It's a lot of work celebrating Easter at our house in RehabLand, but we have fun. Lots of stuff going on. I got up and assembled all the ingredients I needed. I found out that Dahey ate one of them (you just can't leave him alone with certain kinds of canned fruit), so that went on the shopping list.
Next, it was run over to one of Bubba's soccer games at 0800. (So glad it was not an 0700 one!) Bubba got up early anyway, and asked me if I saw what was outside. RehabLand was covered in a huge fog.
Once we got done with soccer, it was back home to start some of the baking, with Dahey on watch (and warned not to eat anything else.) so I could go to the store to pickup the missing items and a couple of other things.
While I was out, I also returned a movie. I'd wanted to see The Intouchables forever. I finally did with Dahey last night. As a rehab nurse, it was an absolute riot. I especially loved the references (and reactions) to teaching the caregiver about bowel programs.
It would be a riot if any of our folks had a Maserati. I can only imagine what might happen with a similar setup.
More later...
Showing posts with label bowel routine. Show all posts
Showing posts with label bowel routine. Show all posts
Saturday, March 30, 2013
Monday, August 8, 2011
You know it's Monday when...
"It's a cruel, crazy, beautiful world./Every day you wake up/I hope it's a blue, blue sky." --Johnny Clegg
1. Your patient is the heaviest one on the floor.
2. The first thing you have to do when you walk into the room and say hi, is suction said patient.
3. After that, you have to change the patient's external catheter, since the last shift somehow managed to pull it off. Said patient has a wet pad beneath him.
4. Clean up patient and change pad.
5. Wait for docs to round. Hold bowel routine, 'cause heaven forbid a doctor see a patient who poops whilst they're in the room!
6. Once Dr. HarvardMedSchool gives you crazy orders (like attach dressings without attaching them and you're not using one of these), start bowel routine.
7. Bowel routine over, so bathe patient. Suction again, and again, and again, before shave, after shave, after turning, etc.
8. Feed patient lunch. Suction patient.
9. Be so happy you follow the rules re: isolation gowns in rooms because as you dress patient, patient has a lot of gas, which is accompanied by a moderate amount of loose stool, which sprays bed rail, bed, and some gets on you.
10. Take off gown, wash hands, put on new isolation gown and other assorted PPE, then suction patient again.
11. Get patient dressed, into wheelchair and adjusted. (This takes 30 minutes including cleanup after explosion).
12. Get patient out door.
13. Patient returns in two minutes frothing. Suction again.
14. This time it works, get patient to therapy for evaluation for new wheelchair.
15. Patient is gone for not quite an hour. Lo and behold, the PT inadvertently pulls off external catheter during transfer. Put patient back to bed and clean up.
16. Suction patient again once in bed. Finish cleanup.
17. Dress patient in new clothes. Get patient adjusted then resupply room for next nurse.
18. Give report.
19. Wash wet cushion cover.
20. Go home.
And in between all that, I had 1) other patients and 2) lots of documentation to do.
So glad I eat fast and early! And I'm thrilled my work Monday is over, over, over!
Stay tuned...
1. Your patient is the heaviest one on the floor.
2. The first thing you have to do when you walk into the room and say hi, is suction said patient.
3. After that, you have to change the patient's external catheter, since the last shift somehow managed to pull it off. Said patient has a wet pad beneath him.
4. Clean up patient and change pad.
5. Wait for docs to round. Hold bowel routine, 'cause heaven forbid a doctor see a patient who poops whilst they're in the room!
6. Once Dr. HarvardMedSchool gives you crazy orders (like attach dressings without attaching them and you're not using one of these), start bowel routine.
7. Bowel routine over, so bathe patient. Suction again, and again, and again, before shave, after shave, after turning, etc.
8. Feed patient lunch. Suction patient.
9. Be so happy you follow the rules re: isolation gowns in rooms because as you dress patient, patient has a lot of gas, which is accompanied by a moderate amount of loose stool, which sprays bed rail, bed, and some gets on you.
10. Take off gown, wash hands, put on new isolation gown and other assorted PPE, then suction patient again.
11. Get patient dressed, into wheelchair and adjusted. (This takes 30 minutes including cleanup after explosion).
12. Get patient out door.
13. Patient returns in two minutes frothing. Suction again.
14. This time it works, get patient to therapy for evaluation for new wheelchair.
15. Patient is gone for not quite an hour. Lo and behold, the PT inadvertently pulls off external catheter during transfer. Put patient back to bed and clean up.
16. Suction patient again once in bed. Finish cleanup.
17. Dress patient in new clothes. Get patient adjusted then resupply room for next nurse.
18. Give report.
19. Wash wet cushion cover.
20. Go home.
And in between all that, I had 1) other patients and 2) lots of documentation to do.
So glad I eat fast and early! And I'm thrilled my work Monday is over, over, over!
Stay tuned...
Wednesday, May 25, 2011
Lather, rinse, repeat
It's not just on a shampoo bottle. It's the story of my life in taking care of Mr. J., one of our usual suspects. My shift went as follows.
1. Suction him (very frothy trach) on first rounds.
2. Do AM bowel routine.
3. Return in 30 minutes to clean up, then suction again.
4. Finish bowel routine.
5. Suction. Leave.
6. Move bed from across unit storage so admission has a bed in his room (and all other assorted furniture). Do dressings on other patient. Thank goodness she can survive without me!
7. Come back, do AM care, dressings, PICC dressing (since he has one that's falling off), turn.
8. Suction 'cause you rolled him a little too much changing the linens.
9. Reposition and all is good for about 30 minutes.
10 Admit new person down the hall.
11. Feed Mr. J. lunch.
12. Suction after lunch. Fluff, buff, make all comfy.
13. Turn, clean up, drop full suction canister on table and floor.
14. Clean up mess, call for Housekeeping. (Thanks Bob! I couldn't live without you.)
15. Get Mr. J. ready to get up. Mr. J. decides to stay in bed today.
16. Suction.
17. Reposition. Fluff, buff.
18. Take care of other patients.
19. Finally, eat lunch during department meeting: elapsed time 10 minutes (I ate slow with a salad).
20. Send labs on new patients. Let new patient take a nap.
21. Finish admission and assorted paperwork.
22. Get ready to leave and hear a tornado warning called on intercom: Code Gray. Everyone out of the pool!
23. Wake up napping patient (already awake) and help him transfer to wheelchair to get into hallway.
24. Quitting time comes.
25. Run out the door, do not pass go, do not collect $200.
Getting Bubba home safely after making it through a hailstorm and watching the tornadic clouds on the horizon just two miles away: priceless.
I celebrated the end of the tornado warning with a drink , a soak in the tub and a good scrubbing, and lather, rinse, repeat.
More to come...
1. Suction him (very frothy trach) on first rounds.
2. Do AM bowel routine.
3. Return in 30 minutes to clean up, then suction again.
4. Finish bowel routine.
5. Suction. Leave.
6. Move bed from across unit storage so admission has a bed in his room (and all other assorted furniture). Do dressings on other patient. Thank goodness she can survive without me!
7. Come back, do AM care, dressings, PICC dressing (since he has one that's falling off), turn.
8. Suction 'cause you rolled him a little too much changing the linens.
9. Reposition and all is good for about 30 minutes.
10 Admit new person down the hall.
11. Feed Mr. J. lunch.
12. Suction after lunch. Fluff, buff, make all comfy.
13. Turn, clean up, drop full suction canister on table and floor.
14. Clean up mess, call for Housekeeping. (Thanks Bob! I couldn't live without you.)
15. Get Mr. J. ready to get up. Mr. J. decides to stay in bed today.
16. Suction.
17. Reposition. Fluff, buff.
18. Take care of other patients.
19. Finally, eat lunch during department meeting: elapsed time 10 minutes (I ate slow with a salad).
20. Send labs on new patients. Let new patient take a nap.
21. Finish admission and assorted paperwork.
22. Get ready to leave and hear a tornado warning called on intercom: Code Gray. Everyone out of the pool!
23. Wake up napping patient (already awake) and help him transfer to wheelchair to get into hallway.
24. Quitting time comes.
25. Run out the door, do not pass go, do not collect $200.
Getting Bubba home safely after making it through a hailstorm and watching the tornadic clouds on the horizon just two miles away: priceless.
I celebrated the end of the tornado warning with a drink , a soak in the tub and a good scrubbing, and lather, rinse, repeat.
More to come...
Friday, March 25, 2011
Queen of BBS
Yes, I am old enough to remember this BBS, but I never had a computer to use it while it was in its heyday.
The BBS I'm talking about it is the crux of what we do as rehab nurses. My preceptor G. told me as a young rehab nurse that most of what we do is about "bowel, bladder and skin." Yes, it surely is, and I had a lot of time to discuss these issues with a couple of patients recently.
Eddie is a guy who's had a lot of bad luck. His Hummer was attacked in Iraq and he lost three buddies. He made it out of there with a mild TBI and his life. He recuperated and things were going along nicely, when he was minding his own business driving home one night and ran off the road dodging wildlife in the rural area he lives in. As a result, he became a paraplegic.
He's still young enough to see the bowel routine as a boring routine. And since it becomes a synchronized routine for many patients, you can expect results at about the same time every day or every other day, depending on how you do it. Yes, he had results at his usual time, while he was doing something else he wanted to do. Lots of cleanup followed--to him, the wheelchair and his clothes. He was upset, but I managed everything so in the end, he was laughing. There are worse things...
Happily, while it's been crazy at the Hotel, we've been able to get things done. It's required a lot of teamwork. People feeding other people, people transferring people, people helping vendors bring in new mattresses. I may have only sat down once or twice, but we got things done.
Let's hope it stays that way! Stay tuned...
The BBS I'm talking about it is the crux of what we do as rehab nurses. My preceptor G. told me as a young rehab nurse that most of what we do is about "bowel, bladder and skin." Yes, it surely is, and I had a lot of time to discuss these issues with a couple of patients recently.
Eddie is a guy who's had a lot of bad luck. His Hummer was attacked in Iraq and he lost three buddies. He made it out of there with a mild TBI and his life. He recuperated and things were going along nicely, when he was minding his own business driving home one night and ran off the road dodging wildlife in the rural area he lives in. As a result, he became a paraplegic.
He's still young enough to see the bowel routine as a boring routine. And since it becomes a synchronized routine for many patients, you can expect results at about the same time every day or every other day, depending on how you do it. Yes, he had results at his usual time, while he was doing something else he wanted to do. Lots of cleanup followed--to him, the wheelchair and his clothes. He was upset, but I managed everything so in the end, he was laughing. There are worse things...
Happily, while it's been crazy at the Hotel, we've been able to get things done. It's required a lot of teamwork. People feeding other people, people transferring people, people helping vendors bring in new mattresses. I may have only sat down once or twice, but we got things done.
Let's hope it stays that way! Stay tuned...
Sunday, September 12, 2010
Heard on the unit
Otherwise known as the evening shift edition
"Don't touch me!" Mr. U.
Mr. U. (short for Unhappy) is not liking the fact that his bowels are not moving. The dreaded combo of pain pills, cardiac (and other major organ problem) history, and new injury aren't helping either. I tried a suppository after he agreed, but I could not get the stool removed prior to insertion, like I usually do, so the suppository works.
Well, something worked, because about an hour later, Mr. U. passed not one, but two small baseballs of stool. That had to hurt more than the suppository! I made sure to alert the doc that Mr. U. definitely wants the stool softener.
Why he wasn't already getting it is a mystery to me.
"When you gotta go, you gotta go." Mr. C.
Mr. C., an old injury patient talked to Mr. U., his neighbor, about using suppositories, but Mr. U. didn't want to hear it. Mr. C. just shook his head. One of these days, he'll come around, Mr. C. said. His neighbor, thankfully, was asleep.
"Whooooaah! Whoooah!" Mr. S.
Mr. S. likes to moan in his sleep. I woke him up to take his pills and he was startled. "Why did you wake me up? I was watching SportsCenter," he says. "I woke you up because I thought you were practicing for a Halloween party or working at a haunted house." I replied. I heard this while I was down the hall, minding my own business charting on one of our workstations on wheels.
Another one of our patients was talking about ghosts and what he'd read about them at our place. We suspect there are plenty, and many patients have stories of shadowy figures in their rooms, mostly on night shift.
Stay tuned for more interesting comments from the Hotel.
"Don't touch me!" Mr. U.
Mr. U. (short for Unhappy) is not liking the fact that his bowels are not moving. The dreaded combo of pain pills, cardiac (and other major organ problem) history, and new injury aren't helping either. I tried a suppository after he agreed, but I could not get the stool removed prior to insertion, like I usually do, so the suppository works.
Well, something worked, because about an hour later, Mr. U. passed not one, but two small baseballs of stool. That had to hurt more than the suppository! I made sure to alert the doc that Mr. U. definitely wants the stool softener.
Why he wasn't already getting it is a mystery to me.
"When you gotta go, you gotta go." Mr. C.
Mr. C., an old injury patient talked to Mr. U., his neighbor, about using suppositories, but Mr. U. didn't want to hear it. Mr. C. just shook his head. One of these days, he'll come around, Mr. C. said. His neighbor, thankfully, was asleep.
"Whooooaah! Whoooah!" Mr. S.
Mr. S. likes to moan in his sleep. I woke him up to take his pills and he was startled. "Why did you wake me up? I was watching SportsCenter," he says. "I woke you up because I thought you were practicing for a Halloween party or working at a haunted house." I replied. I heard this while I was down the hall, minding my own business charting on one of our workstations on wheels.
Another one of our patients was talking about ghosts and what he'd read about them at our place. We suspect there are plenty, and many patients have stories of shadowy figures in their rooms, mostly on night shift.
Stay tuned for more interesting comments from the Hotel.
Sunday, May 9, 2010
Happy Mother's Day
Happy Mother's Day to all from one of the crew. Moms do what no one else will do, just like nurses.
One sweet patient talked Mom into bringing us flowers from the garden and another had a bouquet delivered to the nurses' station.
At least it covers up the bowel routines a little.
More to come...
One sweet patient talked Mom into bringing us flowers from the garden and another had a bouquet delivered to the nurses' station.
At least it covers up the bowel routines a little.
More to come...
Monday, April 26, 2010
Complaints of the Day
Oh, you know it's exciting when lots of people have the same complaints. When the unit wasn't busy preparing for severe storms passing through, we've always got complaints. Here are the latest.
Of our 20 something people, at least 1/4 were complaining of itching last night. We lotioned, powdered and loaded up the Benadryl on all of them. Gotta love Benadryl...it keeps them quiet! No, we do not issue back scratchers. Maybe at those spa rehabs you've been to before, but not here, no sir!
Another favorite complaint: heat. Our unit is just not the place to be if you want actual climate control. We're the poster children for global warming, especially if you consider all the toxic fumes emitted during bowel programs.
And if specific complaints weren't enough, we had people complaining just so they could complain. Can you tell the full moon is coming soon? No...can't be!
Stay tuned...more complaints to come!
Of our 20 something people, at least 1/4 were complaining of itching last night. We lotioned, powdered and loaded up the Benadryl on all of them. Gotta love Benadryl...it keeps them quiet! No, we do not issue back scratchers. Maybe at those spa rehabs you've been to before, but not here, no sir!
Another favorite complaint: heat. Our unit is just not the place to be if you want actual climate control. We're the poster children for global warming, especially if you consider all the toxic fumes emitted during bowel programs.
And if specific complaints weren't enough, we had people complaining just so they could complain. Can you tell the full moon is coming soon? No...can't be!
Stay tuned...more complaints to come!
Friday, February 13, 2009
Friday the 13th...
And for me, it's evenings again. Last night, there was nothing unlucky about it. Yes, I did end up with the med wagon again, but I had three patients who were relatively easy to take care of, so all went off without a hitch. It also helped that the schedule was stacked with more RNs to the rest of staff, so it makes the load lighter. (Not that I don't like the LPNs and NAs, they just can't do everything...)
I had one patient I'll call DQ (that's for Drama Queen). Every time he goes into some rant, I just want to stand outside the room, applaud and yell, "Bravo!" for his Oscar/Emmy/Golden Globe performance. I told the MD about his gentle rant (no one on either side of the hall in the other rooms complained about this one...) yesterday at the beginning of the shift. Since he's not going with the bowel program (which is a big, big problem on our unit), she told me to give him this message, "If the bowels are plugged, I'll just have to drop the pain meds." We'll see what actually happens. Hopefully, he'll be reasonably good again on my shift.
We expect to have a discharge today, but we'll probably get one or two people to take his place. It really depends. Since the Hotel is pretty much to capacity with isolated patients, it's getting more interesting to find places to put people...especially the ones who aren't on isolation. My favorite charge worked with us last night (which she normally doesn't do) and her take is, "we always get extra people in on our weekend." The scary part is that she's usually right. We don't take people back on the weekends, but on Fridays, if any of our folks are at Washington and nearing discharge, they're pleading to come back to us before nightfall. Ahh, isn't it great to feel loved? Hmm....
I'm not too superstitious, but I'll be hoping I'm lucky enough to have another night like last night, which was not too crazy.
More to come...stay tuned!
I had one patient I'll call DQ (that's for Drama Queen). Every time he goes into some rant, I just want to stand outside the room, applaud and yell, "Bravo!" for his Oscar/Emmy/Golden Globe performance. I told the MD about his gentle rant (no one on either side of the hall in the other rooms complained about this one...) yesterday at the beginning of the shift. Since he's not going with the bowel program (which is a big, big problem on our unit), she told me to give him this message, "If the bowels are plugged, I'll just have to drop the pain meds." We'll see what actually happens. Hopefully, he'll be reasonably good again on my shift.
We expect to have a discharge today, but we'll probably get one or two people to take his place. It really depends. Since the Hotel is pretty much to capacity with isolated patients, it's getting more interesting to find places to put people...especially the ones who aren't on isolation. My favorite charge worked with us last night (which she normally doesn't do) and her take is, "we always get extra people in on our weekend." The scary part is that she's usually right. We don't take people back on the weekends, but on Fridays, if any of our folks are at Washington and nearing discharge, they're pleading to come back to us before nightfall. Ahh, isn't it great to feel loved? Hmm....
I'm not too superstitious, but I'll be hoping I'm lucky enough to have another night like last night, which was not too crazy.
More to come...stay tuned!
Tuesday, December 2, 2008
Out of order
Everything functioned pretty well today, but the order of our day was a little off with all the excitement.
One of our patients went off on his day pass. He got a big honor and got the full VIP treatment. We don't know if we'll see him on TV, but we're all proud. I just would have felt better if I had not found his meds that I ran to the pharmacy for yesterday at noon today locked in our med room. The night charge forgot to pack them...arrgh! (We got that problem solved, though.)
I had the same two patients as yesterday, minus one, since I inherited the med cart...again. I got lucky and got the slow hall, where no bed bingo was going on and there were no IVs or oddball meds. Everyone was relatively pleasant, so it was a good time passing all the pills down there.
At lunchtime, I got to discharge one of my patients. He was nervous about leaving, which is not surprising, since we have some people who love to visit us. He was "sick" and despite all his vitals being good and the MD's offer to stay, he decided to leave once his ride showed up to get him.
My other patient got a trip to one of his consults, a shower and had lunch and was doing well, when he came up to me in the hall and said, "I need to have a bowel movement." He's an MS patient so I know he knows when he's got to go. I got him to the bathroom, but the strain to transfer him on the commode was too much and he had a little accident. I got him undressed carefully, and got him squared on the commode. He sat there for a while and I finished his bowel program with the famous mini-enema.
He sat some more and when he had transferred to his wheelchair, he said, "I gotta go back." I got him back to the commode for more sitting. While he was sitting, I folded another patient's t-shirts, which were in the dryer, and got his clothes (he already had a bunch) in the washing machine. All was over for him, so I got him some of our famous PJ pants and got him back to the chair. We got his clothes into the dryer and he was on his merry way.
One of my coworkers was surprised. "Why is he going in the middle of the day?" I told her I figured it was because we have him on all sorts of bowel meds (Colace, psyllium, MOM, etc.) and I think that the MOM at lunch is sending him over the edge early. Many of our patients need 4-6 hours for it to work, but some patients go pretty quickly after you give it. Bowel programs in the middle of the day are definitely out of order on our unit!
Finally, we're dealing with loss on our unit again. We're losing a nurse who has to leave due to health concerns. It's scary because this nurse is not near retirement age. Folks are hoping this nurse can use his/her nursing skills to work a desk job in some capacity.
One of our patients, who was a cute little old guy who everyone grew to love during his time with us, died this past weekend. He was friendly and rehabbed himself from being a feeder who stayed in bed, to getting up in his electric wheelchair racing around the unit and even feeding himself with his equipment.
I was happy when I left with J. at the end of the shift. I plan on enjoying my day off! More to come...
One of our patients went off on his day pass. He got a big honor and got the full VIP treatment. We don't know if we'll see him on TV, but we're all proud. I just would have felt better if I had not found his meds that I ran to the pharmacy for yesterday at noon today locked in our med room. The night charge forgot to pack them...arrgh! (We got that problem solved, though.)
I had the same two patients as yesterday, minus one, since I inherited the med cart...again. I got lucky and got the slow hall, where no bed bingo was going on and there were no IVs or oddball meds. Everyone was relatively pleasant, so it was a good time passing all the pills down there.
At lunchtime, I got to discharge one of my patients. He was nervous about leaving, which is not surprising, since we have some people who love to visit us. He was "sick" and despite all his vitals being good and the MD's offer to stay, he decided to leave once his ride showed up to get him.
My other patient got a trip to one of his consults, a shower and had lunch and was doing well, when he came up to me in the hall and said, "I need to have a bowel movement." He's an MS patient so I know he knows when he's got to go. I got him to the bathroom, but the strain to transfer him on the commode was too much and he had a little accident. I got him undressed carefully, and got him squared on the commode. He sat there for a while and I finished his bowel program with the famous mini-enema.
He sat some more and when he had transferred to his wheelchair, he said, "I gotta go back." I got him back to the commode for more sitting. While he was sitting, I folded another patient's t-shirts, which were in the dryer, and got his clothes (he already had a bunch) in the washing machine. All was over for him, so I got him some of our famous PJ pants and got him back to the chair. We got his clothes into the dryer and he was on his merry way.
One of my coworkers was surprised. "Why is he going in the middle of the day?" I told her I figured it was because we have him on all sorts of bowel meds (Colace, psyllium, MOM, etc.) and I think that the MOM at lunch is sending him over the edge early. Many of our patients need 4-6 hours for it to work, but some patients go pretty quickly after you give it. Bowel programs in the middle of the day are definitely out of order on our unit!
Finally, we're dealing with loss on our unit again. We're losing a nurse who has to leave due to health concerns. It's scary because this nurse is not near retirement age. Folks are hoping this nurse can use his/her nursing skills to work a desk job in some capacity.
One of our patients, who was a cute little old guy who everyone grew to love during his time with us, died this past weekend. He was friendly and rehabbed himself from being a feeder who stayed in bed, to getting up in his electric wheelchair racing around the unit and even feeding himself with his equipment.
I was happy when I left with J. at the end of the shift. I plan on enjoying my day off! More to come...
Saturday, October 25, 2008
Heard on the unit...
Yes, I haven't had an installment of this in a while, so here goes...
"I'm so happy to see your smiling face." Mr. J.
Some people love to see you come back to work. Others...well, they aren't exactly thrilled. Mr. J. is a riot and he's always got a funny perspective on things. I think some of that has to do with his previous job--police detective.
"It really smells down here." Nursing supervisor last night when he was on the unit.
"That's the smell of success." Yours truly (RehabRN)
Yes, it's not really a secret, but to all of you nursing students going to rehab, especially with SCI patients, evening shifts tend to be...shall we say, aromatic. Many patients who do active rehab have bowel programs in the evenings, usually immediately (30-60 minutes) following dinner. The reason? This allows the patients to get the most out of therapy, particularly, in terms of time, since while nurses work 24/7, therapists do not. Most of them work the day shift Monday through Friday and usually they rotate the weekends, where they work a max of four to eight hours, depending on the rules of the unit, etc.
If you smell something, that means we have people with good, working bowels. If they're consistent, this also means that they won't have accidents in between, either and will get the most out of therapy. We start everyone on bowel routines daily, and then after two weeks, they will move to qod (or every other day). Some people do well like that, and if that doesn't work, they stay on a daily schedule.
"I don't know what her (MD's) rationale is, but I'm getting out of here on Monday." Mr. R.
I admitted this guy on Tuesday. Sure he's in for a short trip, but for some reason, we get a lot of patients who get sick once they arrive and then they have to stay with us. Mr. R. is very impatient to leave, which is pretty unusual for most of our patients. We tend to keep people a long time.
"I'm so happy to see your smiling face." Mr. J.
Some people love to see you come back to work. Others...well, they aren't exactly thrilled. Mr. J. is a riot and he's always got a funny perspective on things. I think some of that has to do with his previous job--police detective.
"It really smells down here." Nursing supervisor last night when he was on the unit.
"That's the smell of success." Yours truly (RehabRN)
Yes, it's not really a secret, but to all of you nursing students going to rehab, especially with SCI patients, evening shifts tend to be...shall we say, aromatic. Many patients who do active rehab have bowel programs in the evenings, usually immediately (30-60 minutes) following dinner. The reason? This allows the patients to get the most out of therapy, particularly, in terms of time, since while nurses work 24/7, therapists do not. Most of them work the day shift Monday through Friday and usually they rotate the weekends, where they work a max of four to eight hours, depending on the rules of the unit, etc.
If you smell something, that means we have people with good, working bowels. If they're consistent, this also means that they won't have accidents in between, either and will get the most out of therapy. We start everyone on bowel routines daily, and then after two weeks, they will move to qod (or every other day). Some people do well like that, and if that doesn't work, they stay on a daily schedule.
"I don't know what her (MD's) rationale is, but I'm getting out of here on Monday." Mr. R.
I admitted this guy on Tuesday. Sure he's in for a short trip, but for some reason, we get a lot of patients who get sick once they arrive and then they have to stay with us. Mr. R. is very impatient to leave, which is pretty unusual for most of our patients. We tend to keep people a long time.
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