canter1221

I still feel those were so much cleaner! I worked at a chronic hospital and each patient had two ... One in, one autoclave do/sterile packaged & hanging above the bed ready to put in any time. As soon as it was changed the old one got sterilized and back in place.

Wow! Great stories-- write down more of them please :). About 10 years ago, in LTC, I had a patient who remembered the flu pandemic of 1917... She was about 6 & lived in Canada ... Remembered seeing the horse-drawn heorifice go by every day. Her father had to stay home to care for her and her younger siblings who got sick but didn't die-- but several of his cows died because he couldn't leave the house of very sick children to go feed & water the cows

Being told that, except for sterile procedures, wearing gloves was disrespectful to the patient !

Where and when was this?? The Ritz :)

It may not be the cure for this particular situation (lack of patient education preparation in lots of subacute settings), but if may help. i used to Complain about all the state surveys etc in my state, but a comment by a consulting wound doc actually made me appreciate the oversight. He said he has done wound care in 5 states -- and in the three states that had much less frequent DPH monitoring he *more then once* came across nursing homes that would have 5,6,10 nosocomial stage IV wounds. Here, if there is one it's a big deal, and if DPH finds 2 if 3 there are repercussions. Which there should be! maybe the difference is not the oversight, maybe instead who is the corporate owner & how they translate 'mission and values' statements into action.

Exactly-- a form to document education-- But not one single other tool available.. In a way, I wish joint commission of the states would start handing out tags for this (and for poor staffing!) then facilities /corporations with lots of facilities would put some effort here

This is exactly what I've experienced, but I know there has to be a way. The patients are so sick & in need, and nurses in this setting have No time leftover from the purest necessities. I was hoping some facility (or chain of them??) had decided that patient education might shift the stats on patient satisfaction & 30 day readmission rates. I'm in school chasing my masters... I'm 99% sure my capstone project will be to create a staff ed piece along with an complete set of patient teaching tools (written, pictures, video etc) along with resources efc. If it works out, I figured I can pick one topic/condition/area of need at a time to address .... maybe I'll find a way to make it better in some small way :)

I guess the silence is itself as answer í ½í¸€

The best thing about doing those bed baths is the excellent assessment opportunity-- skin mobility pain endurance mental status etc etc. plus, patients tending to reveal important social details when they had the nurse 1:1 for a dedicated block of time

Oh I feel your pain! I was a LTC unit manager in the past-- loved many parts of the job, even care planning, working the cart *sometimes* even bathe a resident or three first off in the am if short z cna (great to do for staff morale!)... But also hated many parts of the job especially 24/7 on all to cover call outs, which affected my child as it became more frequent. That was the final straw for me as a manager. also, was finally at job 10+ years do lots of seniority & vaca time .....But eventually those didn't make up for the negatives, so I jumped ship to a less stressful role elsewhere. Happier, Free to pursue further education, but still miss the perks :) you might consider asking your place if there's another told you can take for a 3-4 month block ... They could use it to train up a potential manager ....does your place have a home care arm it sister agency you can swap out to for a bit? Is there a local hospital you could shadow at, maybe sell it to your bosses as a chance to better understand the experience of your residents when they are at the hospital? Good luck & take a vacation soon :)

Hi all, Have any if you worked at s facility (subacute/SNF) that has an organized, helpful approach to patient education? Maybe a staff/patient educator combined role? Maybe sets of patient education resources (handouts, videos, etc) that are convenient, accurate, useful and address most of the common patient needs at your facility? Maybe also available in other languages prevalent in the area? I wonder how many nurses have time to do this again & again. I have usually seen staff nurses having to reinvent the wheel time and again-- and wonder if there is a better, evidence-based, proven way. I'd love to hear your experiences with this. Thanks.

My work place still charts in color-by-shift for anything remaining on paper :)

Ha! When i switched from wearing whites in about 92, I felt like I was wearing pajamas :)

once had a youngish (50's) lady dying--badly-- breast CA; had perforated bowel & refused intervention other than pain med...took 5 days to die... terrible...despite utmost attention to trying to medicate pain away...was on huge amounts continual morphine iv, myoclonus started increasing, continual Ativan iv infusion started for those (started at 1mg/hr...went up to 8 mg/hr by day 3)...the doc consulted with national level palliative care specialists for more input... then put her on alternating morphine/dilaudid drips to cut metabolites which did stop the myoclonus from getting worse (but they didn't leave).... everything kept being titrated UP for symptom management (120 mg/hr dilaudid with 120mg bolus q 15 min prn)... (a day later, finally they put her on a versed drip--this was several years before I saw any articles on terminal sedation--only after ethics committee emergency meeting etc---which was the only thing that gave her a little peace before she died....& her family as well, since they had been with her 24/7 in the hospital for the duration....) I haven't worked in palliative care of the acute sort since shortly after then (not because of this situation) .... none of the LTC patients dying have every approached this level of suffering.... but I really feel for you, because it takes a whole different level of skill, compassion, etc to start to cope with that extreme agitation or suffering that isn't soothed by interventions available....