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Mom&Mima 2 many

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  1. rn/writer

    Therapeutic Lying With Dementia Patients

    "Lying" has such a negative connotation for many of us that it's just too darn difficult to give it the stamp of approval. Instead, we need to look at this therapeutic connection as meeting our patients where they are. Who are we caring for if we tell a woman she retired from a job she loved twenty years ago, or we say to a man that the cows he wants to go milk have been dead and gone for decades? Here are a couple of strategies to keep ourselves honest while not clubbing these tender souls with unwanted truth. Let the fabrication be mostly theirs. Work with the names and places and situations they supply. One of the very best pieces of advice I have ever heard on this subject is to ask the patient how old he or she is. The answer will tell you a lot about where they are in their own heads. Address the emotions at hand without dwelling on the details. Mid-stage dementia patients can't identify that they're losing their minds, but they can convert that anxiety into other feelings and attach the tension to the people and places they still have left. One patient's agitation over feeling out of control becomes worry that her husband won't know where to pick her up. You deal with the concern by saying that you'll be sure he gets the message and encourage her to have a light meal while she's waiting. Chances are she'll be distracted enough by the normal routine (and by her feeble short-term memory) that she'll move on to something else before too long. Ask open-ended questions about the people and things they talk about. This can come in handy later when some of the details begin to slip away. "You're worried about your car, Ed? Are you talking about the old Chevvy? The red one you told me about?" If he had indeed talked about such vehicle, your words--your connection--may help settle him or at least get him talking about something less stressful. Mostly, just put the patients' needs before your own. Join them wherever they happen to be and only attempt to re-orient if they're in harm's way. And even then, try to do it in such a manner that it's more of a gentle redirection than a harsh slap of reality. Thanks, Commuter, for this article on such an important subject.
  2. rn/writer

    Who the Heck Am I Now??

    Aw, swweetie, you're still the "you" we've always known and loved. :hug: Getting your diagnosis didn't really alter your identity. It just put some blurry things (that were there all along) into focus. As far as your self-perception goes, isn't it just a teensy bit easier to look at some of the whacko moments--times when even you couldn't explain what you were doing or why you were doing it--and know there was a reason for them other than sheer perversity? No one who has taken the time to know you will see this as anything but a victory. Naming the "enemy" gives you power to live well in spite of whatever it throws at you. I put enemy in quotes because bipolar is such an odd duck. For all the havoc it can wreak, it can also make you funny and energetic and creative. Just look at your fabulous and heart-felt writing. Maybe the best thing to do is embrace all of your mental landscape. Appreciate the lovely gardens and fill in the divots as needed. You are a treasure, mood swings and all.
  3. rn/writer

    While My Little One Sleeps

    Marla, can we clone you and send you around to about 10,000 assisted living and skilled care facilities? Pretty please? Now I just need to figure out how to type with tears in my eyes. Thanks again, for choosing to feel the pain of caring instead of numbing out. We're all the better for your decision and your willingness to share it.
  4. rn/writer

    10 Things Nurses Can Be Thankful For

    Thanks, Marla, for a great reminder of what's right with nursing. Good to keep things in perspective.
  5. rn/writer

    Nursing and The Art of Arboricide

    This reminds me of a cross-stitched picture of a little girl on a potty with the roll of tissue on the wall next to her. The caption read, "No job is finished till the paperwork is done." I take my hat off to you, Marla. I'm an odd duck who actually doesn't mind paperwork, but even I would find what you're dealing with daunting. Just the sheer repetition would push me over the edge. And heaven forbid you used a different word or phrase in document #7506 than you did in document #3609. Someone here at AN has this tagline, and it's true--some days it doesn't pay to chew through the restraints.
  6. rn/writer

    Out, Out, Damned Spot!

    I can see you now, Marla, taking a pitchfork to the living organism that is your carpeted floor and telling it to lie down and behave. We have carpeted hallways where I work and they never looked good to me, even when they were relatively new. There are lots of somewhat cushioned alternatives to the old, hard vinyl tiles that used to make our calves ache by the end of a shift. Someone with half a brain ought to figure out that short of flooding the place with culture medium, you couldn't find a better way to cultivate those lovely nosocomial germs than installing carpet that will be totally nastified within days. You really do have a picturesque way with words.
  7. A&O x 4 = Alert and oriented to person, place, time, and recent events that led up to medical situation.
  8. rn/writer

    Job Suspension

    I think you're right. Thanks.
  9. rn/writer

    am I that "b" nurse? or am I being an advocate?

    My thoughts exactly. You don't want to set the orientee up to disrespect/blame the preceptor or cause the preceptor to react defensively and take it out on the orientee. It's usually a good idea to allow the higher ranking person to save face by taking them to task privately so as not to undermine them in front of someone they're supposed to be teaching.
  10. Just remember--night shift only works if it works for you. Some people have a terrible time adjusting and frequently go on short sleep. That can take a terrible toll if it goes on too long. Others, like me and dh, would have the same difficulty getting used to days. We have also learned how to protect our sleep and are happy to "educate" anyone who doesn't respect our sleep schedule. There used to be some scary studies that talked about health problems associated with working nights. Additional research found that the fallout occurred mainly with people who worked night shift unwillingly or who worked rotating shifts. Those who work only nights and do so happily didn't appear to suffer the ill effects. The absolute worst schedule in my mind is one that changes all the time, alternating days, PMs and nights. Your body can't get used to any dependable timetable and that wreaks far more havoc than straight nights.
  11. rn/writer

    Job Suspension

    Could PT nurse mean "part-time" nurse?
  12. rn/writer

    Stuck in the rumor mill at work...

    Avoid speculation. Back off on the flirtation. Stay off the radar as much as possible. Keep quiet about the whole situation unless you are summoned for questioning. The best thing you can do is behave professionally and refuse to be sucked into the drama vortex.
  13. rn/writer

    Possible dilemma

    The more notice the camp has, the greater the number of options they have to work things out. Let them know this is tentative and that you will tell them as soon as you know something for sure. June 10th is a Friday. If you haven't heard anything by then, I'd call on Monday or Tuesday to find out if they have notified everyone they are interested in. You don't want to call the camp and say, "Don't worry about it," and then get called Monday afternoon. If you don't communicate, you are the one who is going to worry. This is real life. Things happen. You actually show more respect for the camp folks by calling and telling them the situation early than trying not to worry them and keeping it under your hat while the possibilities for handling the situation dwindle.
  14. rn/writer

    Possible dilemma

    Give the camp as much notice as possible so they can seek out other options for the time you won't be there. While it's good to honor your commitments, in this case you have a commitment to provide for your family the best way you know how that conflicts with a volunteer commitment made in good faith before you knew about the job possibility. I suggest leveling with the camp folks and trying together to brainstorm a solution. Best wishes with all of it.
  15. rn/writer

    I feel so bad

    Many facilities have ways to block social and entertainment sites. Maybe that needs to happen where you work. If this CNA has to log on to use the computer, it shouldn't be too difficult to track the sites she's going to while she's supposed to be working. As for the attitude, if you feel bad (and you said that you do), expect her to exploit your emotions. You shouldn't have to feel like the grinch for expecting people to do their jobs. Keep your tone matter of fact and DON'T show any sign that you're second-guessing yourself.