studious

We had a lovely gentleman, who after surviving a Japanese prisoner of war camp, ended up with parkinsons disease later in life. As his condition deteriorated he started to choke quite a lot. He was still able to tell us what he wanted though. We told him of the risks of not having a modified diet(dietician,consultant etc:), and he accepted the risks with the same courage he'd endured during the war. He even seemed to rally for a while, brussell sprouts were his favourite vegetable and thick toffees were his favourite sweet (candy). If we even attempted to cut his food up or suggest thickened fluids, he would just give us a look of complete contempt, yip, even managed that with his Parkinsons. It was an honour and a privelege to look after him. He eventually decided when it was his time, and took to his bed (something he did not do even when ill), dying very peacefully with his family beside him.

I am also anal about oral care, this feels like an AA meeting. Education is invaluable though, I'm thinking about getting a portfolio together of all the things that can go wrong systemically if oral hygiene isn't being attended to. After four years of the nice approach, I'm feeling a little bit of "in your face style" coming on.

Has anyone used the phrase "wiggle your toes" to a patient with a double amputation????? when your about to give an injection. I have to say I think this is one of my worst as a student nurse. Quite a worry.:)

Unbelievable!!!!!!!!!!!! I can't believe they have all these do's and don't do's, a nurse can be written up for the slightest thing, but when it comes to documenting evidence of obvious abuse by a facility, they don't want to know. JEEEEEZ!!!! Looks like they are out to protect each other, and forgetting the patient, or their rights. Keep your chin up Stidget.

Hadn't been to the toilet for a couple of days(if you get my drift), but this had me laughing so hard, I finally went whewwwwwwwwwww!!!! thank you:rotfl:

Hi Stidget, I was so sorry to hear about your patient. Like you, I'm not surprised either, but I do know she will have received the best care in your facility, even if it were only for a week or so. I hope it was a peaceful end for her. As far as I know, it is not illegal to take photographs in hospital, as it is mandatory these days to photograph and document pressure ulcers for legal purposes, in case anyone decides to sue. This lady may have family that will want to do that. As these pressure sores were there when she arrived at your facility there will not be any come back on yourselves. We always photograph Ulcers if we get patients with them. So we are able to physically see them getting better, check and document treatment regimes etc: It's considered part and parcel of holistic care over here. Although I appreciate you may have different policies and practices over in the States. It's a difficult one. But considering the complete lack of care this lady received before coming to you, I feel justice needs to be served for her sake, and others who are still going through it. Take care Stidget, and know your doing the right thing budd!!!!! Best wishes Tania

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Doesn't have to be normal saline, the docs can interchange with, normal saline, glucose, and potassium. As well as hydrating the patient these fluids can also maintain adequate urea and electrolyte balance.

I agree Gen, There is a fine line between being the best nurse you can and working under tremendous stress, and arrogance.

Hi everyone, This is just to thank everyone for their input, it has been marvelous. I'ts nice to know that others agree with me, and that I am doing the right thing. The dietician reckons that if she wants to eat then she should be given as much or as little as she requires. I haven't seen the Consultant yet, but I will discuss the same with her. We are very lucky that our Consultant is so very into being a geriatrician, and cares as much as she does. I spoke with my Charge Nurse as well, and stressed the point of individualised care to her. I can remember having another lady who was 97 years old, and all she would eat was rice crispies in the morning and jelly and ice-cream for tea. She survived on this diet for two years, and died peacefully in her sleep without a single bedsore or red mark on her frail form, but that was what she wanted to eat, so that's what she got. My wee lady at the moment is not too well though, she was sick last night, and didn't want anything to eat today at all, so I'm a bit worried about her. She is supposedly that demented, she actually told me this a.m when I was caring for her that she was "sick last night". I'm glad I had witnesses to the fact, so now they know she remembers other things and not just my name, which is being put down to learning parrot fashion. She was so poorly that she didn't even call me her usual bad names, didn't hit me once, which is why I'm so worried. However, she is drinking plenty of milk and juice, and keeping it down, So, hopefully she'll be feeling better soon. Probably just a wee virus. Anyway, thanks again everyone for your input. Take care.:)

Vaseline gauze has it's place but new research suggests that the skin can actually start to granulate throught he holes in the gauze. So I suppose it would be a matter of how long the gauze is in place.

Hi, We had a similar situation and used nystaform powder with the same results unfortunately. How about using nystatin, but the cream kind, much kinder when washing off, and more soothing. Poor thing it can't be nice for her. Makes me glad I'm extremely small up top.

Yep! wer'e having the same problem. We complained to the boss, and now some of the carpeting has been changed to laminate flooring(of a kind, it's really linoleum that looks like carpet). It really does make a great difference. Have to make double sure the brakes are always on the beds though. In twenty years instead of lower back injuries due to lifting patients, us lot are all going to have dowagers humps, and no necks.

[Please people, stand up for yourself . . .be a professional and an adult]

I agree totally, We had a very similar situation with a husband who ddin't deal very well with his wifes stroke (he was used to her doing everything for him), he used to shout and moan, even prod or grab her sometimes, still does to a certain extent. She was eventually rehabilitated back home, was still in her w/c though, she eventually came back to us (social admission) because of abuse. When I became his primary nurse, I told him in no uncertain terms(if I witnessed anything out of the ordinary) that it needs to stop. I also gave him counselling as well, because I really felt that a part of him was just plain scared of losing her. We have a responsibility to intervene when it becomes abuse, patients need to feel safe both physically and emotionally. If they are in your facility then it your responsibility to ensure this happens. Tell him to sue if he likes, that will give your facility the chance to stand up in court and tell the world what he is doing to his wife. He won't like that one bit if he is truly abusing her. Document and record if your allowed everything he does to her. Or phone someone anonymously to come and see for themselves. Is she not entitled to have some dignity or happiness before she dies.

I'm afraid to say you really have to deal with puke pee pee and all that in any kind of nurse setting. I don't know what RN, PA or NP mean, but I'm a registered general nurse in the UK, and I clean up exactly what my Junior staff members clean up. It's called teamwork, ecept when there is sputum involved, so I'll try to swap with someone else doing poo poo duty. Our Student nurses do the same. It never ceases to amaze me the amount of people who think nursing is glamourous, or all about fawning over the Doctors with tight uniforms on and no slip on underneath (talking from personal experience), and that some people refuse to clean up stuff in case they break a nail. Even in theatre, if there is a blocked bowel, you get it. I tell you though, you might not get it in minor injuries, or minor surgery very often.

I wonder if they are deliberately trying to make your life a misery for going on holiday???????? Sorry I'm a cynic. When you are mandated, do you get paid for the extra hrs??? Probably a silly question, and also sooooooo off the point. I was also amazed that you don't have unions. I can see why they don't have them, otherwise they couldn't treat you like they do. I'd go for another job. I'm sorry your having such a hard time. I'm starting to see the NHS with slightly more rose coloured glasses.

I would have to say, that over the years, and the gradual development of cynisism(spelling prob. WRONG) when it comes to the so called "caring profession", that my biggest weakness would have to be the general lack of patience I have developed regarding the way nurses can treat each other. I'm very much an advocate for the downtrodden nurse/patient. Gets me into trouble all the time. Why can't I keep by big mouth shut. I suffer from dreadful verbal diarrhoea sometimes, but if I see a cause that needs it, I'm there. Mmmmmmm wonder if I have a self destruct button somewhere.

My all time fav, was when I worked in a longterm ward with dementia patients. This day I took an elderly lady to the bathroom, not thinking anything of it, normal duty. Until it came time to attend to her, she had this blue thing sticking out from her anal region. I wondered what on earth it was. So, you know what it's like, a wee gentle prod here and there. Then it hit me like a bolt, and I started to pull. It was a blue plastic apron she had had on at some point to eat her meal, and it was whole. When she ate it could be anyones guess, but thank god she didn't obstruct.

And ensure you inspect the coconuts once in a while.

I could not have put this better myself Stidget, we have several individuals in our place who are confined to bed for varying reasons, even those with horrendous appetites(30 patients in total) don't have a mark on their wee frail bodies. We are as short staffed as anyone else is in this profession, however there is wayyy too much research out there on pressure care, and wound management etc, for any nurse to make an excuse for an area even getting as far as stage 4. As soon as a red mark is evident, action needs to be taken (special mattresses, dietician, 2hrly turns....... the lot) documented, and photographed, and direct observation of the area. Wound dehiscence is different if you're in surgical, these patients may have other underlying causes, at a push. Peripheral vascular disease and resulting leg ulcers!!!! mmmmmm, a problem that can be managed effectively with the correct input from various members of the multidisciplinary team. I still cannot get my head round the story you have told Stidget, it's inhuman. If anyone is interested in a site for wound care. I'm in the middle of my wound management course at University and came across this great place. http://worldwidewounds.com Stidget, can I ask what IMO means????? please let us know the outcome of this horrible situation. Having been a nurse who blew the whistle on bad practice several years ago now (and still suffering for it, but they can't sack me, 'cause they know I told the truth), I'd like to know that justice is being served for this poor lady, and anyone else being cared for in this manner.

[We made do-nuts to put on her foot to keep the pressure off. We had her foot healed up in no time flat.QUOTE=LPN1974] I'm sorry, but if we were ever found putting donuts or (filled up plastic gloves for that matter), anywhere near a patient in this day and age of special mattresses, wound care courses etc: we'd get hung drawn and quartered.

[Get in a (clean) sling ] Like it :rotfl:

They have to accomodate you, do not give up. It makes my blood boil when I hear stories like this:angryfire My friend always thought she was stupid, and was made to feel she would never amount to anything by her teachers at school. I urged her to get tested, the doc even did an IQ test on her, turns out she's a genuis. HAH! I knew she was intelligent, as well as warm and kind and very funny. She is now a very successful home carer, has recently purchased her own home, and has a car, she also has her certificate from MENSA proudly hanging in her hallway. You can do it, and don't ever let anyone tell you otherwise. Hell! you could be even more intelligent than half of your proffessors. Now wouldn't that be a turn up for the books!!!!! Good luck and let us know how you go!!!!!!!:)