detailed description once a week/month or as required by facility policy. Agree that behaviours need to be documented so that successful interventions can be developed. Our main problem seems to be people documenting behaviours but not what was tried to manage it. It's also true that staff get used to the way residents are, and work around this (use interventions) without even realising what they are doing. That's where you get the 'oh she's always like this' and in a way it's a good thing because it means that staff are meeting the resident's needs. The behaviour does need to be documented though; I think that sometimes some staff feel that it reflects badly on the resident if they write some of this down and will only document a behaviour if they find it personally upsetting. Maybe some staff education is needed at OP's facility?
  10. CompleteUnknown

    "Pull-up" high-absorbency overnight diaper for adult male?

    That's great news CabanaDay, hope the Abena pads do the trick! :) Totally agree that the more expensive pads are worth it, and probably cheaper in the long run.
  11. CompleteUnknown

    Blue or white collar?

    I agree with you Been there done that, but I can also see where what PMFB-RN is saying could happen. I don't think that an experienced nurse is going to 'forget' how to manage a patient crisis and all nurses should be able to identify an impending crisis, whether it's that gut feeling or a subtle sign or a trend or something else. However if everything is being left to the team to manage (because the nurse already has an unmanageable workload, as you say) I guess it's possible that inexperienced nurses might never actually learn what to do next after they have identified that something is wrong. Sorry, off topic I know. Back to collar colour!
  12. CompleteUnknown

    Blue or white collar?

    I've been sitting looking at this post for quite a while. Very scary to think that this could be the case.
  13. CompleteUnknown

    What's Wrong With 21st Century Nursing

    I don't want to sound harsh either, but I agree with this post. If I'm looking after a patient with a tracheostomy, I need to know how to manage it. If I don't know, or don't feel confident, it's my responsibility to make sure I do find out, become confident with the changing procedure, and make certain I can handle any complications that may occur, especially in a situation like this where there is no back-up. If that's not possible for some reason (not enough time, no-one to teach me, whatever), it's up to me to turn down the assignment until I do have the skills.
  14. CompleteUnknown

    Texting while doing patient care?

    Unbelievable. And to then snap a pic of the BP reading because she didn't have a pen??? I have never sent (or received) a text to another staff member about an administration or patient issue, it wouldn't even occur to me! Besides, I don't even have my phone on me when I'm working, it stays in my bag and I might check it occasionally if I'm expecting a message about something important. Most days I don't even look at it until I get home.
  15. CompleteUnknown

    Documenting on patient falls or what looks like one in LTC

    I'd be willing to bet that, one day, a resident fell and someone wrote an unsatisfactory note that happened to include the words 'found on floor'. Then, a surveyor came along and saw that note (we all know they have an uncanny ability to choose to review exactly the chart you wish could be lost in a fire or swept away in a flood or something ) and those in charge, instead of explaining why the note was unsatisfactory, made a rule that you must not say 'found on floor'. Or maybe they did explain why the note was unsatisfactory and maybe 'found on floor' was a bad choice of words in that particular situation but all that has been lost in the mists of time and all anyone remembers now is that the world will end if you write found on floor. Such is life in LTC!
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