StacieRN

Do you read it back to him? That usually causes them to realize how inappropriate they're being.

Or: Ok, I charge an extra $10.00 an hour for maid service - CASH and in advance!

Female here. I had some adhesions due to radiation and was given Flomax to try to increase output - I was down to a dribble. Didn't work for me though. I had to be cathed and keep a cath while the adhesion area healed.

Love it. Very enticing. I appreciate how hard you work to get the medical details right. I really hate when I'm reading a book and wrong information jars me out of the story. Kudos!

Very nice imagery. A few things though: A newly trached pt has to be taught to speak. And they can't speak while hooked to the ventilator. For speech to happen, air must move over the vocal cords. While connected to the vent, air exits before that happens. The vent will be unhooked (after a breathing trial) and the end of the trach tube will be capped or the pt will be taught to cover the end of the tube with a finger when speaking. Next: if this patient has been in a coma long enough to be trached, she will NOT have restraints on. They would be unnecessary. She was comatose - i.e. not trying to pull tubes out. So upon awakening she would probably reach up and pull the vent tubing away from the trach in confusion. Thus setting off the vent alarms and bringing your nurse running to reattach it. I do agree that the nurse would do pupil checks almost immediately after re-attaching the vent (usually while updating the pt on her condition).

A TLSO (thoracic lumbar sacral orthotic) brace should be worn whenever pt is upright. Pt should logroll from side to side as brace is placed and fastened. Only then should pt be allowed to raise from being flat. Once in the brace, the pt may sit, stand and walk. The brace is custom made and fitted and should not be adjusted. If the pt is uncomfortable, have the orthotic specialist come out for a re-fitting. A shirt should be worn under the brace to protect skin integrity. The brace should only be taken off to sleep and should be wiped down after each wearing to prevent bacterial growth and smell (using mild soap and water or alcohol). The pt will usually have to roll to the side of the bed and put their legs off then push up with one arm to rise from the bed. When sitting, the brace should not be pushed up by the thighs, but remain in place. Ask for a re-fitting if that happens. It IS possible to move so as to twist/turn the spine while wearing the brace. The patient should be reminded to avoid doing this. Depending on severity of injury and pt's healing, the brace is usually worn 8-12 weeks.

Additionally: Depending on policy at your facility, pt may need to be on bottled water only. If that is the case - no ice (ice machines possible source of bacteria.) Limit sticks. Make sure pt has soft toothbrush or switch to toothettes. No straws (may cause gums to bleed and introduce bacteria.) No alcohol based mouthwashes. Absolutely no children around. If antibiotics are ordered on a neutropenic pt, always consider these orders STAT. No visitors (or staff members) that have had a live vaccine in the last month. No tampons. And no blue cheese dressing (it contains live mold).

But, of course, according to the National Quality Forum, falls are never events. I tell you, if anyone figures out how to keep all of these health care monitoring agencies happy with their wildly differing agendas....that person can count on an immediate nomination for sainthood (having performed a miracle of the highest order).

I agree with sending the patient to the hospital and then not accepting her back. If your facility director will not agree to this, I would have her notify the family that they must provide home health aides around the clock who will be responsible for the patient's toileting needs as your staff are not trained to do this and it is outside of their job description. I would have them sign a statement saying that they had been notified of this and after 48 hours you would no longer see to her toileting needs. At the same time, I would give a 30 day move out notice. Hopefully these provisions would get the family off their duffs and make them take care of this.

My grandmother's cure all is Vaseline. If you have an arthritic limb or sprained joint. She spreads .the pain away within an hour. By the way, the only food that doesn't spoil is honey. There have been pottery jars of honey found in the pyramids that are perfectly fine (well, a little crystalized). My grandfather raised pigs. The local grocery store would give him all their spoiled meats and produce for the pigs. If he thought it wasn't quite spoiled yet, he'd bring it home and my grandmother would cut of the bad bits and cook it up. Then the leftovers would stay out until supper and they'd eat them then. I guess their stomachs were made of cast iron, because it never bothered them.

Unless they give you a PAID lunch, they cannot legally prevent you from leaving during lunch. They CAN require you to clock in and out to make sure you're getting back to the facility in time. I used to work nights. (also no cafeteria) We'd get together and decide what we wanted to eat and one person would go out to pick it up.

Stomach acid will take care of most anything picked up from a surface that is not obviously dirty (if the oral and esophageal lining is intact). So, yaeh, I'd have done the same - and have.

Honestly, I feel that being a nurse made me a better patient not the other way around. Knowing what the nurses were going through helped me understand when things didn't go exactly easy or quick.

Agreed. If management really wants good customer service, They should hire staff specifically to address these needs (wants). We really have our hands full NURSING. When DID it become our job to tend to housekeeping, dietary, clerical, social work, television repair, etc anyway? Not to mention becoming our patient's social secretary and visitor traffic monitor/director? Because it was never covered in school, on the Board exam or in my job description.

I don't know. I'm off work now because of cancer. I'm in remission now and hope to be well enough to return to work soon. I'm paying close to $400.00 a month for COBRA. Everyone keeps telling me to just apply for Medicaid. Also, have been on me to apply for SSI disability. I'm not permanently disabled. I think it would be an abuse of the system and no one gets that. So my family keep telling me THEY"RE tired of worrying about my financial situation and I should apply for benefits. SIGH!