[NPInfo] My Reply...Back to Sue

Sun Sep 9 12:10:16 PDT 2007

I worked Ortho for many years in the early 1980-1989 when joint replacements
was still "relatively" new and patients were in the hospital 7-10 days
before going home (no sending them to rehab-- they rehabbed there). Pts were
up in the chair 2-3x a day for meals for 1-2 hours by post-op day 2 (and if
they were my patients, they were bathed and up in the chair before
breakfast-- after PT they were returned to a beautifully, and wrinkle-free,
freshly made bed and fluffed pillow <G>) and had PT 2x/day. The nursing
assistant, ortho tech, or nurse got the patients up to the BR, and walked
them in the halls in between therapy sessions once cleared by PT. Actually,
these poor patients got very little time to rest and sleep during the day
<G> but I don't remember using anything other than TED hose and SCDs (once
they were invented) to prevent DVTs. Of course, back in the early '80s was
before the whole DRG thing started...

In my last job on a new NeuroSurgery unit, the nurses and CNAs NEVER got a
patient out of bed in a chair or walked them in the hall-- they were
supposedly too busy. PT managed to see the patients once a day although
frequently didn't see them at all and actually had little notes in the
charts about being "short staffed" (YIKES!). 

I really fail to see how this is progress.....
Dena Galler

-----Original Message-----
From: npinfo-bounces at nurse.net [mailto:npinfo-bounces at nurse.net] On Behalf
Of Marilyn Dean
Sent: Sunday, September 09, 2007 11:22 AM
To: NP Info
Subject: RE: [NPInfo] My Reply...Back to Sue

I have to agree. I was very disappointed in the care my Mom-in-Law had
recently in a large hospital after an extensive surgery to redo a prosthetic
hip which had loosened over time and finally resulted in a femur fracture.
At 88 it was a great risk. 5 people were in each day for a care conference,
but no one but PT got her up and she went to a care center on Friday AM
after having surgery on Tues late afternoon. She had not been sitting in a
chair yet. Does it make you wonder why we now have to have all the DVT
prophylaxis with meds with hospitalizations. She is completely non-weight
bearing on one leg with a congenial hip malformation on the other where she
may bear weight.
Now in the care center they are doing a great job of getting her up, but I
can't quite get anyone to order something for her gerd, although I have
talked to them twice and she has lost her "cookies" a couple of times
because of it. They have till Tues to get an order or I will personally call
her Dr. I think communications are a real problem. Promises don't cut it.
Marilyn

-----Original Message-----
From: npinfo-bounces at nurse.net [mailto:npinfo-bounces at nurse.net]On Behalf Of
Priscilla Merrill
Sent: Saturday, September 08, 2007 5:37 AM
To: 'NP Info'
Subject: RE: [NPInfo] My Reply...Back to Sue

Amen to that!  Couldn't have said it better, Dena.  I'm truly heartsick to
see this part of nursing go by the wayside.  True nursing care for the most
part has gone down the toilet as nurses are more and more multitasked and
forced to be documentation/computer queens.  My friends that have stayed in
nursing are few and far between and burnt to a crisp with the new mountains
of expectations, shorter than ever staffing and the fluffing has suffered as
have the patients.  That's been my mantra over and over on these threads- -
the patient MUST be our center.  It's not all about money, power, prestige,
turf, role delineation -- we must put CARE in the center and all would be
happy.
OK, I salute you my JANGO sister!  This obviously made us fluffers from a
very early age. When you take care of men and do your hs perineal care, does
that make you a Fluffer-Nutter?  And as my 2 cents, there's a difference
between comfort and fluffing and waking folks for mundane tasks when you
don't have to.  That's why they call it the ART of nursing.  OK< flame suit
on, POOF.

Priscilla Merrill FNP

-----Original Message-----
From: npinfo-bounces at nurse.net [mailto:npinfo-bounces at nurse.net] On Behalf
Of Dena
Sent: Saturday, September 08, 2007 2:39 AM
To: 'NP Info'
Subject: RE: [NPInfo] My Reply...Back to Sue

I remember back in the '80s working 3-11, pushing a cart from patient to
patient starting at 9:00p.m., handing out a hot wet washcloth, a towel,
changing the drawsheet, putting a new pillow case on the pillow before
fluffing it, and offering a back rub to everyone. It was my favorite part of
the shift. Did I ever think I was playing the stereotypical handmaiden role
while I was doing it? No-- I only knew I was helping my patients relax and
feel better. Several years ago while working agency on the floor for extra
money, I fell back into the same pattern and the nurses were astonished.
None of them had ever heard of p.m. care before. When working the day shift,
I was shocked to find out that none of the nurses apparently had ever heard
of a.m. care or baths before either.

My girlfriend's 20 yr old son was in the ICU a couple of years ago with
bilateral spontaneous pneumothorax and was, appropriately, scared to death.
He later told his mom (a NP herself) that the best nurse he had was one who
gave him a back rub one night and then pulled up a chair and spent 20
minutes just talking to him. That was what he needed more than anything else
at the time.

I have often said that people go into nursing for one of two reasons-- the
art of nursing (the nurturing, hand holding, talking) or the science of
nursing (the machines, the numbers, the technical aspects). I'm definitely
the hand-holding nurturer type, always have been and always will be-- and I
will never apologize for it.
Dena Galler

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