OKAY. LET'S DO IT.

WE HAVE A LOT TO DO TODAY.

EVEN THOUGH IT SEEMS LIKE
NOT MUCH BECAUSE IT
JUST LOOKS LIKE

YOU ARE GOING TO MAKE A BED
AND COLLECT SOME URINE.

AND OKAY, BIG DEAL.

AND THAT IS SO TRUE, IT'S NOT A
HUGE DEAL IN THE SCHEME OF LIFE.

WE'VE GONE FROM A-SKILLS
BACK TO B-SKILLS.

OKAY SO WE ARE GOING TO
WHIP OUT THIS DEMO.

IT WILL TAKE ABOUT 45 MINUTES,
IT WON'T TAKE THAT LONG MAYBE
AN HOUR.

AND THEN WE ARE GOING TO
START WORKING ON MATH.

WE HAVE FIVE WEEKS TO DO MATH

AND GET IT UNDER OUR BELTS
AND BE GOOD AT IT.

SO PLENTY OF TIME TO PRACTICE,
PLENTY OF TIME TO REVIEW.

I HAVE A LOT OF PRACTICE TESTS
AND THINGS FOR YOU TO DO

SO THAT YOU WILL BE PREPARED
AND YOU WILL BE READY.

FIVE WEEKS, THE BIG
MATH TEST, IT'S COMING.

SO ABOUT THREE WEEKS AND WE
WILL HAVE OUR MIDTERM EXAM.

SO WHAT HAPPENS IS I END UP
DOING A MED MATH REVIEW
FOR, LIKE, THREE WEEKS.

AND THEN THE FOLLOWING WEEK

WE USE THE SECOND HALF OF
THE CLASS FOR YOUR EXAM.

AND THEN WE DO ONE MORE MED
MATH EXAM OR MED MATH REVIEW

AND THEN DEMO FIRST AND THEN
I'LL INSTRUCT YOU FOR THE EXAM

THAT WAY YOU CAN LEAVE
WHEN YOU'RE DONE.

OKAY, SO IT'S KIND OF
A PLAN OF ATTACK HERE.

ALRIGHT. USUALLY, I START FROM
THE BEGINNING OF YOUR CHECKLIST,

BUT TODAY I AM GOING
TO START BACKWARDS

BECAUSE IT'S A LITTLE EASIER
TO GO BACKWARDS THAN IT IS
TO GO FORWARDS.

AND THAT IS BECAUSE I AM GOING
TO TALK ABOUT SPECIMEN
COLLECTION FIRST

AND THEN WE ARE GOING
TO DO THE SKILLS.

ALL THE SPECIMEN COLLECTION
IS PASS/FAIL.

AND SOME OF THEM YOU HAVE TO
DEMONSTRATE OR TALK THROUGH

AND SOME OF THEM YOU DON'T. IT'S
JUST ON A NEED-TO-KNOW BASIS.

THERE'S TONS OF SPECIMENS
AND TONS OF AMOUNTS

AND REASONS WHY WE GATHER THEM

SO WE JUST BE A LITTLE FLEXIBLE
AND ADAPTABLE HERE.

ALSO OUR FOCUS ISN'T ALL
SPECIMENS TODAY,
IT'S URINE SPECIMENS.

SINCE WE ARE DOING BED PANS,

WE ARE GOING TO TALK ABOUT
URINE SPECIMEN COLLECTION.

AND THAT'S HOW WE INTEGRATED
SPECIMEN COLLECTION IS

WITH EACH OF THE MODULES
COMING UP,

THERE WILL BE A DIFFERENT
SPECIMEN THAT WE WILL COLLECT
WITH THE EACH SYSTEM

WE ARE KIND OF FOCUSED ON.

SO THE FOCUS
FOR THE NEXT TWO WEEKS --
THIS IS A TWO WEEK MODULE

SO YOU'VE GOT A SLUG
OF READING TO DO.

AND I MEAN A LOT BECAUSE
IT NOT ONLY INCORPORATES

THE SPECIMEN COLLECTION
AND THE BED MAKING,
BUT IT'S ALL PERSONAL HYGIENE.

SO IT'S GOING TO TALK ABOUT
THINGS THAT WE ARE NOT
GOING TO DO AT ALL

AND THAT'S WHERE YOU REALLY
NEED TO FOCUS YOUR READING.

LIKE HOW TO PUT IN
AND OUT CONTACTS,

HOW TO DO A FAKE EYE,
HOW TO DO HEARING AIDS,

HOW TO SHAMPOO HAIR.

I MEAN MANNEQUINS,
THEY DON'T HAVE HAIR.

HOW TO BRUSH TEETH,
I MEAN, BRUSH YOUR OWN

SO YOU GOT A GOOD POINT
OF REFERENCE THERE.

BUT IT GIVES YOU SOME TIPS AND
SOME POINTERS FOR PEOPLE

THAT ARE UNCONSCIOUS, FOR PEOPLE
THAT ARE LESS CO-OPERATIVE,

DENTURES THAT KIND OF THING.

AND WE WILL TALK MORE ABOUT
IT WHEN WE DO PERSONAL CARE,

BUT THERE'S JUST A TON
OF THINGS TO REVIEW.

YOU KNOW HOW TO COMB YOUR HAIR,
YOU KNOW HOW TO DO --
TAKE A SHOWER,

YOU KNOW HOW TO DO
PERSONAL HYGIENE.

BUT WHEN YOU ARE READING,

TAKE ON THE MINDSET OF HOW WOULD
I DO THIS FOR SOMEONE ELSE,

SOMEONE THAT'S HAD A STROKE,
SOMEONE THAT'S MAYBE COMATOSE,

SOMEONE THAT I AM
HAVING TO HELP OUT.

AND DIFFERENT VENUES THAT
YOU WOULD BE PARTICIPATING

IN THOSE KINDS OF CARE ISSUES.

AND READ RATIONALES MORE THAN
YOU HAVE TO DO REALLY,
STEP BY STEP.

YOU KNOW HOW TO DO
A LOT OF STUFF.

"WHY AM I DOING THIS?
AND HOW CAN I DO IT BEST
FOR CERTAIN CLIENTELE?"

ALRIGHT, ENOUGH OF THAT.

SPECIMENS. WE ARE GOING
TO START WITH URINE.

WE WILL START WITH THE BASIC
URINE SPECIMEN COLLECTION.

IF YOU'VE EVER GIVEN A URINE
SPECIMEN, USUALLY THEY JUST
HAND YOU A CUP

AND SAY, "WE NEED A SPECIMEN."

BUT WE MOST CLEARLY WANT TO
DISTINGUISH OUR SPECIMEN

TO BE A MIDSTREAM COLLECTION.

A MIDSTREAM COLLECTION, IF YOU
CAN GET THAT FROM YOUR PATIENTS

ANYTIME YOU ARE DOING A URINE,
JUST A PLAIN URINE ANALYSIS,

GIVES YOU THE ADVANTAGE OF
BEING ABLE TO DO A CULTURE
ON THAT SPECIMEN.

IF IT'S IS JUST THE
URINE SPECIMEN,

MAYBE THEY ARE DOING FOR
DRUG SCREEN OR SOMETHING.

THEN THEY ARE PROBABLY NOT GOING
TO CULTURE IT FOR BACTERIA.

THE CLIENT DOESN'T
NEED TO CLEAN UP.

BUT IF WE GET 'EM CLEANED
AND YOU DO A SPECIMEN,

AND THEY SPOTTED SOMETHING, THEN
THEY COULD ALSO CULTURE THAT

SPECIMEN. IF THEY HAD A GOOD
SPECIMEN RATHER THAN HAVING
TO DO A REPEAT,

AND THIS IS WHAT I MEAN.

FOR URINE SPECIMEN, IT'S
PASS/FAIL, SO JUST SAY
I DO YOUR --

YOU DO YOUR HIGH FIVE, OF
COURSE YOU CHECK YOUR ORDERS,

SEE THAT YOU NEEDED IT,
GATHER YOUR EQUIPMENT

WHICH IS BASICALLY
THE SPECIMEN CUP.

IT ALSO MAYBE A WIPE
OR A WASHCLOTH FOR YOUR CLIENT

SO THAT THEY
CAN CLEAN THEMSELVES.

YOU ARE GOING TO NEED A SPECIMEN
BAG TO PUT THE URINE SPECIMEN
IN.

AND THAT'S ABOUT IT.

HAVE YOUR CLIENT
WASH THEIR HANDS.

OF COURSE, YOU WOULD IF YOU
WERE GOING TO GET THE SPECIMEN
FROM THEM.

AND I WOULD BE WEARING GLOVES
AND SO WOULD YOU IF YOU HAD
TO CATCH THE SPECIMEN.

IDENTIFY YOUR CLIENT,
PROVIDE PRIVACY.

ALRIGHT, WE HAVE THE SEXES HERE
THAT WE HAVE TO DEAL WITH.

WE ALWAYS GIVE EQUAL TIME
TO BOTH.

SO FOR THE FEMALE WE
WILL START FIRST.

IF A FEMALE HAD TO GIVE YOU
A MIDSTREAM URINE SPECIMEN,

WHAT YOU WANT TO
INSTRUCT HER TO DO IS,

WHEN YOU GO IN
TO GIVE YOUR SPECIMEN,
I WANT YOU TO TAKE THE --

YOUR LABIA WHICH ARE
THE TWO FATTY PADS THAT
YOU HAVE DOWN BELOW.

YOU HAVE THE OUTER PADS AND THE
INNER LIPS OR FLAPS THERE.

YOU NEED TO GET TO THE INNER LIP
AND PULL THAT APART, THE INSIDE.

THEN HOLDING THAT APART,
TAKE YOUR WIPE

AND WIPE FROM FRONT
TO BACK AND DROP IT.

DON'T SCRUB UP DOWN THERE,
FRONT TO BACK, DROP.

THEN STILL HOLDING ON,
KEEPING THE LABIA SEPARATED,

START YOUR URINE STREAM,

YOU WILL HAVE TO HAVE THE
LID OFF, OF COURSE, FIRST.

START YOUR URINE STREAM AND THEN
PASS THE CUP INTO THE STREAM.

AND JUST GET ABOUT A HALF
A CUP AND PULL OUT AND

THEN YOU CAN RELEASE THE LABIA
AND FINISH URINATING.

OKAY, THAT'S A MIDSTREAM.

THEY DON'T HAVE TO FILL
THE CUP TO THE BRIM.

HAVE YOU EVER GOTTEN ONE OF
THOSE BACK AND YOU'RE
JUST GOING...

ALL THEY REALLY NEED IS 1 CC.

THEY USUALLY SAY 10 CC
TO 30 CC IN THE BOOK.

YOU ONLY NEED A SMIDGE TO
LOOK UNDER A SCOPE WITH,

THEY DON'T NEED THAT MUCH.
SO I JUST TELL THEM A HALF,

THAT GIVES PLENTY
TO SPILL IN THE LAB

AND YOU DON'T HAVE TO
FUSS WITH THE CUP.

OKAY, SO WIPE FRONT TO BACK,
START THE STREAM WHILE
HOLDING THE LABIA,

PASS INTO THE STREAM, PASS OUT
AND -- WELL, DON'T PASS OUT.

BUT COME OUT OF THE STREAM,
RELEASE, GO.

PUT THE LID ON, YOU
WILL LABEL THE CUP

AND THEN PUT IT INTO
THE BAG LABELED.

NEVER LABEL THE BAG BECAUSE
THE BAGS GET THROWN AWAY.

ALRIGHT, FOR THE MALE,

WHAT THEY NEED TO DO
IS TAKE THE PENIS,
HOLD THE PENIS SHAFT --

PENAL SHAFT AND THEN TAKE
THE WIPE AND WIPE FROM
THE GLANDS BACK.

THEY DON'T HAVE TO WIPE
THE WHOLE PENAL SHAFT,
JUST THE GLANDS PART.

THEN WHILE HOLDING, SAME THING.

THEY ARE GOING TO START THE
STREAM, PASS INTO THE STREAM,

BACK OUT AND THEN THEY
CAN CONTINUE URINATING.

BUT YOU WANT THE MIDDLE
PART OF THE STREAM.

YOU DON'T WANT WHAT'S BEEN
SITTING IN THAT URETHRA.

YOU DON'T WANT OLD URINE,
THAT HAS BACTERIA.

SO YOU WANT TO CLEAR SOME URINE
OUT, GET THE MIDDLE
CLEANEST PART,

BE DONE AND THEN FINISH BECAUSE
YOU DON'T WANT JUST

THE BOTTOM OF THE BLADDER
PART EITHER.

YOU WANT THE CLEANEST PART AND
THAT'S WHAT WE ARE AIMING FOR.

ALRIGHT, SIMPLE URINE
MIDSTREAM ANALYSIS.

ALRIGHT, ONCE YOU HAVE YOUR
SPECIMEN, OF COURSE,
WASH YOUR HANDS

AND SEND IT TO THE LAB,

IT NEEDS TO BE IN THE
LAB WITHIN 15 MINUTES.

AND THEN DOCUMENT THAT YOU
DID SEND IT TO THE LAB.

AGAIN ON AS FAR AS LABS GO,
THEY NEED TO GO DIRECTLY TO
THE LAB.

THEY NEED TO BE REFRIGERATED
AND YOU CAN'T JUST THROW THESE

INTO THE SNACK REFRIGERATOR
IN THE NURSE'S LOUNGE.

AND YOU WOULD BE SURPRISED
WHAT WE SEE SOMETIMES.

THEY HAVE TO BE IN A
CONTROLLED ENVIRONMENT.

SO IT HAS TO BE A
SPECIMEN-REFRIGERATOR

AND THAT'S THE REFRIGERATOR
WHERE SOMEONE HAS CALIBRATED

AND CHECKED THE TEMPERATURE
OF THAT REFRIGERATOR
EVERY 24 HOURS

TO MAKE SURE THAT IT'S
THE RIGHT TEMPERATURE.

SO WE DON'T MIX WITH FOOD
AND IT HAS TO BE IN A
REGULATED REFRIGERATOR.

ALRIGHT, ANOTHER THING THAT WE
DO RELATED TO URINE SPECIMENS
AND COLLECTIONS --

IT'S NOT ON YOUR CHECKLIST,
IS THAT WE CALCULATE I&O,

WHICH IS INTAKE AND OUTPUT.

EVERYTHING THAT A CLIENT
PUTS IN WE KEEP TRACK OF IT,

AND EVERYTHING THAT COMES
OUT WE KEEP TRACK OF.

SO FOCUSING ON URINE,

ONE OF THE WAYS WE CATCH URINE
IS THROUGH A POTTY HAT.

I GUESS IT KIND OF LOOKS LIKE
A HAT, I DON'T REALLY KNOW,

BUT THAT'S WHAT THEY CALL IT
AND IT SITS IN THE TOILET.

SO IT'S JUST CALLED POTTY HAT.

GOES IN THE TOILET AND WHAT
YOU DO IS YOU LIFT THE SEAT
OF THE TOILET,

THEN IT GOES INTO THE TOILET
AND THEN ON THE RIM THERE

AND THE SEAT GOES
DOWN ON TOP OF THIS

SO THAT WHEN YOU SIT IT'S
FACING LIKE THIS TO CATCH.

ONCE THEY URINATE,
THEN YOU CAN SEE INSIDE
THE GRADUATED AMOUNTS.

AND THEN YOU JUST LOOK TO SEE
HOW MUCH IS IN THERE,

DUMP IT IN THE TOILET,
GIVE IT A LITTLE RINSE

AND THEN PUT IT BACK
INTO THE TOILET.

IF IT'S A SEMI-PRIVATE ROOM,
MORE THAN ONE PERSON SHARING
THE ROOM,

THEN YOU HAVE TO WRITE
THEIR NAME ON THE SIDE

AND THEN THE HATS,
KIND OF, ARE STORED ON
THE FLOOR BASICALLY

AND THEN SWITCHED OUT FOR
THE APPROPRIATE CLIENT

SO THAT YOU CAN KEEP
TRACK OF THEIR URINE.

ANOTHER WAY THAT WE DO THIS
IS WITH FOLEY CATHETERS.

WE MAY WANT TO POUR IT
INTO A GRADUATE, SO.

WE'VE TALKED ABOUT FOLEY
CATHETERS QUITE A BIT.

WHAT YOU WOULD DO...

IS COME OVER TO THE FOLEY
CATHETER...ALWAYS WITH GLOVES.

REMEMBER WE NEVER TOUCH
THESE BAGS WITHOUT?
- GLOVES.

- IT'S A LITTLE DIFFICULT
TO SEE OVER THERE.

JUST CONNECT IT TO THE BED.

SO I WILL GO AHEAD AND PULL IT
UP HERE SO YOU CAN SEE.

THIS WILL BE ON THE FLOOR.
DON'T EMPTY 'EM ON PATIENT'S
BEDS COS THEY SPILL.

BUT WHAT YOU WANT TO COME AND DO
IS GET THE LITTLE SPOUT OUT.

THEN YOU HAVE TO FLICK
IT TO OPEN IT UP AND THEN
EMPTY IT ALL OUT IN HERE.

GOT TO SAVE SOME FOR FRIDAY'S
CLASS. AND YOU CAN SEE IT'S
KIND OF --

IT KIND OF FLICKS AND
SPLASHES ON THERE

SO YOU WANT TO BE
CAREFUL ABOUT THAT.

AND THAT'S WHY I ALWAYS HANDLE
THESE BAGS WITH GLOVES

BECAUSE ALL THAT SPLISH
AND SPLASH

IS GOING TO GET ALL ON
THIS OUTSIDE HERE.

ALRIGHT. ONCE YOU HAVE
YOUR URINE,

THEN YOU WOULD TAKE THIS,
MEASURE THE AMOUNT
THAT'S IN HERE,

TAKE IT TO THE TOILET,
DUMP IT, RINSE IT OUT

AND THEN AGAIN.
USUALLY, THEIR NAMES ARE ON IT

IF THERE IS MORE THAN ONE PERSON
IN A ROOM, SO YOU ARE NOT
SHARING GRADUATES.

AND THAT'S ALL THESE ARE CALLED,
GRADUATES, FOR MEASURING URINE.

OKAY.

ANOTHER THING WE DO IS --

I HAVE TO KIND OF JERRY-RIG
THIS A LITTLE BIT.

WE COLLECT URINE SPECIMENS
FROM FOLEY CATHETERS.

NOW IF YOU ARE GOING TO GET
A URINE SPECIMEN FROM
A FOLEY CATHETER,

WHAT DO YOU THINK ABOUT
GETTING IT FROM THE BAG?

- NO.
- OH, NO. BAD IDEA, RIGHT?

BECAUSE IT'S BEEN
SITTING AROUND THERE.

AND IF WE TALKED ABOUT NOT
WANTING THE SPECIMEN

THAT COMES FROM THE URETHRA,
THAT FIRST PART

THAT'S BEEN SITTING AROUND,
IT'S GOING TO BE ALL
CONTAMINATED.

SO WE DON'T WANT WHAT'S
SITTING IN THE BAG.

NEVER TAKE A URINE
SPECIMEN FROM THE BAG.

SO WHAT WE WANT TO DO
IS GET A CATH SPECIMEN,

BUT WE WANT TO GET IT
FROM THE CATHETER.

SO WHAT YOU WOULD WANT TO DO IS

EMPTY ALL THE URINE OUT
OF THE CATHETER TUBING.

BECAUSE SOMETIMES THE TUBING
IS, LIKE, SITTING HERE

AND THERE IS OLD URINE
SITTING IN THE TUBING.

SO YOU DRAIN ALL OF THE
OLD URINE OUT.

THEN WHAT YOU WANT TO DO
IS CLAMP THE CATHETER.

AND THERE'S A COUPLE OF
KINDS OF CLAMPS HERE.

WHAT I AM GOING TO DO
IS TAKE A RUBBER BAND.

AND I AM GOING TO BEND
THIS CLOSE TO THE PORT.

THIS IS A PORT. AND IT IS KIND
OF HARD TO DISTINGUISH.

BUT IT'S A RUBBER PLACE WHERE
I CAN STICK A NEEDLE IN

AND GATHER MY SPECIMEN

SO, I AM GOING TO
TAKE A RUBBER BAND

AND YOU'VE GOT TO PUT ONE
ON REALLY TIGHT.

OH, I HAVE MY GLOVES IN HERE.

I'M GOOD. THAT WILL BE HERE
FOR THE REST OF MY LIFE.

AND GET IT NICE AND TIGHT.

ALRIGHT. AND THEN URINE
WILL BEGIN TO COLLECT.

SO DON'T LOOK, THAT
WILL MAKE URINE COME.

OKAY. NEVER RE-CAP NEEDLES.

URINE HAS COME INTO MY CATHETER
AND IT LOOKS JUST LIKE THAT.

IT WILL GET TRAPPED IN THERE
AND YOU LET IT SIT THERE

FOR ABOUT 5, 10, 15 MINUTES.

AND I TELL THE CLIENT
AFTER I CLAMPED IT,

"I HAVE CLAMPED YOUR CATHETER,
I NEED TO GET A SPECIMEN.

DOCTOR WANTS TO LOOK
AT YOUR URINE,

SO IF I DON'T GET BACK
HERE IN 10-15 MINUTES

OR YOU ARE UNCOMFORTABLE,
PUT THE CALL LIGHT ON."

OH, HOW EASY TO FORGET WHILE
YOU ARE IN ANOTHER ROOM

AND THEIR BLADDER IS FILLING ALL
UP AND THEY ARE UNCOMFORTABLE.

SO I COME BACK IN
15 MINUTES OR SO

AND I BRING IN, THIS TIME, A
SYRINGE AND MY SPECIMEN CUP.

YOUR SYRINGE NEEDS TO BE ABOUT
A 10 CC SYRINGE MINIMUM.

YOU CAN DO A 20
OR 30 CC SYRINGE.

AND WHAT YOU WANT TO DO
IS GET AN ALCOHOL SWAB.

ALL GOOD NURSES --
WHEN YOU GO ON THE FLOOR,

THROW ABOUT 10-20 ALCOHOL
SWABS INTO YOUR POCKETS

AND A COUPLE OF BAND AIDS.

YOU ARE GOING TO GET
AN ALCOHOL SWAB HERE,

AND YOU ARE GOING TO CLEAN THIS
RUBBER PORT VIGOROUSLY.

THEN YOU ARE GOING TO --
WHENEVER YOU HANDLE SYRINGES
AND NEEDLES,

PULL AWAY FROM YOURSELF
LIKE THIS. NONE OF THIS
KIND OF STUFF.

WE WILL TALK ABOUT MORE
NEEDLE SAFETY LATER.

YOU ARE GOING TO TAKE YOUR
NEEDLE AND PUT IT INTO
THE RUBBER STOPPER

AND THEN YOU ARE GOING TO
PULL AND GET THE URINE OUT.

AND THAT'S JUST EXACTLY
WHAT IT LOOKS LIKE.

PULL OUT 10-15 CC,
WHATEVER YOU CAN GET.

THEN WE NEVER RECAP, SO YOU
COULD SCOOP OR YOU COULD
GO DIRECTLY -

WHAT DID I DO WITH MY CUP?

YOU GUYS SAW ME GRAB THE BAG.

YOU GET YOUR SPECIMEN CONTAINER.

NOTICE MY NEEDLE'S ALWAYS FROM
ME SO I DON'T STICK MYSELF.

AND THEN THE SPECIMEN
GOES INTO THE CONTAINER.

YOU DON'T EVER SEND A SYRINGE
AND A NEEDLE TO THE LAB.

OKAY. I HAVE ALL MY TABLES
USED UP OVER HERE.

THIS WOULD GO DIRECTLY INTO
A SHARP'S CONTAINER.

AND I NEED TO SAVE THIS
FOR MY DEMO ON FRIDAY.

CLEAN UP YOUR SUPPLIES.

AND THEN LABEL IT, AND
SEND IT TO THE LAB.

NOW IT WOULD BE REALLY KIND
IF WE WOULD UNDO THE CLAMP

BEFORE WE LEAVE AND THEN
DRAIN ALL THAT URINE DOWN.

AND MAKE SURE OUR
CLIENT IS COMFORTABLE.

AND YOU ARE GOOD TO GO.

I PROBABLY COULD HAVE
PUT A CHUX UNDER THERE,
BUT I NEVER SPILT A DROP,

SO LUCKY FOR ME.

ALRIGHT, SO THAT'S COLLECTING.
TAKE YOUR GLOVES OFF,
WASH YOUR HANDS

AND DOCUMENT THE
CATHETER SPECIMEN.

OKAY. CATHETERS. I DID WANT TO
SHOW YOU A COUPLE OF THINGS.

I SHOWED YOU HOW TO TAPE 'EM.

DID I SHOW YOU HOW TO TAPE 'EM?

OH, WELL, THEN I WILL SHOW YOU
HOW TO TAPE THEM TODAY.

THIS IS A LEG STRAP.

WHEN THEY HAVE A FOLEY
CATHETER, PUT IT ON THEIR LEG.

IT'S A VELCRO STRAP. IT JUST
GOES AROUND THE THIGH
PIECE HERE.

AND THEN THE CATHETER --

OH, I AM RUNNING OUT
OF CATHETER TUBING.

THE CATHETER TUBING GOES IN HERE
AND THEN IT JUST VELCRO'S HERE
TO POSITION IT,

SO IT'S NOT
ALWAYS TUGGING ON THE CLIENT.

ANOTHER THING THAT WE DO WITH
FOLEYS IS WE PUT LEG BAGS ON.

CAN YOU IMAGINE IF YOU
ARE AMBULATORY?

YOU HAVE TO HAVE A CATHETER
BECAUSE INCONTINENT
ALL THE TIME.

SO, YOU HAVE TO GO TO THE
DOCTOR'S OR YOU ARE GOING OUT
WITH YOUR KIDS SHOPPING

OR SOMETHING AND YOU
DON'T WANT TO BE WAGGING
AROUND YOUR PURSE.

SO, YOU GOT TO SWITCH OVER.

AND YOU CAN SWITCH
OVER TO A LEG BAG.

TO DO THAT, YOU ARE GOING TO,
AGAIN, DRAIN IT ALL OUT.

WE WILL TALK A LITTLE MORE
ABOUT THIS WHEN
WE DO FOLEY CATHETERS,

BUT YOU'D PUT A CHUX
OR SOMETHING ON HERE.

I WOULD PROBABLY
RELEASE THIS TAPE,

PINCH THIS OFF SO IT DOESN'T
DRIBBLE ON YOU.

DISCONNECT AND THEN PUT
THIS ONE ON.

THIS NEEDS TO BE CLEANED
AND CAPPED.

IN THE MEANTIME, WHAT I MIGHT
DO HERE IS PUT AN ALCOHOL SWAB.

JUST PUT IT IN THE PACKET HERE.

AND THAT WILL PRESERVE THAT
FOR THE TIME BEING TILL I CAN
GET TO IT.

THEN THIS, YOU CAN SEE THAT I
HAVE SECURED THIS ON THE LEG.

I PUT A PIECE OF TAPE HERE
AND THEN TWO TAPES TO
KEEP IT STABLE.

WE ALWAYS TAPE OUR CATHETERS
SO THAT THEY ARE
NOT FLOPPING AROUND.

IT'S THAT FLOPPING THAT
STRETCHES THE MEATUS

AND CAN CAUSE URINARY TRACK
INFECTION BECAUSE GERMS ARE
ABLE TO MIGRATE

WITH ALL THE TRAUMA.

SO YOU WANT TO STABILIZE IT
AS BEST YOU CAN.

AND THE RECOMMENDATION IS THAT
WE DO IT ON TOP OF THE THIGH,

NOT INSIDE THE THIGH
BECAUSE THEN THEY PRESS
THEIR LEGS TOGETHER

AND IT'S IN THE WAY.

SO ON TOP OF THE THIGH.

AFTER I PUT A LEG BAG ON, I
WOULD REMOVE THESE, THIS TAPE.

BECAUSE THIS IS NOT
IN A GOOD PLACE.

BECAUSE RIGHT NOW THE LEG BAG

IS GOING TO BE WHAT
STABILIZES THE CATHETER.

AND NOW WHAT YOU ARE GOING
TO DO IS TAKE THE BAG

AND WRAP IT AROUND THEIR THIGH.

AGAIN, ON THE TOP OF THE THIGH.
AND IT HAS THESE BUTTONS.

I'VE GOT TO GET IT WHERE YOU
CAN SEE HERE.

AND YOU JUST STRETCH IT AROUND.

NOT TOO TIGHT, YOU DON'T WANT
TOURNIQUET AROUND THEIR LEG,

BUT TIGHT ENOUGH SO IT'S NOT
FLOPPING ALL OVER THE PLACE.

AND THEN PUT IT ON THE BUTTON.

OH, NOW I'VE LOST MY BUTTON.
THAT'S JUST HOW RINKY-DINKY
THEY ARE.

WELL, LET'S IT GIVE IT TWO.
THERE'S THIS ONE. STRETCH IT
AROUND HERE.

AND THEN DO THE SAME
THING ONTO THE BOTTOM.

NOW LOOK AT THE DIFFERENCE
BETWEEN THE VOLUME HERE

AND THE VOLUME HERE.
HUGE AMOUNT.

BE SURE AND REMIND THEM
WHEN THEY FIRST GET IT

THAT THEY ARE GOING TO HAVE
TO CHECK THIS FREQUENTLY

AND THEY MAY HAVE TO GO INTO
BATHROOMS, YOU KNOW, IN
THE MALL OR SOMETHING

AND EMPTY THESE OUT BECAUSE
IT WILL GET TOO FULL

AND THAT WOULD NOT BE
A GOOD SITUATION.

ALRIGHT, SO YOU CAN WEAR
THESE DURING THE DAY

WHEN THEY ARE UP AND ABOUT AND
THEN USUALLY IT'S RECOMMENDED

THAT THEY SWITCH BACK
TO THE GRAVITY BAG,

DRAINAGE BAG FOR BED TIME.

AND SO COME AND GET MY CATHETER,
CLEAN IT OFF WITH ALCOHOL.

TO MAINTAIN THESE, THEY RINSE
'EM WITH VINEGAR WATER

AND THEY CAN KEEP
THEM FOR A WEEK.

THAT'S A CLEAN SYSTEM HERE.

SWITCH IT OUT, WIPE THE ENDS
WITH ALCOHOL, RECONNECT.

THIS WILL GO GET RINSED OUT
WITH VINEGAR WATER SOLUTION

AND THEN TO TAPE WHAT
YOU WANT TO DO,

PUT YOUR TAPE RIGHT HERE
WHERE THE ARM BIFURCATES.

THIS IS THE BALLOON,
REMEMBER I TALKED TO YOU
ABOUT FILLING UP THE BALLOON.

THIS IS THE BALLOON ARM.

COME, THEN DOUBLE STICK THE TAPE
TO THE BACK THERE A LITTLE BIT.

TAPE IT ON OVER THE LEG AND
THEN TAKE ANOTHER PIECE
OF TAPE

AND GO REAL CLOSE TO THE EDGES
TO STABILIZE THAT TAPE.

OTHERWISE THAT TAPE PULLS
RIGHT OFF, IF YOU JUST PUT
ONE PIECE ON THERE.

THIS IS WHEN -- REMEMBER WHEN
I SHOWED THE BALLOON THAT
HOLDS THE CATHETER IN,

THIS IS HOW WE FILL THE BALLOON.

THAT'S THE ARM FOR
INJECTING THE WATER

AND ALL THAT IS IS THIS WOULD BE
FULL OF WATER THROUGHOUT HERE.

IF I CONNECT LIKE THIS,
I CAN TAKE THE WATER OUT
OF THE BALLOON,

THAT I DON'T WANT TO FALL OUT
ON MY CLIENT, SO I AM GOING
TO GET IT BACK IN.

AND THAT'S HOW THE BALLOON
ARM WORKS, OKAY.

ALRIGHT, SO THERE'S SOME URINE.

OKAY, WASH YOUR HANDS
AND DOCUMENT.

I'M GOING TO NEED GLOVES
FOR EVERYTHING.

ALRIGHT, ANOTHER PLACE WHERE
WE COLLECT URINE IS OFF
FROM BABIES.

BABIES NEED TO GIVE
SPECIMENS PERIODICALLY.

WHEN A BABY IS BORN,

THERE IS A COUPLE OF REASONS WHY
I'VE COLLECTED URINE FROM THEM.

ONE IS THE MOTHER MAY
HAVE AN INFECTION

AND SO THEY ARE
LOOKING FOR STREP.

MOM MAY HAVE A STREP INFECTION
OR SOME BACTERIA

AND SO THEY ARE WANTING TO
MAKE SURE THAT THE BABY
DOESN'T HAVE ANYTHING.

OR IF THE BABY HAS GOT
A FEVER, WE ARE CHECKING

TO SEE IF THE BABY'S
GOT SOMETHING GOING.

AND WE WILL NEED
A URINE SPECIMEN.

THE OTHER REASON IS
FOR DRUG SCREENING.

MOM HAS A HISTORY OF DRUG
USE OR THERE'S --

WE SUSPECT DRUG USE, THEN WE
WILL BAG THE BABY FOR 24 HOURS

AND CATCH URINE SO THAT
WE CAN TEST IT FOR DRUGS

TO SEE WHAT THE BABY'S
HAS GOT ONBOARD.

SO A COUPLE OF REASONS
WE COLLECT URINE.

THIS TIME WE ARE GOING
TO HAVE TO DO SOMETHING
A LITTLE MORE CREATIVE.

WE DON'T LIKE TO PUT CATHETERS
IN LIKE ON THE ADULTS.

YOU CAN, YOU CAN CATHETERIZE
A BABY,

BUT WE WOULD RATHER NOT.
IT'S TRAUMATIC
AND IT CAUSE INFECTION.

SO WE PUT PD BAGS ON THEM.

AND THEY ARE LITTLE BAGS LIKE
THIS THAT GO OVER GENITALIA.

THEY HAVE LITTLE ADHESIVE
STRIPS ON HERE.

THESE HAVE BEEN PEELED
SO MANY TIMES

THEY HAVE KIND OF LOST IT. BUT
THEY ARE STICKY HERE

SO THEY STICK TO BABY.

ALRIGHT, AND THEY COME
IN ALL VARIETIES.

ON THIS ONE, YOU CAN SEE I'VE
HAVE USED QUITE A FEW TIMES.

HERE IS THE STICKIES,
BUT IT GOES OVER GENITALIA.

AND THIS ONE IS SO THAT THEY
CAN -- IT HAS A BAG
ON THE END OF IT,

LIKE IF THEY ARE
IN INTENSIVE CARE OR SOMETHING

AND WE CAN KEEP
COLLECTING THE URINE

BECAUSE WE NEED TO CHECK HOW
MUCH IS COMING OUT OF THEM.

WHAT WE ARE PUTTING IN AND
IT IS COMING OUT IF
THEY'RE ON IV'S AND SO FORTH.

AND THEN THERE IS A COUPLE
OF OTHER VARIETIES.

THIS IS THE ONE I HAVE USED
THE MOST OFTEN, THE U-BAG.

THEY COME AS YOU CAN SEE IN
DIFFERENT SIZES OBVIOUSLY...

HERE AS FAR AS THE HOLE GOES
AND THEN THIS STICKY.

ALRIGHT, HERE IS THE DEAL.
I HAVE TWO BABIES,

ONE IS A BOY AND ONE IS A GIRL,
I DON'T REMEMBER WHICH IS WHICH

SO WE WILL JUST LOOK AND SEE.

ALRIGHT, IF YOU HAVE A
BABY GIRL, PARDON ME, JUNIOR.

ALRIGHT, CLEAN THE PERINEUM
AND YOU CLEAN JUST THE SAME AS

YOU WOULD ON ADULT FEMALE,
FROM FRONT TO BACK AND DROP,

FRONT TO BACK, DON'T
SCRUB AROUND.

NOW TYPICALLY, FEMALE
GENITALIA

ON NEWBORNS IS KIND OF SWOLLEN

BECAUSE THEY PICKED
UP MOTHER'S HORMONES

AND SO THE LABIA MAJORA
IS PUFFY AND RED.

SO IT MAKES IT A LITTLE
CHALLENGING TO STICK THIS
LITTLE THING ON.

WHAT YOU WANT TO KNOW AND YOU
WANT TO CLEAN ALL THE WAY BACK

THROUGH ANUS BECAUSE --
AND MAKE SURE IT'S DRY.

WHAT YOU WANT TO DO WHEN YOU
STICK IT,

LET ME JUST SET HER DOWN, IF YOU
JUST STRADDLE THAT, THERE WE GO.

DON'T DO THAT TO THE BABY, BUT.

I WANT YOU TO APPRECIATE THAT
YOU HAVE GOT THIS LITTLE
PIECE OF STICKY HERE.

IT'S VERY LITTLE.

THE LITTLE SPACE BETWEEN
THE VAGINA AND THE ANUS

IS WHAT IS REALLY PERINEUM.

IF YOU LOOKED IT UP IN THE
DICTIONARY, THAT'S PERINEUM.

WE TEND TO REFER TO THE WHOLE
GENITALIA AREA AS THE PERINEUM,

IT SEEMS FRIENDLY, BUT
IT'S JUST THAT LITTLE STRIP.

WHAT YOU WANT TO DO ON THE GIRL

IS TO PUT THE LITTLE BAG ON
AND IT'S JUST GOING TO LAY ON
TOP OF LABIA.

BUT YOU'VE GOT TO MAKE SURE THAT
THAT LITTLE STICKY PIECE
IS STUCK

ON PERINEUM, OTHERWISE WHEN
THE LITTLE GIRL PEES

SHE PEES RIGHT DOWN THE BUTT
AND IT GOES ALL OUT OF THE
BAG.

YOU'VE GOT TO HAVE STICKY ON
THERE OR YOU WILL LOSE
YOUR SPECIMEN.

ONCE YOU STICK IT ON, YOU CAN
KIND OF WAD IT UP A LITTLE BIT

AND THEN PUT A DIAPER ON 'EM.

YOU NEED TO CHECK THIS EVERY
15 MINUTES MINIMUM

TO MAKE SURE THAT YOU GOT THE
SPECIMEN BECAUSE IF YOU
WAIT AROUND

AND PIDDLE AROUND
FOR TWO HOURS,

THE BABIES THEY HAVE BURNEX AND
THEY HAVE CREAMY WHITE STUFF

THAT IS ON THEIR SKIN AND THIS
THING WILL JUST SLIP
RIGHT OFF.

IT DOESN'T STICK REAL GREAT AND
YOU LOSE THE WHOLE SPECIMEN

BECAUSE IT DUMPS BACK OUT, SO
YOU GOT TO CHECK 'EM A LOT.

WHAT YOU WANT TO DO AFTER YOU
GET THE SPECIMEN

IS EVER SO CAREFULLY TAKE IT OFF
OF THEM KEEPING THE URINE DOWN.

IT'S SUPPOSED TO HAVE
LIKE A BACK CHECK IN IT,

YOU CAN SEE THAT
LITTLE DOUBLE BAG

SO THAT URINE DOESN'T
FLOW BACK, BUT IT STILL DOES.

ALRIGHT, AS BEST YOU CAN
GET IT ALL DOWN THERE.

THEN YOU SEE THIS LITTLE
PULL TAB RIGHT HERE,

THIS LITTLE BLUE, THERE
IS A HOLE RIGHT THERE.

YOU ARE GOING TO GET YOUR
URINE SPECIMEN CUP,

WHEREVER I PUT MY LITTLE CUP
AND THEN YOU ARE GOING
TO PULL THE TAB

AND LET THE URINE
GO INTO THE CUP.

YOU DON'T WAD THIS UP
AND SEND THIS TO LAB.

OH, HOW MANY OF THESE HAVE
I SEEN SENT TO LAB.

WHAT A JOKE.
THAT'S A MESS FOR THEM
AND IT GETS IT ALL CONTAMINATED.

SO YOU GOT TO DUMP THE
URINE INTO THE CUP

AND THEN LABEL IT JUST
THE SAME.

LITTLE BOYS, PUT A DIAPER
ON 'EM AND WRAP 'EM UP
AND MAKE 'EM COMFORTABLE.

LITTLE BOYS ARE MUCH EASIER.

IF AND WHEN YOU CAN, YOU WANT
TO PUT THE WHOLE SCROTUM

AND PENIS INTO THE BAG WHICH
MAKES IT SO MUCH EASIER

BECAUSE THEN YOU KEEP --
CLEAN 'EM OFF,

BUT THEN IF THE WHOLE THING
FITS IN THERE, TA-DA, IT'S
JUST BEAUTIFUL

AND YOU DON'T TEND TO LOSE AS
MUCH OF THE URINE SPECIMEN.

IF IT DOESN'T, SOMETIMES
THEIR LITTLE SCROTUMS
MAYBE SWOLLEN TOO

FOR VARIOUS REASONS. THEN AGAIN
YOU WILL JUST TAPE IT RIGHT UP

TO THE SCROTUM, BUT GET THEIR
LITTLE PENIS SHAFT
INTO THE BAG

AND YOU WILL CATCH, MUCH OF
IT, MOST OF THE SPECIMEN.

ALRIGHT, CLEAN 'EM UP,
PUT A NEW DIAPER ON 'EM

AND AGAIN SEND IT TO
THE LAB WITHIN 15 MINUTES.

OKAY, 24 HOUR SPECIMEN.

SOMETIMES WE GET OUR
ONE LITTLE SPECIMEN,

BUT SOMETIMES YOU ARE GOING TO
YOU NEED TO COLLECT A SPECIMEN
FOR 24 HOURS

TO CHECK FOR A LOT OF THINGS,
TYPICALLY CATECHOLAMINES, ACIDS,

DIFFERENT THINGS THAT
ARE IN THE SYSTEM.

WHEN YOU HAVE A 24 HOUR
SPECIMEN THAT'S BEEN ORDERED,

YOU HAVE TO CALL LAB AND
GET A 24 HOUR CONTAINER.

THEY MAYBE ON YOUR
CENTRAL SUPPLY CART,

BUT YOU ARE LOOKING
FOR SOMETHING LIKE THIS,
MOST OF THE TIME IT'S IN LAB.

YOU TELL 'EM WHAT THAT YOU NEED
AND THEN THEY WILL PUT STICKERS

ON THE LITTLE BOTTLE SO THAT
YOU WILL DO THE RIGHT THING.

FOR EXAMPLE, THIS ONE NEEDS
TO BE REFRIGERATED

AND WE ARE LOOKING FOR --
OUR CAUTION IS ALKALINE.

CREATININE CLEARANCE WILL
DO SOMETIMES FOR 24 HOURS
OR WHATEVER.

ALRIGHT, SO THIS IS WHAT YOU DO.

GOT TO WILL MAKE SURE
YOU GOT HATS

AND THIS IS ONE THING
THAT HAS HAPPENED TO ME
BEFORE AND THAT IS

SOMETIMES PEOPLE DON'T
HIT THE POTTY HAT.

THEY JUST SIT DIFFERENT ON IT
OR SOMETHING, I DON'T KNOW.

SO WHAT YOU MAY NEED TO
DO IS GET TWO HATS.

ONE FACING THIS WAY AND
ONE FACING THIS WAY.

SO YOU GET THE SPECIMEN COMING
OR GOING, THAT'S IMPORTANT.

WHAT YOU DON'T WANT WHEN YOU
ARE COLLECTING URINE IS

TO COLLECT STOOL WITH THE URINE.

SO SOMETIMES THAT'S A
LITTLE CHALLENGING TO KEEP
THE TWO SEPARATED.

BUT THAT'S THE GOAL.

SO GET YOUR HATS,
GET YOUR CONTAINERS.

AND ALSO YOU NEED TO DECIDE
HOW YOU ARE GOING TO KEEP IT
REFRIGERATED.

DONE VARIOUS THINGS OVER
THE YEARS,

MOST OF THE TIME NOW WHAT
THEY DO IS GET AN ICE CHEST

AND YOU JUST GET ICE
FROM ON THE FLOOR.
PUT IT IN THE ICE CHEST

AND THEN YOUR CONTAINER WILL
GO IN THE ICE CHEST. ALRIGHT.

LET'S SAY YOU WANTED
TO COLLECT A URINE SPECIMEN
FOR ME RIGHT NOW.

SO YOU WOULD SAY, "DIANE,

WE NEED TO GET 24 HOUR URINE. I
WANT YOU TO GO INTO THE BATHROOM

AND GO TO THE BATHROOM." SO I
WOULD GO IN AND GO TO THE
BATHROOM RIGHT NOW.

YOU THROW THAT SPECIMEN AWAY.

ALRIGHT, SO THAT'S OUT
AND WE START AT 10:30.

AT 10:30, YOU HAVE SIGNS
UP ON THE BATHROOM DOORS,

ON THE DOOR -- EVERY
PLACE IN THAT ROOM.

SO THAT PEOPLE DON'T
INADVERTENTLY DUMP THE URINE.

OKAY, AND YOU TELL YOUR CLIENT,

PLEASE REMIND PEOPLE THAT
WE ARE COLLECTING THIS

SO THAT IT DOESN'T GET
DUMPED INADVERTENTLY.

"AND TRY NOT TO PUT TOILET
PAPER IN THE SPECIMEN."

ALRIGHT, THEN EVERY TIME THE
CLIENT GOES AFTER THAT,

YOU TAKE IT AND THEN
YOU POUR IT IN HERE

AND YOU WOULD TELL ME
AT 10:30 TOMORROW,

"DIANE, CAN YOU GO
TO THE BATHROOM?"

IF I CAN, I GO. YOU TAKE
THAT SPECIMEN AND PUT IT IN.

BUT IF I CAN'T GO, I CAN'T GO.

THAT'S ALL THERE IS TO IT,
AND YOU ARE DONE AT 10:30,

BUT YOU TRY TO GET EVERY
LAST DROP AT 10:30.

SO YOU GOT YOUR FULL 24
HOURS OF URINE CLEARANCE.

ALRIGHT, WHAT HAPPENS IF --
WHEN THEY SEND IT TO THE LAB?

MAKE SURE THAT IF IT TAKES --
IF SOMEBODY TAKES MORE
THAN ONE CONTAINER,

LIKE, IF THEY'RE A TWO OR
THREE CONTAINER PERSON,

ALL THE CONTAINERS STAY
TOGETHER IN THAT ICE CHEST

AND THEY ALL GO TO
THE LAB TOGETHER.

YOU DON'T WANT THEM TO GET
SEPARATED IN THE LAB AND GET
MIXED UP.

ALRIGHT. WHAT HAPPENS IF
AT NOON YOU GO TO LUNCH

AND HAVE A VOID AND I LEAVE IT
THERE FOR YOU TO PUT
IN THE THING.

BUT SOMEONE ELSE DECIDES TO HELP
YOU OR MY ROOMMATE IN THE ROOM,

DOESN'T KNOW THAT STORY AND
DUMPS THE URINE, THEN WHAT DO
YOU DO?

- START OVER.
- START OVER AT THE TIME OF
THAT URINE, IF YOU KNOW IT.

BOY, SOMETIMES WE ARE STARTING
OVER MORE THAN WE ARE GOING.

YOU KNOW, KEEP STARTING
OVER, STARTING OVER,

BUT YOU'VE GOT TO GET
AN ACCURATE SPECIMEN, SO.

SAME THING IF THEY GET
STOOL IN IT.

SOMETIMES IF WOMEN ARE ON THEIR
PERIOD AND THERE IS MENSES

AND SOMETIMES THAT WILL
FOUL UP THE SPECIMEN,
IT JUST DEPENDS.

ALWAYS CALL THE LAB AND DOUBLE
CHECK BEFORE YOU JUST DUMP AND
RESTART.

"CAN THERE WILL BE A LITTLE
STOOL IN THERE?

IS IT OKAY IF THEY ARE ON
THEIR PERIOD FOR THIS TEST?"

AS FAR AS CONTAMINANTS GO,
WHEN YOU ARE COLLECTING.

ALRIGHT. LAST BUT NOT LEAST,

A CONDOM CATHETER.

CONDOM CATHETER. ALRIGHT.

RUNNING OUT OF SPACE THERE.

CONDOM CATHETERS. WE HAVE
TO TALK THROUGH THIS ONE.

SO I THINK YOU HAVE TALK
THROUGH THE MIDSTREAM,
A REGULAR --

THE MIDSTREAM
AND A CONDOM CATHETER,
IS THERE ANYTHING ELSE?

I SAID PD BAGS IN YOUR CHECK --
OR IN THE SYLLABUS,

BUT I PROBABLY WON'T HAVE
YOU DO IT COS I DIDN'T MAKE
A CHECKLIST FOR IT.

ALRIGHT, CONDOM CATHETER.

HIGH FIVE.

THIS IS ALWAYS A FUN THING TO DO

AND JUST GET OVER IT. IT'S
GOT TO BE DONE. ALRIGHT.

CONDOM CATHETERS,
TYPICALLY ON MALES.

THEY HAVE SUGGESTED SOME
FOR FEMALES. WHAT A JOKE.

OKAY. BUT I WILL TALK ABOUT IT.
EQUAL TIME FOR THE SEXES.

AND MY APOLOGIES, I DIDN'T
TALK ABOUT WOMEN

AND WHERE TO PUT YOUR
STETHOSCOPE ON BREAST TISSUES
FOR THE WEDNESDAY GROUP.

FORGOT. SORRY I GOT
JUST SO INVOLVED.
WHO WAS WITH MY PERSON?

ADAM. I HAD A GUY AND I WAS
JUST INTO GUY THINGS, I GUESS.

SO TOTALLY FORGOT.

WE CAN CUT THIS OUT OF HERE
AND CLIP IT IN SOMETHING ELSE,

BUT FOR WOMEN AND WE ALL
FIGURED IT OUT LATER.

BUT IF YOU JUST GO TO THE UPPER
PART OF BREAST TISSUE,

MID-LINE,
FIFTH INTERCOSTAL SPACE,

YOU USUALLY WILL HEAR IT JUST
FINE. IT WILL CONDUCT THE SOUND.

IF NOT, YOU CAN GO
UP UNDER THE SHIRT

AND GO BELOW BREASTS AND SEE
IF YOU CAN PICK IT UP BETTER.

BUT MOST OF THE TIME IF YOU
JUST GO ON TOP, YOU WILL HAVE
NO TROUBLE AT ALL.

JUST SLIDE THE STETHOSCOPE
IN, WORK IT FROM THE TOP

AND THERE IS USUALLY NOT
MUCH OF A PROBLEM, SO.

ALRIGHT. MALE, CONDOM CATHETER.

YOU NEED TO UN-ROBE YOUR CLIENT

AND CLEAN YOUR CLIENT
SO YOU GET A GOOD ADHESION.

AND THAT'S THE WHOLE GOAL
WHEN WE HAVE A CONDOM CATHETER.

SO MAKE SURE THE CLIENT HAS
BEEN CLEANED, YOU WANT TO GIVE
GOOD PERI CARE.

WE ARE GOING TO CLEAN FROM
MEATUS DOWN THE PERINEAL SHAFT.

NOW THE GOAL ON A CONDOM
CATHETER IS THAT WHEN WE ROLL
THE CONDOM CATHETER,

THE CATHETER HAS STICKY
STUFF ON IT.

AND IT'S SUPPOSED TO ADHERE
TO THE SHAFT OF THE PENIS.

IF THERE IS A LOT OF PUBIC
HAIR THAT'S COMING UP,

YOU MAY WANT TO CLIP
THAT, SO THAT IT'S NOT

GETTING ALL STUCK IN THERE
BECAUSE THAT CAN BE
A LITTLE UNCOMFORTABLE.

DON'T SHAVE, WE DON'T SHAVE.
YOU CAN GET MICRO ABRASIONS

AND THAT CAN CAUSE INFECTION
SO IT'S JUST THE CLIPPING
TO KEEP IT

FROM IT ALL GETTING
STUCK. ALRIGHT.

ONCE THE CLIENT IS CLEAN,
YOU HAVE TO MEASURE.

AND I KNOW, BUT YOU GOT TO
BECAUSE YOU GOT TO GET THE
RIGHT SIZE.

THESE ARE ALL SIZED.

SO WHAT YOU WANT TO DO IS
PULL UP THE PENAL SHAFT

AND YOU ARE GOING MEASURE
TOWARDS THE MIDDLE BASE
OF SHAFT.

AND THEY HAVE THESE
FUN LITTLE THINGS.

AND THIS ONE MEASURES
AT A FOUR, WHICH IS 28 CM.

AND ACTUALLY IF I GO ALL THE
WAY TO BASE IT'S 30.

I KNOW FROM LOOKING, DOING THIS.

ALRIGHT, THAT'S ONE LITTLE
MEASUREMENT GAUGE. THERE
IS THIS OTHER ONE

AND ALL YOU HAVE TO DO IS JUST
KIND OF LINE IT UP TO THE SIDE

AND THIS ONE ACTUALLY SAYS 35

AND THAT'S 30 UP TO THE TOP.
DID THAT SAY 28?
MAYBE IT'S MY GLASSES.

YEAH, THAT WAS 35. I AM
LOOKING BACKWARDS, 35.

ALRIGHT, SO ONCE YOU KNOW
THE SIZE OF THE SHAFT,

YOU WANT TO GO TO YOUR CONDOM
CATHETERS AND I HAVE
TWO DIFFERENT BRANDS.

AND THEY WILL SAY ON HERE
THE SIZE.

THIS ONE SAYS MEDIUM.

WELL, HOW DO YOU KNOW WHAT
MEDIUM IS UNTIL YOU
GO TO THE BACK

AND THEN IT TELLS YOU, MEDIUM --

WELL, THIS DOESN'T EVEN
GIVE YOU THE MILLIMETERS.

THIS SAYS, FITS MEDIUM
TO SMALL IS MEDIUM.

GERIATRIC IS JUNIOR OR SMALL
AND LARGER FITS LARGE TO MEDIUM.

THIS ONE GIVES YOU
A BETTER INDICATOR

BECAUSE IT TELLS YOU
THAT LARGE IS 35MM.

MEDIUM IS USUALLY 25 TO
30 AND SMALL IS BELOW 25.

AND IT WILL USUALLY TELL
YOU ON THE WHOLE BIG BOX,

WHERE YOU GET THEM ALL OUT. AND
THEY COME IN BOXES OF, LIKE, 100

OF THESE AND THEY WILL
BE ON THE CENTRAL SUPPLY CART.

ALRIGHT, THIS IS
MY FAVORITE ONE.

THIS IS ONLY AT THE VA RIGHT
NOW. AND WHY EVERYONE DOESN'T
CARRY THIS ONE IS BEYOND ME,

BUT IT'S JUST
THE COOLEST THING EVER.

ALRIGHT, YOU GET YOUR
CONDOM CATHETER -- OH!

ONE OTHER THING YOU
GOT TO DO. ALRIGHT.

PULL THE PENIS UP,

AND THEN WHAT YOU WANT TO DO IS
PUT SOME BARRIER FILM ON HERE.

AND BARRIER FILM --

DON'T REALLY PUT THIS
ON MY MANNEQUINS.
BUT BARRIER FILM IS LIKE --

HAVE YOU HEARD OF
LIQUID BANDAGE?

LIKE, I THINK IT'S
JOHNSON & JOHNSON MAKES AN
OVER-THE-COUNTER BANDAGE.

IT'S THIS IS CLEAR STUFF LIKE
THIS THAT GOES ON THE SKIN

AND THEN IT JUST DRIES
LIKE A PLASTICOAT.

AND WHAT THAT DOES IS
IT KEEPS THE OIL,

BODY OILS FROM GETTING TO THE
ADHESIVE AND SO YOU GET
GOOD STICK.

AND THAT'S WHAT WE WANT.
WE WANT THIS TO STICK.

WE DON'T WANT IT TO SLIDE
OFF OR IT DEFEATS

THE WHOLE POINT OF THIS
LITTLE ACTIVITY.

I DO WANT TO POINT OUT, THIS
IS MY FAVORITE PRODUCT.

WHEN I AM NOT A NURSE, I
AM GOING TO BE A 3M REP.

3M MAKES JUST SOME OF
THE FINEST PRODUCTS

AND 3M MAKES WHAT THIS IS
CALLED IS A NO STING BARRIER.

THERE IS NO ALCOHOL
IN THIS PRODUCT.

I DON'T KNOW OF ANOTHER PRODUCT
RIGHT NOW THAT DOESN'T.

THERE IS A LOT OF OTHER SKIN
PREPS OR BARRIER PREPS

AND THEY LOOK LIKE THIS.

THEY ALL HAVE ALCOHOL IN THEM.

NOW THAT'S USUALLY NOT A BIG
DEAL IF THE SKIN IS INTACT

BUT IF THERE ARE ANY ABRASIONS
OR ANY LITTLE NICKS,

OH, BABY! THAT'S GOING TO HURT.

BE KIND TO YOUR CLIENTS, OKAY?
SO CONSIDER THE NO STING
ELEMENT RELATED TO THESE.

WHAT DO THESE REMIND YOU OF?

- ALCOHOL WIPES.
- ALCOHOL WIPES.

YOU MIGHT WANT TO
KEEP THEM STRAIGHT

WHEN YOU ARE ALL PULLING
OUT, RIGHT?

BECAUSE THEY LOOK SIMILAR
SO THERE YOU ARE
CLEANING SOMETHING

AND IT'S REALLY ADHESIVE.
OH, NO. NOT GOOD.

OR YOU ARE NEEDING TO, YOU KNOW,

PUT SOME NO STING ON SOMEONE AND
YOU ARE SCRUBBING 'EM WITH
AN ALCOHOL PREP.

NOT GOOD EITHER. ALRIGHT.

SO YOU WANT TO PUT THAT
PLASTICOAT

JUST ON THE SHAFT
NOT ON THE GLANDS.

IN FACT WE ARE NOT EVEN AIMING
TO GET ANY OF THE
CONDOM CATHETER.

AM I DRY? YOU GUYS WANT TO
FEEL IT...

PLASTICOAT, RAISE YOUR
HAND IF YOU JUST...

I'M PLASTICOAT. ANYONE ELSE?

I CAN PASS IT AROUND IF
YOU WANT TO TRY IT.
- YEAH.

OKAY. I WILL PASS IT AROUND.

ONE LITTLE THING ABOUT THESE.

I HAVE TONS AND TWO OR THREE
PEOPLE CAN USE -- USE THESE,

ANYONE ELSE WANT TO
CHECK OUT MY SKIN?

KIND OF COOL.

NOW IF I DON'T GET THIS OFF, IT
WILL PROBABLY TURN
KIND OF BLACKISH.

OH, I DIDN'T TELL YOU THAT.
YEAH IT CAN ALSO...

- I DID GET IT OFF.
- YEAH.

IT'S A REAL EASY TO
GET IT OFF.

ALCOHOL TAKES IT OFF FAIRLY
WELL. I HAVE ADHESIVE REMOVER.

AND ACETONE FINGERNAIL POLISH
REMOVER WILL TAKE IT OFF.

SO YOU WANT TO CONSIDER THAT

WHEN YOU ARE PUTTING
IT ALL PLACES.

WHEN I USE A PREP LIKE THIS,

I AM USING IT PURPOSEFULLY, AND
I WANT IT TO STAY ON.

AND I KEEP APPLYING IT EVERYDAY
TO MAINTAIN THE PLASTICOAT.

ALRIGHT SO GIVE IT A WHIRL.

ALRIGHT, SO I PLASTICOATED
THE PENAL SHAFT.

NOW YOU GET YOUR CONDOM
CATHETER.

THE CONDOM CATHETER HAS AN
OPENING. THAT'S WHAT WE ARE
GOING TO STICK

OUR DRAINAGE BAG ONTO.

THIS ONE RIGHT HERE IN THE
FUNNEL IS NO ADHESION
WHATSOEVER.

SO WHEN WE PUT THAT ON TO THE
GLANDS,

IT'S NOT STICKING TO GLANDS,
THAT'S THE WHOLE POINT.

AND THEN EVERY -- THIS HAS
AN APPLICATOR HOLDER

SO THAT YOU CAN PUT IT ON
LIKE THIS AND THEN GRAB THE
SHAFT WITH THE LITTLE GRIPPER

AND PULL UP. YOU PINCH AND
PULL UP AND THEN --

OH, I GOT TO GET THIS WHERE
YOU CAN SEE IT. IT'S GOT THIS
RIP CORD.

WE CALL IT THE RIP CORD.

UNDER HERE, IT'S ALL STICKY
WHEN I START ROLLING IT.

SO IF I START ROLLING
IT WITH MY FINGERS,

IT STARTS STICKING TO ME. BUT
IF YOU PULL THE LITTLE CORD...

IT DOES IT FOR YOU
AND YOU DON'T HAVE TO GET
SO STICKY SO FAR DOWN.

OKAY? AND THEN YOU ROLL IT DOWN.

THEN THE LITTLE HOLDER COMES OFF

AND THEN -- I AM SURE THIS
WILL BE YOUR FAVORITE PART.

YOU GOT TO GO AROUND AND SQUEEZE

BECAUSE YOU GOT TO GET IT TO
HERE AND THEN RELEASE. ALRIGHT.

I KNOW. I KNEW I WOULD MAKE
YOUR DAY TODAY.

NOW.

THEN YOU WOULDN'T PUT HERS
ON HIM, BUT YOU WOULD --

OH, I FORGOT TO GET ANOTHER BAG.
YOU'LL GET A CLEAN ONE,

PUT IT ON HERE AND THEN
IT CATCHES THE URINE.

TA-DA, TA-DA. ALRIGHT, NOW THIS
THING IS HEAVY, THIS BAG.

SO YOU CAN SEE IT'S GOING
TO BE PULLING.

THERE IS A COUPLE OF THINGS I
WANT TO MAKE SURE BEFORE I GO.

I WANT TO MAKE SURE THAT
THIS IS STUCK ON.

I WANT TO MAKE SURE THERE IS
WRINKLES BECAUSE IF THERE
IS WRINKLES

AND URINE COMES OUT -- OKAY.

HE VOIDS. URINE IS GOING
TO PUDDLE A LITTLE BIT

IN THIS PART THAT DOESN'T
HAVE ADHESION

AND IT WILL RUN DOWN THE
WRINKLES AND RUN OUT

AND THEN THE WHOLE THING WILL
FALL OFF IN LIKE NO TIME AT ALL.

THE OTHER THING THAT HAPPENS IS
THERE IS USUALLY SOME SWEATING,

DIAPHARESIS, BODY OILS, WHATEVER

AND THEN THIS THING JUST
SLIDES OFF ANYWAYS.

SO YOU'VE GOT TO CHECK THIS
FREQUENTLY, JUST TO MAKE SURE
IT'S ON THAT.

YOU WANT TO COME BACK
IN 15-30 MINUTES OR SO,

I WOULDN'T GO FURTHER THAN
THAT. AND MAKE SURE THAT THERE
IS NO SWELLING,

THAT URINE'S COMING OUT, THAT
YOU HAVEN'T CONSTRICTED THIS
THING ON,

YOU HAVEN'T GOT A TOO SMALLER
ONE ON THERE OR WHAT NOT,

THAT EVERYTHING'S WORKING
CORRECTLY HERE AS FAR AS
URINE FLOW.

ALRIGHT, AND THEN CHECK
'EM FREQUENTLY.

THESE CAN STAY ON FOR
TWO OR THREE DAYS,

IF THEY STAY ON TWO
OR THREE DAYS.

I JUST HAVE ALWAYS BEEN
EXCITED IF THEY STAYED
ON MY WHOLE SHIFT.

IN 24 HOURS, IT'S LIKE,
WHOA! THIS IS BIG.

BECAUSE THEY JUST DON'T STAY ON
THAT GOOD BECAUSE OF THE
WEIGHT, THE URINE,

THE CRINKLING, THE SWEATING,
THE WHOLE OF IT,
THEY JUST COME OFF.

I WALK IN THE ROOM AND THERE
LAYS THE CONDOM CATH ON
THE FLOOR.

WHAT A SIGHT? LITTLE PUBIC
HAIRS ALL STUCK TO IT.

ALRIGHT. I KNOW, YOU
DON'T WANT TO ASK.

BUT EVERYONE'S SITTING
THERE GOING, "OH, MY GOSH!

WHAT IF HE HAS AN ERECTION?"

THANK GOD BECAUSE THEY ARE
HARDER THAN A BEAR TO GET ON.

WHO IS GOING TO WEARING THESE?
SOMEONE THAT'S CONTINENT?

NO. A GERIATRIC CLIENT, SOMEONE
THAT'S HAD A STROKE,

A QUADRIPLEGIC OR PARAPLEGIC.
AND A NURSE -- TO TELL YOU.

I DIDN'T COME UP WITH
THIS BY MYSELF.

SHE SAID TO TELL YOU,
IT'S LIKE PUTTING THEM
ON A MARSHMALLOW.

IT'S NOT EASY.

SO HERE I DID IT SO NICELY
ON THIS MANNEQUIN.

IT'S JUST SITTING THERE
SO EVER PRETTY FOR US,

BUT THAT'S NOT THE REAL WORLD.

YOU ARE PULLING UP A LIMP SHAFT

AND TRYING TO GET THIS
STICKY THING ON

AND SQUEEZE AND URGH,
AND IT'S NOT THAT EASY.

ALRIGHT. THAT'S WHY THE GRIPPER
THING IS REALLY NICE. RIGHT.

THIS IS WHAT MOST OF THE OTHER
HOSPITALS ARE CARRYING
FREEDOM CATH.

FREEDOM CATH IS THE SAME THING,

IT'S GOT ALL THE SAME PARTS,
BUT NO GRIPPER AND NO RIP CORDS.

SO YOU ARE JUST GOING TO PUT
THIS AGAIN ON ADHESIVE.

AND THEN YOU ARE GOING TO ROLL
IT DOWN, ROLL IT DOWN,
ROLL IT DOWN.

MY FUNNY STORY. THERE IS MANY.

AND I HAVE -- I HAVE TO
HOLD BACK STORIES.

BUT TWO STUDENTS WENT
TO PUT ON THE CATHETER

A COUPLE OF YEARS AGO AND THEY
CAME BACK TO TELL ME THEIR STORY

AND THEY SAID, "OH DIANE,
THIS IS SO EMBARRASSING.

I WAS ALL PSYCHED UP AND
I DID EVERYTHING.

MY INSTRUCTOR WAS WITH ME,
I WENT IN TO DO THE CATHETER.

AND I HAD THE RIGHT SIZE
I HAD MY CATHETER,
I HAD THE WHOLE THING.

SO WE WENT TO PUT IT ON AND
I STARTED PUTTING IT ON

AND MY GLOVES GOT STUCK IN THERE
AND I COULDN'T GET 'EM OUT.

I WAS SO EMBARRASSED.
AND MY INSTRUCTOR,

SHE PUT ON HER GLOVES TO HELP
ME AND SHE GOT STUCK TOO.

AND THERE WE ALL WERE,
WE WERE ALL STUCK IN THERE."

HE WAS MORTIFIED AND
I AM DYING LAUGHING.

WHAT DO YOU KNOW? YOU KNOW
FOUR HANDS SO ANYWAYS, IT CAN
JUST BE...

ALRIGHT, SO NEVER DULL,
NURSING IS NEVER DULL.

IF A CLIENT COULD DO IT
THEMSELVES, LET THEM.

IF A FAMILY MEMBER
WILL DO IT, LET THEM.

I MEAN, THIS IS -- YOU KNOW,
THIS IS SOMETHING YOU CAN TEACH
SOMEONE TO DO.

IT'S PROBABLY GOING TO
BE A LONG TERM THING

IF THEY ARE NEEDING THIS
KIND OF A CATHETER.

WHAT HAPPENS IS WE TRY NOT
TO PUT THE IN-DWELLING
CATHETERS IN

BECAUSE IT CAUSES INFECTION.

SO WE WILL PUT THESE ON
FOR A WHILE FOR SOMEONE
THAT'S INCONTINENT

BECAUSE IF YOU KEEP GETTING
URINE ON TO YOUR SKIN

THEN IT CAN CAUSE SKIN BREAKDOWN
AND THEN YOU'VE GOT
PRESSURE SORES.

OKAY, SO WHEN THE PRESSURE SORES
GET TOO BAD

OR WHAT HAPPENED -- I WAS
I CARING FOR A CLIENT

AND I WOULD GO IN AND DO
HIS CATHETER SOMETIMES,

HIS WIFE DID IT MOST
OF THE TIME.

HE WOULD GET SORES ON HIS
PENIS FROM THE CATHETER.

IT WOULD CAUSE IRRITATION SO
HE WOULD GET SORES ON THE
SHAFT OF HIS PENIS.

SO WE WOULD PUT
THE INDWELLING CATHETER IN

SO THAT WE COULD HEAL
UP THE PENAL SORES.

ONCE THOSE GOT HEALED UP, BY
THEN HE USUALLY HAD A URINARY
TRACT INFECTION.

AND SO WE WOULD SWITCH AND
WERE JUST IN A CONTINUAL MODE
OF SWITCH, SWITCH, SWITCH

FROM ONE TO THE OTHER.

SO NEITHER COMES WITHOUT
SIDE-EFFECTS OR POTENTIAL HARM.

SO YOU ARE LOOKING FOR
SORES AND SO FORTH.

AND THAT'S WHY ADHESION IS SO
VERY IMPORTANT THAT YOU GET
A GOOD STICK.

SO AS MUCH AS YOU'RE GOING,
"OH. MY GOSH. URGH!"

YOU'VE GOT TO. YOU'VE GOT TO
GET THAT THING ON THERE.

SO WHAT'S THE POINT OF DOING IT
IF YOU DON'T GET GOOD STICK?

ONE OF THE OTHER THINGS THAT'S
HAPPENED WHEN THE STUDENTS
GO OUT IS

WE ARE TEACHING YOU
BEST TECHNIQUE

AND YOU ARE NOT ALWAYS GOING
TO SEE BEST TECHNIQUE OUT IN
THE COMMUNITY,

WELL, WHAT A SHAME. BECAUSE
BEST TECHNIQUE SHOULD HAPPEN
WHENEVER POSSIBLE.

AND THEY WEREN'T BUYING INTO
THE SKIN PREP ON THE SHAFT OF
THE PENIS.

WHY NOT? WHAT'S IT COSTING
THEM? WHAT'S THE BIG DEAL?

IF YOU ARE GOING TO GET GOOD
STICK AND NOT HAVE TO DO THIS,
BUT ONCE A DAY.

SO WHATEVER YOU CAN DO TO GET
YOUR PRODUCT TO WORK BEST

AND WORK BEST FOR THE CLIENT,
DO IT.

JUST -- IF SOMEONE GIVES
YOU GRIEF ABOUT
THAT KIND OF STUFF,

SAY, "LET'S TRY IT. MY
INSTRUCTOR SAID IT WORKS.

WHY DON'T WE JUST TRY IT?"

DON'T SAY, "DIANE SAID."
I HATE THAT.

BECAUSE THEY DON'T KNOW WHO
THE HECK I AM AND THEY DON'T
CARE.

YOU CAN SAY, IN THE BOOK.

ACCORDING TO HARRY M. POTTER,

ACCORDING TO ALKEM AND IT IS
IN YOUR BOOK TO USE IN FROM.

ALRIGHT, I THINK THAT'S ENOUGH
OF SHOW AND TELL. OH!

THIS IS ANOTHER ONE,
A PENAL POUCH.

I WAS GOING TO GIVE EQUAL TIME
FOR THE LADIES. WELL, WE DON'T
DO MUCH.

SO ANYWAY, THIS IS THE SAME
THING. IF YOU CAN --

IT'S JUST GOT A LITTLE
DIFFERENT ADHESIVE POUCH.

YOU TAKE THIS OFF AND IT'S
LIKE A HYDROCOLLOID.

WE WILL LEARN MORE ABOUT
THOSE, BUT IT IS A DIFFERENT
ADHESIVE TO GO ON.

YOU HAVE TO CUT IT TO THE SIZE
OF THE PENIS.

SOMETIMES IT'S MORE FOR THE
PENIS THAT DOESN'T COME OUT,

IT'S JUST FOR -- IF GLANDS
WILL COME OUT.

SOMETIMES THE PENIS
RETRACTS INTO THE SCROTUM,
YOU CAN'T HARDLY FIND IT.

SO THIS IS TO STICK
ONTO SCROTUM

AND THEN IT CATCHES
URINE OUT OF THE BAG

AND YOU CAN EITHER CATCH IT IN
THE BAG OR CONNECT A TUBING TO
IT, OKAY.

FEMALES, WHAT DO WE HAVE?

WE HAVE SIMILAR PRODUCT
LIKE THE PD BAGS.

DO THEY WORK VERY GOOD?
NO, I DON'T THINK SO.

- SO THE TOP OF THAT -- THE
BOTTOM OF THE SKIN STICKS TO THE
SCROTUM. THE TOP OF THE SKIN...?

- ON SKIN, YEAH. JUST UPPER
PUBIC SKIN. UH-HUH. YEAH.

IT'S NOT THE GREATEST
AND IT DOESN'T HAVE
GOOD ADHESION EITHER.

DOESN'T HAVE --
- DOES IT HURT LIKE HECK WHEN
YOU TAKE IT OFF?

NO. BECAUSE IT DOESN'T STICK.

IT DOESN'T STICK THAT GOOD.

IF YOU FELT IT, IT JUST DOESN'T
HAVE AS GOOD AN ADHESION

AS THESE OTHER STICKY PRODUCTS.

SO ON THAT ONE, I WOULD PROBABLY
DO A LITTLE MORE TRIMMING

AS WELL IF YOU ARE GOING
ON THE SCROTUM, SO.

YOU COULD, YEAH. NOW
THAT COULD STICK.

YEAH, BUT GET SKIN PREP ON AND
YOU COULD TAPE THE EDGES.
THAT'S WHAT SHE ASKED,

"COULD YOU TAPE THE EDGES?" I
DON'T KNOW. I HAVE NEVER USED
THAT ONE.

IT'S A NEW PRODUCT AND I JUST
WENT, "DOESN'T HAVE
A VERY GOOD STICK."

- IF YOU'RE GETTING GOOD SKIN
ADHESION AND YOU NEED
TO TAKE OFF, THEN WHAT?

- I WOULD GET AN ADHESIVE
REMOVER. AND IT ALSO COMES IN
A LITTLE PLEDGETS PACKET,

JUST LIKE AN ALCOHOL SWAB.

AND IT'S KIND OF OILY BASE AND
I WOULD TAKE IT AT THE BASE,

AND I WOULD JUST WIPE IT.
ALCOHOL WILL ALSO TAKE THE
ADHESION OFF.

SO I WOULD TAKE AN ALCOHOL
SWAB, IF THERE'S NO SORES

AND I WOULD WORK IT OFF.

BUT I AM TELLING YOU
GETTING THEM OFF HAS JUST
NOT BEEN THE PROBLEM,

IT'S KEEPING THEM ON.

SERIOUSLY, THEY JUST DON'T
STAY ON AS WELL.

SO. BUT YEAH, I WOULD USE AN
ADHESIVE REMOVER OR ALCOHOL,

WIPE, KIND OF, EASE IT OFF.
ALRIGHT.

ENOUGH SHOW AND TELL.

WE ARE GOING TO GET DOWN TO
BUSINESS. ALRIGHT, YOUR
ASSIGNMENT.

OH, I AM DOING FAIRLY GOOD.
THIS IS IT.

WE HAVE TIMED ACTIVITIES
ON THIS PARTICULAR DRILL

BECAUSE WE DON'T WANT
THE FOREVER BED.

I HAPPEN TO SAY THAT BEDMAKING
IS ONE OF THE MOST BORING THINGS

THAT I WATCH BECAUSE THEY DON'T
REALLY NEED TO WATCH IT,

I JUST NEED TO SEE
THE END PRODUCT.

ARE YOU WITH ME ON
THAT? I MEAN, SO,

JUST TO SEE SOMEONE WALKING
AROUND THEIR BED FOR 30
MINUTES IS, LIKE,

"OH, COME ON. GET
ON WITH IT." OKAY?

SO WE HAVE TIMED THESE BEDS TO
REASONABLE STUDENT BEDMAKING
TIMES.

ALRIGHT, SO I THINK I SAID,
WHAT? 11 MINUTES OR SOMETHING?

YOU GUYS CAN LOOK ON THE BACK.
WHAT DOES IT SAY?
- 11 MINUTES.

- 11 MINUTES. MOST OF THE TIME
-- OUR FASTEST EVER WAS SEVEN.

I THINK IT WAS SEVEN
AND THEN 11,

IS VERY REASONABLE TIME
AND VERY FEW 12S EVER.

AND EVERY NOW AND THEN
A 13 OR 15 OR SO.

SO HERE'S WHAT IS
GOING TO HAPPEN.

YOUR ASSIGNMENT IS THE CLIENT
HAS PUT ON THE CALL LIGHT

AND THEY NEED
TO USE THE BEDPAN.

THEY ARE A BEDRIDDEN CLIENT.

ANYBODY CAN MAKE A BED
WITHOUT SOMEONE IN IT,

BUT YOU ARE GOING TO BE MAKING
A BED WITH SOMEONE IN BED.

BUT YOUR CLIENT NEEDS A BEDPAN.

THEY CAN'T GET OUT OF BED, SO
YOU ARE GOING TO PUT YOUR
CLIENT ON A BEDPAN

AND THEN YOU ARE GOING
TO CHANGE THE BED.

THE BEDPAN ISN'T TIMED,
BUT GET ON WITH IT,

IT DOESN'T NEED TO TAKE FOREVER.

ALRIGHT, SO IF YOU WERE NEEDED
TO CHANGE THE SHEETS

AND YOUR CLIENT NEEDED
A BEDPAN,

OR IF I NEEDED TO
CHANGE THE SHEETS,

EITHER WAY I WOULD
OFFER MY CLIENT THE BED PAN

PRIOR TO CHANGING THE SHEETS.

BECAUSE THERE IS ALWAYS THE
RISK OF SPILLING THE BED PAN

WHEN YOU DO THE SHEETS,
SO I ALWAYS JUST OFFER.

THAT WAY MY SHEETS MIGHT LAST
A LITTLE BIT LONGER IN THE
COURSE OF THE DAY.

SO KIND OF KEEP THAT IN YOUR
IDEA, FRAME OF REFERENCE HERE.

SO I CHECKED MY DOCTOR'S ORDERS.

IS MY DOCTOR GOING TO SAY
ANYTHING ABOUT MAKING THE BED
EVERYDAY?

- NEVER.
- NEVER. SO YOU JUST DO IT
WHENEVER YOU NEED TO.

YOUR HOSPITALS ESPECIALLY --
THE GERIATRIC HOSPITALS

WILL HAVE DIFFERENT CRITERIA
BECAUSE OF, YOU KNOW, WATER,

ENERGY SHORTAGE AND ALL
THIS KIND OF STUFF.

THEY MAY SAY THEY CHANGED
THE SHEETS ON MONDAYS

AND FRIDAYS OR WHEN
SOILED KIND OF A DEAL.

POINT IS, YOU CHANGE
'EM WHEN THEY ARE SOILED.

IN THE ACUTE CARE HOSPITALS,
MOST OF THE TIME

THEY CHANGE THEM EVERY DAY AND
IF I AM SICK I WOULD LIKE

FOR YOU TO CHANGE
MY SHEETS EVERYDAY.

BECAUSE IF YOU ARE IN BED ALL
DAY AND YOU ARE JUST SWEATING

AND SICK AND URGH.

FRESH SHEETS IS MAYBE THE
NICEST PART OF THE WHOLE DAY
NEXT TO YOUR BATH.

SO CHANGE 'EM AS MUCH AS
THEY WILL LET YOU CHANGE
THEM WITHIN REASON.

ALRIGHT, SO I'VE CHECKED MY
DOCTOR'S ORDERS. CARE PLAN WILL
GIVE ME A LITTLE OF CLUE.

BUT THE DOCTOR'S ORDERS WILL
GIVE YOU AN ACTIVITY LEVEL.

SO THEY WILL SAY EITHER
UP AD-LIB, BEDSIDE COMMODE,

THEY MAY EVEN SAY BEDPAN,
IT WILL SAY BED REST.

IF THEY ARE BED REST ONLY, THEN
YOU KNOW THEY ARE A BEDPAN.

SO THAT'S WHERE YOU ARE GOING TO
GET SOME CUES AS TO GETTING
THE CLIENT UP.

WHENEVER POSSIBLE
GET THE CLIENT UP.

THEY WILL JUST VOID BETTER.
THEY WILL EMPTY THEIR BOWELS

AND BLADDER BETTER
IF THEY CAN AT LEAST
GET TO A BEDSIDE COMMODE.

A CHAIR THAT SITS RIGHT HERE
AT THE SIDE OF THE BED.

GRAVITY HELPS, BUT IF THEY CAN'T
WE ARE STUCK WITH BEDPAN.

SO YOU ARE STUCK
WITH BEDPAN TODAY.

SO WE ARE GOING TO
GATHER UP OUR EQUIPMENT.

THE EQUIPMENT WILL BE
IN YOUR BEDSIDE TABLE.

WHEN YOU ARE LOOKING AT THE
BEDS, THE BEDSIDE TABLE.

IF YOU ARE FACING THE
BED TO THE LEFT,

IF YOU ARE THE CLIENT TO THE
RIGHT IS THEIR BEDSIDE TABLE.

SO DON'T BE SNARFING THINGS
OUT OF THE OTHER BED

AND STUFFING 'EM ALL AND
THEY GET ALL MIXED UP

BECAUSE WE HAVE STUFF IN EVERY
TABLE FOR THE CLIENTS.

ALRIGHT, SO MY CLIENT
NEEDS A BED PAN, I AM GOING
TO GATHER UP MY SUPPLIES.

AND THAT MEANS I AM GOING
TO PUT GLOVES ON.

NEVER TOUCH A BED PAN, NOT EVEN
IN MY LAB WITHOUT GLOVES ON.

WHERE HAVE THOSE BEDPANS BEEN?

OH, WE ARE GOING TO JUST
MAKE A VISUAL FOR YOU.

OKAY, SO I AM GOING TO
GATHER MY SUPPLIES.

IF YOUR HOSPITAL WILL LET YOU,
POWDER IS A WONDERFUL PRODUCT

BECAUSE CLIENTS STICK TO
PLASTICS. IF YOU CAN PUT A
LITTLE POWDER ON, GREAT.

SOME OF YOUR HOSPITALS WON'T
LET YOU USE POWDER

BECAUSE OF THE
VENTILATION SYSTEM.

AND THEIR DIAGNOSIS MIGHT
NOT ALLOW YOU.

FOR EXAMPLE, IF THEY HAD
PRODUCT CHRONIC OBSTRUCTIVE
PULMONARY DISEASE,

ANY KIND OF RESPIRATORY PROBLEM,

THEY ARE NOT GOING TO WANT
POWDER, SO.

BUT MY CLIENT NEEDS IT.

ALRIGHT, I AM GOING TO
GATHER UP SOME BEDPANS
HERE TO TALK TO YOU.

I CAN LAY THAT ON THE BED COS
IT'S HIS. URINALS.

THAT'S JUST HERE. WE GOT
TO TURN THIS A LITTLE.

OKAY. NOW I TOLD YOU I DIDN'T
KNOW WHERE BEDPANS HAD BEEN,
RIGHT?

THE ONLY TIME YOU
KNOW A BED PAN IS CLEAN IS

IF YOU GET IT FROM THE
CENTRAL SUPPLY CART

AND THEN YOU WOULD BE ALLOWED
TO TOUCH IT WITHOUT GLOVES.

BUT AFTER THAT, NEVER TOUCH
IT WITHOUT GLOVES.

AND THIS IS WHERE THEY EAT
LUNCH AND BREAKFAST AND SNACKS.

OKAY, ALWAYS PUT A BARRIER DOWN.

YOU HAVE TO USE THE TABLES.

YOU WILL FIND IN THE HOSPITALS,
THERE IS SO MUCH JUNK IN THOSE
ROOMS,

THERE'S FLOWERS AND CARDS

AND JUNK ALL OVER. WHERE ARE
YOU GOING TO PUT STUFF?

SO AT LEAST YOU HAVE THIS TABLE
AND YOU CAN SET THINGS ON THERE.

ALRIGHT. THERE ARE TWO KINDS
OF BED PANS THAT I WANT TO
SHOW YOU.

THIS IS A REGULAR BED PAN.

THIS IS MY FAVORITE BED PAN,
IF THEY CAN GET ON IT.

THEY HAVE TO BE FAIRLY MOBILE

BECAUSE THEY HAVE TO BE
ABLE TO LIFT THEIR WHOLE
BODY ONTO THIS SEAT.

THE REASON I LIKE IT IS
BECAUSE IT HOLDS MORE

AND THAT'S A GOOD THING. AND
ALSO WHEN CLIENTS ARE SITTING
ON IT

THEIR BOTTOMS TEND TO DIP IN.

OKAY? SO IF THEY GOT MORE OF
A SEAT, THERE'S LESS OF A DIP.

AND THAT WAY IT'S
NOT ALL ON THEM.

SO THIS IS MY FAVORITE.
IF IT'S A METAL BEDPAN,

WE DON'T SEE TOO MUCH
OF THOSE ANY MORE,

BUT YOU COULDN'T WARM THIS UP
UNDER WARM WATER, IF YOU WANT TO
BE A KIND NURSE.

PUT A LITTLE POWDER ON THE EDGE
SO THAT THEY DON'T STICK TO IT.

THIS IS A FRACTURE PAN.

THIS IS NICE BECAUSE IT'S EASY
TO GET ON THE CLIENT.

AND IT WAS CREATED
BY AN ORTHOPEDIC DOCTOR

JUST FOR THAT PARTICULAR REASON.

FOR THE HIP FRACTURED CLIENTS
THAT COULDN'T MOVE REAL WELL,

HE NEEDED SOMETHING A LITTLE
FLATTER FOR 'EM.

SO IT ACTUALLY GOES THIS WAY...

SO THAT THE FLAT PART
IS TOWARDS THE BACK.

CAN YOU IMAGINE SITTING
ON IT LIKE THIS

AND YOUR BACK INTO THAT HOLE?

SO IT GOES LIKE THIS
AND THEN THEY SIT.

THEIR BUTT JUST, LIKE, GOES
RIGHT STRAIGHT IN IT.

LOOK HOW MUCH IT HOLDS.

OH, THESE ARE AWFUL.

IT'S JUST URINE EVERYWHERE.
AND STOOL AND URINE TOGETHER.

OH, IT'S JUST TERRIBLE.

IT'S STOOL ON THEIR BACKSIDE
AND
URINE AND THEN EVERYTHING.

AND THEN YOU GO TO CLEAN IT
AND THINK ABOUT IT...

AND SO THAT'S WHY,
YOU KNOW, GLOVES.

SO I WOULD USE THESE FOR
PEOPLE THAT CAN'T MOVE MUCH.

LITTLE LADIES THAT WON'T MOVE
MUCH.

BUT IF THEY ARE FRACTURE PAN
DEPENDENT,

YOU BETTER OFFER THIS EVERY TWO
HOURS OR SO. AND HERE'S
THE DEAL.

PEOPLE ARE ON BEDPANS,
I MEAN, THINK OF YOURSELF.

ARE YOU GOING TO, LIKE, CALL THE
NURSE EVERY TWO HOURS,

JUST SO YOU CAN TRY
YOUR BEDPAN?

I WOULD DIE. I WOULD BE PUTTING
IT OFF TILL THE LAST
PRECIOUS MINUTE.

IT'S EMBARRASSING, RIGHT?

SO THEY TEND TO WAIT TOO LONG.

SO OFFER THE BEDPAN FREQUENTLY.

"COULD YOU USE A BED PAN RIGHT
NOW? YOU KNOW, WHILE I'M HERE?"

AND THEN IT WON'T BE
SO OVERFILLED.

ALRIGHT, AND LAST BUT NOT
LEAST, THE URINAL.

THEY SAY THESE ARE FOR WOMEN
TOO, BUT THESE ARE FOR MEN.

THE GIRLS LAUGHED.
THE GUYS WENT, "WHAT?"

"WE CAN'T HIT THESE.

I DON'T EVEN LIKE GIVING
A URINE SPECIMEN,

I CAN HARDLY HIT THE DUMB
CUP."

ALRIGHT. SO THESE ARE FOR MALE
CLIENTS. I THINK I HAVE
A MALE HERE.

LET'S JUST SEE WHAT WE'VE GOT.
I GOT BLAH BLAH.

THIS, YOU PUT THE PENIS IN HERE

AND THEN THEY URINATE AND
THEN YOU JUST TAKE IT OUT.

AND THEY JUST USUALLY STICK
IT ON THE EDGE OF THEIR
SIDE RAILS HERE

AND YOU SEE THERE'S URINE
AND THEN YOU DUMP IT.

AND IT'S NICE BECAUSE
IT'S PRE-MEASURED.

SOMETIMES, WHAT I DO WITH THESE,

WHEN I USE THE URINAL IS I PROP
'EM A LITTLE WITH A TOWEL HERE.

AND I MAY PUT A TOWEL ON TOP
AS WELL TO KIND OF SECURE IT.

IF THEY'RE WIGGLING A LOT AND
I'M TRYING TO CATCH A SPECIMEN.

I MAY PULL IT AND TRAP IT LIKE
THAT SO THAT IT'S STABLE.

ALRIGHT.

YOU'LL READ ABOUT -- I THINK
IT'S IN THIS BOOK

THAT IT HAS A URINAL
FOR A FEMALE.

CHUCKLE, JUST CHUCKLE.

BECAUSE IT'S HARD TO CATCH AND
URINE ON THE FEMALE RUNS DOWN

BETWEEN THE BUTTOCKS' CHEEKS.

AND SO CATCHING IT THROUGH
THE PERINEUM, IT'S,
LIKE, IMPOSSIBLE.

YOU HAVE TO HAVE SOME KIND
OF ADHESIVE TO KEEP IT
COMING OUT STRAIGHT.

IT DOESN'T WORK.

ALRIGHT, I'M GOING TO GET RID
OF A COUPLE OF THESE HERE.

ALRIGHT, SO I'VE GATHERED UP
MY EQUIPMENT, I HAVE WASHED
MY HANDS,

I HAVE IDENTIFIED MY CLIENT.
GOOD MORNING, MR. SPADE.

YOU NEED TO USE THE URINAL?
I SAW THE CALL LIGHT WAS ON.

GREAT. I HAVE THAT READY,
I MEAN, THE BEDPAN.

AND I WANT TO CHANGE
YOUR SHEETS TOO

SO WE'LL KIND OF WORK
THROUGH ALL THAT.

PRIVACY. ALRIGHT.

FIRST THINGS FIRST. BECAUSE I'M
JUST GOING TO BE EFFICIENT

AND I KNOW I'VE GOT TO
CHANGE THE BED ANYWAYS,

I'M GOING TO PROVIDE PRIVACY
AND GET MY TOP SHEETS OFF.

OKAY.

AND THAT WILL SAVE ME
A LITTLE TIME HERE.

WHEN I DO A BATH BLANKET,
I USUALLY DO IT DOUBLED
AND LONG WAYS

SO THAT IT'S A LITTLE BIT WARMER
AND THEY DON'T GET SO
TWISTED UP IN IT.

- OKAY.

- ALRIGHT. I'M GOING TO PUT
THE BED UP HERE A LITTLE BIT.

MR. SPADE, CAN YOU LIFT UP YOUR
BOTTOM TO SIT ON THE BEDPAN?

NO, YOU CAN'T. ALRIGHT.

IF THEY CAN JUST LIFT UP AND YOU
JUST SLIDE IT UNDER, BEAUTIFUL.

BUT IF THEY CAN'T AND THEY
CAN'T, THIS IS WHAT YOU'RE
GOING TO DO.

ALRIGHT. MR. SPADE, CAN YOU ROLL
OVER ON YOUR SIDE?

WELL, YES, HE CAN, SO.

I'M JUST GOING TO
PUT HIM RIGHT OVER.

NOW BECAUSE I'VE DONE A
BEDPAN OR TWO IN MY LIFE --

COS I'VE SPILT A BEDPAN OR TWO
IN MY LIFE. HANG ON THERE.

I'M GOING TO MAKE SURE THAT I
HAVE A CHUX HERE TO PROTECT
MY LINEN.

EVEN THOUGH, I'M GOING
TO CHANGE THE LINEN,

IT'S NICE IF YOU CAN SAVE
THE BED -- THE MATTRESS PAD.

SO THAT'S KIND OF
A GOOD THING.

ALRIGHT, NOW THIS IS THE TRICK.

IF YOU JUST LAY IT HERE AND
YOU'LL THINK THEY'LL
ROLL AND HIT IT,

NEVER IN YOUR
WILDEST IMAGINATIONS.

SO, WHAT YOU'VE GOT TO DO IS
KIND OF PRESS IT INTO THE BED

AND THEN TELL
YOUR CLIENT TO ROLL OVER
AND GET ON THE BEDPAN.

THEN YOU WANT TO MAKE SURE
THEY'RE KIND OF CENTERED
ON THERE.

AND THAT'S, OH, KIND OF GOOD.
CAN YOU LIFT UP A LITTLE?
THERE YOU GO.

WHICH IS NICE FOR
SITUATING IT WITH POWDER

BECAUSE IT DOESN'T MOVE SO EASY
IF IT'S NOT POWDERED
UNDER THERE.

ALRIGHT, YOU KNOW WHAT? THAT'S
NOT VERY COMFORTABLE, IS IT?

I'M GOING TO PUT THE HEAD OF
THE BED UP A LITTLE BIT
FOR YOU.

SO, WOOPS! NOT THE WHOLE BED.

MIGHT AS WELL PUT IT DOWN
BECAUSE I'M GOING TO GIVE HIM
A MOMENT.

HOW'S THAT?

YOU KNOW HOW THE BED FELT WHEN
YOU WERE GETTING SQUINCHED
IN IT.

THINK ABOUT A BEDPAN
NOW UNDER YOU WHEN YOU'RE
SQUINCHING 'EM.

OKAY, YOU'RE GOING TO NEED
TO GIVE THIS ONE MORE
LITTLE PEAK HERE

TO MAKE SURE THAT AFTER
YOU SQUINCHED 'EM,
THAT THEY'RE ON.

BECAUSE IN THIS MANEUVER,
THEY CAN COME OFF.

NOW IF HE WAS GOING TO
URINATE AS WELL, MALE,

I MIGHT PUT A URINAL THERE
AND DO A DOUBLE CATCH.

AND IF IT'S A FEMALE,
I'M GOING TO PUT A TOWEL
THERE.

YOU WOULD THINK THAT FEMALE
URINE WOULD GO DOWN,

BUT THEY TEND TO SQUIRT UP.

AND IT GOES UP ONTO THEIR GOWN,

SO YOU KIND OF WANT
TO CATCH STUFF IF YOU CAN.

ALRIGHT,
HE LOOKS QUITE SITUATED.

HERE'S SOME TOILET PAPER.

AND BED'S IN THE LOW POSITION.

HERE'S YOUR CALL LIGHT, IF
YOU'LL CALL ME WHEN YOU'RE DONE,

I'LL COME GET YOU OFF THE PAN.

I'M GOING TO TAKE THESE
SHEETS OFF WHILE I GO.

AND I'M GOING TO GO OUTSIDE THE
CURTAIN AND GIVE HIM A MOMENT.

SOMETIMES THEY JUST GO,
PEOPLE AREN'T BEDPAN,
YOU KNOW, SENSITIVE.

AND THEY'RE DONE BEFORE
I EVEN GET THE BED DOWN
AND THAT'S FINE.

WHATEVER. BUT I DON'T KNOW.
I'D WANT A MOMENT ALONE.

OKAY, CALL LIGHT'S BACK ON.

SO YOU'RE GOING TO COME BACK IN.

NOW IF THEY COULDN'T LIFT THEIR
BOTTOM TO GET ON THE PAN,

YOU SUPPOSE THEY'RE GOING TO
LIFT THEIR BOTTOM TO CLEAN
THEMSELVES?

NEVER.

SO WERE YOU ABLE TO WIPE? NO.

OKAY, SO I'M GOING
TO GET HIM UP HERE.

DON'T GET OFF
THAT PAN YET, THOUGH.
WAIT TILL I GET A HOLD OF IT.

OH, DON'T LET 'EM BE JUMPING
OFF THE THING TILL YOU'RE READY.

OKAY.

YOU KNOW WHAT, I'M GOING
TO PUT THE HEAD DOWN HERE

WHILE I'M HOLDING ON HERE.
DON'T GET OFF OF IT YET, THOUGH.

IT SAYS IN YOUR BOOK

THAT YOU COULD, FOR
COMFORT PUT A ROLL,

A TOWEL ROLL BEHIND THEIR
BACK IF THEY'RE GOING TO
SIT THERE WHILE.

THAT WOULD HAVE TO BE SOMEONE
THAT WAS GOING TO SIT UP WAY
GOOD FOR YOU

AND YOU GET IT BEHIND 'EM.
IT'S A LITTLE DIFFICULT.

ALRIGHT, I'M GOING TO
GET THIS TOWEL OUT.

AND IF YOU COULD, CAN
YOU JUST ROLL OVER.

WHILE YOU HOLD ONTO THIS
FOR THE WHOLE PROCESS?

AND THEY ROLLED OVER.

ALRIGHT, NOW WHAT DO
YOU DO WITH THIS?

RIGHT, BECAUSE WHAT'S THE RULE?

- BIOHAZARDOUS.
- PEOPLE BEFORE EQUIPMENT.

MY FIRST INCLINATION
IS GET RID OF IT.

OKAY, BUT I HAVE TO TAKE
CARE OF MY CLIENT FIRST.

SO YOU HAVE A COUPLE OF OPTIONS.

IF YOU CAN JUST PUT IT
AT THE FOOT OF THE BED,

COVER IT FOR A MOMENT SO THAT
YOU CAN CLEAN YOUR CLIENT OFF.

OKAY, FRONT TO BACK.

WE'RE GOING TO PERI CARE WITH
OUR BATH NEXT WEEK.
BUT FRONT TO BACK.

DRY 'EM.

TA-DA. OKAY.

THEN YOU BASICALLY AT THIS POINT
CAN TALK THROUGH THE REST.

WE SHOULD TALK ABOUT PRIVACY.

OKAY, I WOULD PUT THE BED DOWN.

I'M GOING TO LEAVE 'EM ON HIS
SIDE. ARE YOU COMFORTABLE? GOOD.

I'M GOING TO LEAVE HIM
ON HIS SIDE,

BECAUSE I'M GOING TO
CHANGE THE BED SHEETS.

YOU'RE GOING TO NOW TAKE
THIS TO THE BATHROOM.

WELL, LET ME TALK ABOUT
A COUPLE OTHER OPTIONS.

YOU COULD'VE PUT IT ON THE BED.

YOU COULD HAVE PUT IT
BACK ON YOUR TABLE.

I LIKE TO COVER IT WITH
SOMETHING, USUALLY THEY'RE A
LITTLE ODOROUS.

AND SOMETIMES ON THE BEDS,

THERE'S A RACK UNDERNEATH
THE BED FOR BEDPANS.

AND YOU CAN SLIDE
IT ONTO THE RACK.

DON'T FORGET IT.

OKAY. NOW, YOU HAVE YOUR BEDPAN.

YOU WANT TO MAKE SURE YOUR
CLIENT IS NOT ON I&O OR NOT.

AND IF THEY ARE,
YOU'VE GOT TO POUR

WHATEVER INTO THE GRADUATE AND
IT IT'S STOOL, YOU'VE GOT
TO DESCRIBE IT.

WE'LL TALK ABOUT THAT LATER.
ALRIGHT, DUMP IT INTO THE
TOILET.

THEN AT THE TOILET,
THERE'S THIS BAR.

OKAY, YOU KNOW, THERE'S TOILET
SEAT AND THEN THERE'S THE PIPES.

THE PLUMBING COMES UP.

THERE'S A BAR ON THE PLUMBING
THAT YOU CAN PULL DOWN.

SO THAT WHEN YOU FLUSH,
WATER COMES OUT OF THE BAR

INSTEAD OF JUST FLUSHING TOILET.

YOU PULL THE BAR DOWN,
THEN YOU GO LIKE THIS.

AND SEE HOW MUCH PRESSURE YOU'RE
GOING TO GET ON THAT BAR.

SOMETIMES IT JUST
BARELY DRIZZLES OUT.

BUT YOU WANT TO RINSE THIS
OUT, THIS IS IN NO WAY
STERILIZED OR ANYTHING.

IT'S JUST RINSED OUT. SOMETIMES
THERE'S A TOILET BRUSH

AND YOU CAN SCRUB IT
AND I WONDER HOW
DISGUSTING THOSE ARE.

YOU KNOW, THEY LEAVE THINGS
THAT ARE JUST GROSS AROUND.

IF YOU CAN'T GET IT ALL OFF OF
THERE, THEN THEY HAVE SOME
SPRAY.

AND SO I MIGHT GET
CHUX OR SOMETHING.

I MIGHT JUST THROW THE WHOLE
THING AWAY. FORGET IT.

IT JUST DEPENDS
ON HOW BAD IT IS.

CLEAN IT OFF, DRY IT.

AND THEN IT COMES BACK AND GOES
INTO THE BOTTOM DRAWER.

IT SHOULD BE IN THE
BEDPAN DRAWER.

IT SHOULDN'T GO IN WITH
THEIR BATH SUPPLIES

OR THEIR PERSONAL HYGIENE OR
THEIR TOOTHBRUSH OR ANY OF
THAT STUFF.

YOU'LL NOTICE THAT WHEN
I'VE SET UP MY DRAWERS,

THE TOP DRAWER HAS TOOTH BRUSH

AND POWDER AND COMBS
AND THAT KIND OF STUFF.

THE MIDDLE DRAWER HAS
THEIR BATH BASIN

AND THE BOTTOM DRAWER
IS FOR BEDPANS.

ALRIGHT,
SO I'LL PUT IN THE DRAWER.
I WOULD TAKE MY GLOVES OFF,

WASH MY HANDS.

AND I MIGHT EVEN LEAVE
MY GLOVES ON OR I CAN DECIDE
WHAT I WANT TO DO.

BUT OFFER THE CLIENT A WASHCLOTH
SO THEY CAN WASH THEIR OWN HANDS

AFTER THEY'VE BEEN
TO THE BATHROOM.

ALRIGHT.

I WOULD WANT TO DOCUMENT IN I&O,
THE WHOLE PROCEDURE.

ALRIGHT, WE'RE BASICALLY
DONE WITH BEDPANS, RIGHT?

AND YOU'VE TALKED THROUGH IT.
NOW WE'RE GOING TO START
BED MAKING.

WELL, YOU'VE ALREADY
DONE YOUR HIGH FIVE.

IT'S THE SAME CLIENT,
YOU HAVEN'T GONE ANYWHERE.

THE CLOCK STARTS NOW.

AND...

YOU NEED TO BE QUICK, SO...

NOTICE THAT WHEN I DID MY BED,

I TOOK THE TOP SHEETS OFF.

THEY'RE IN THE BATH BLANKET
AND THEY'RE READY TO GO.

SAVE YOUR BEDSPREAD.

DON'T WASTE YOUR TIME FOLDING
UP YOUR BEDSPREAD.

IT JUST WASTES TIME BECAUSE
YOU'RE GOING TO PUT THE SAME
BEDSPREAD BACK ON.

OKAY, I'VE GATHERED MY EQUIPMENT
FOR MY LINEN CHANGE.

THE EQUIPMENT FOR LINEN
CHANGE IS THIS.

YOU HAVE A BOTTOM SHEET,
A PILLOW CASE,

A DRAW SHEET OR PULL SHEET
WHATEVER YOU WANT TO CALL IT
AND A TOP SHEET.

AND I HAVE THEM IN THAT ORDER.

NOW. I'M GOING TO GET
THIS WAY UP.

AND I'M GOING TO BE WATCHING
AGAIN BODY MECHANICS.

MAKE SURE THESE ARE UP TO
YOUR ILIAC CREST.

HIGH. YOU SHOULD NOT -- HARDLY
BE BENDING. I'M SWEATING.

AND I'M A LITTLE SHORT THING,
I'M 5'3"

AND IT'S ALL THE WAY
TO THE TOP, SO.

HERE YOU GO. HOW YOU
DOING THERE, MR. SPADE?

I'M GOING TO GO AHEAD
AND CHANGE THE LINEN.

SO I'M GOING TO WAD ALL
THIS LINEN UP BEHIND YOU.

SO WHAT I'M GOING TO DO
IS ROLL THIS TOWARDS HIM.

NOW, OH, THIS IS NICE.

WE HAVE FITTED SHEETS. WE HAVE
FITTED SHEETS AND FLAT SHEETS.

SO LUCK OF THE DRAW, WHATEVER
YOU GET IN THE BOTTOM SHEET.

ALRIGHT, I HAVE...A FLAT SHEET.

THE STUDENTS CAME BACK AND SAID,
"DIANE, YOU GOT TO TEACH US

HOW TO DO FITTED SHEETS ON
THE BOTTOM, THEY'RE HARD.

YOU TAUGHT US FLAT SHEETS."
AND I DO TEACH FLAT SHEETS

BECAUSE I THINK THEY'RE ACTUALLY
HARDER THAN PUTTING ON A FITTED.

BUT THERE WERE HAVING DIFFICULTY
WITH THE STRETCHY ELASTIC TRYING

TO KEEP IT ON THE BED WHEN
THEY WERE FOLDING, SO. WHATEVER.

ALRIGHT, WHAT YOU WANT
TO DO IS WITH YOUR SHEET,

IT'S FOLDED IN 2 SHORTS

SO THAT YOU END UP WITH A LONG.

YOU GUYS DON'T HAVE TO TAKE
THE END OF THE BED OFF.

I'M JUST TAKING IT
OFF SO YOU CAN SEE.

IN CPR, WHEN THEY TEACH YOU CPR

AND THEY SAY PUT YOUR CLIENT
ON A BACKBOARD, THAT'S WHAT
THEY MEAN.

PULL THE END OF THE BED UP, ROLL
YOUR CLIENT OVER, PUT 'EM ON.

THROW 'EM ONTO THE BOARD SO
THAT YOU HAVE A HARD SURFACE
TO DO CPR.

OKAY, FOOTBOARD.

ALRIGHT, SO I HAVE --
NOW I HAVE A LONG SHEET.

I WANT TO UNFOLD THE LONG
SHEET...

SO THAT THE FOLD IS IN THE
MIDDLE AND THE SHEET IS EVEN.

THE FLAT SHEET IS EVEN
WITH THE FOOT OF THE BED.

NOTICE IT DOESN'T COME
OVER THE END OF THE BED.

YOU DON'T NEED SHEET DOWN THERE.

NO ONE PUTS THEIR FOOT AT
THE END OF THE BED.

SO CENTER THE PLEAT

AND THEN UNFOLD THE
SHEET HALFWAY

AND TOWARDS THE MIDDLE.

WHAT IF YOUR CLIENT WAS
INCONTINENT

AND THE LINEN WAS ALL SOILED?

GLOVES WOULD BE GOOD.

AND THE OTHER THING THAT WAS
JUST LIKE, "AH! WHAT DO I DO?"

WAS ALL MY LINEN WAS, LIKE, FULL
OF STOOL AND IT WAS GETTING
ONTO MY CLEAN LINEN.

SO IF YOU'LL TAKE A CHUX
AND MAKE A BARRIER

BETWEEN THE SOILED LINEN
AND CLEAN LINEN,

THEN YOU WON'T GET YOUR CLEAN
LINEN ALL DIRTY IN THE PROCESS.

- WHAT IS A CHUX?
- I'M SORRY, THE CHUX
ARE THESE BLUE --

- OH, OKAY.

- THESE ARE CALLED CHUX.

ON A CHUX,
THE BLUE SIDE IS DOWN.

THE PAPER SIDE IS NOT
AGAINST THE CLIENT,
BUT TOWARDS THE CLIENT.

YOU HAVE TO PUT A CLOTH LINER

BETWEEN THE CLIENT AND THE PAD
BECAUSE IT'S IRRITATING.

THESE DON'T HAVE A NICE DRY
WEAVE LAYER LIKE, YOU KNOW,

A PAMPERS OR THAT
KIND OF PRODUCT.

WHEREAS THE PINK PADS AND
THAT'S THE OTHER TERM THEY USE
IN THE HOSPITALS.

IT'S LIKE A QUILTED BABY PAD,

IF YOU WANT MY OPINION
ON THE WHOLE THING.

IT'S A BIG PLASTIC PAD AND IT'S
PLASTIC PINK ON THE BOTTOM SIDE

AND IT'S THE WHOLE
WIDTH OF A DRAW SHEET.

BUT IT'S QUILTED ON THE TOP,
IT HAD KIND OF DRY WEAVE LAYER

AND THEY PUT THOSE ON
THE BEDS AS A BARRIER.

SO PINK PAD, CHUX.

SO I WOULD --
IF THIS WAS SOILED,

I WOULD JUST KIND OF BARRIER
IT UP LIKE THAT SO THEY
WOULDN'T TOUCH.

ALRIGHT, IT'S HARD TO MAKE A
BED WITH GLOVES ON SO YOU
DON'T HAVE TO.

OKAY, SO I'VE SMOOTHED OUT,
IT'S GOOD TO GO HERE.

WHAT IS WANT TO DO NOW IS
TO MITER THE CORNER.

I'M GOING TO MITER
THE CORNER BY TAKING THIS...

PUT IT IN HERE.

I'M GOING TO SWEEP
IT DOWN LIKE THIS SO
IT'S TUCKED UNDER.

I'M GOING TO PULL MY SHEET
OUT AT ABOUT 12 INCHES OUT,

STRAIGHT OUT LIKE THIS
AND FOLD IT LIKE THAT.

SEE HOW IT MAKES THIS
PERFECT 90 DEGREE.

IS THAT 90? 45.

STUFF IT UNDER LIKE THIS.

AND THEN TUCK THE SHEET UNDER.

OKAY, SO THIS COMES HERE.

I ALSO WANT TO POINT OUT THAT
THE SEAM ON THIS SHEET
IS SMOOTH.

THE SEAM, THE HOLDED
EDGE IS UNDERNEATH

SO NO SEAMS AGAINST CLIENT.

SO WHEN YOU'RE FOLDING YOUR
SHEETS, YOU WANT TO FOLD THE
BOTTOM SHEET,

SEAMS TO THE OUTSIDE.

ALRIGHT, SO THAT WHEN YOU OPEN
IT, THE FLAT IS AGAINST SKIN.

IN OUR LAB, YOU CAN TELL
THE BOTTOM SHEETS FROM
THE TOP SHEETS

BECAUSE BOTTOM SHEETS HAVE TWO
ONE INCH SEAMS

AND TOP SHEETS HAVE A ONE INCH
SEAM AND A THREE INCH SEAM
AT THE TOP

BECAUSE THEY'RE
A LITTLE BIT LONGER.

ALRIGHT, THEN YOU WANT
TO GET THIS AS CLOSE AS

YOU CAN TO THE CLIENT AND
UNDERNEATH THOSE SHEETS.

SO THAT WHEN THEY ROLL OVER
THEY'LL HAVE PLENTY
OF CLEAN SHEET.

THE NEXT THING YOU WANT TO DO
IS PUT YOUR PULL SHEET ON.

YOU CAN DO YOUR PULL SHEET
ONE OF TWO WAYS.

YOU CAN DO IT LIKE
WE DID IT WITH THE --

WHEN WE WERE TRANSFERING
OUR CLIENT.

AGAIN PUT THE SEAM
IN THE MIDDLE

AND THEN THIS WOULD BE TUCKED.

POSITIONING THIS SO THAT --

ACTUALLY MY SEAM SIDE IS
UP SO I'VE GOT TO TURN IT.

SO THAT IT'S SMOOTH.

AND SO THAT IT COMES, LIKE, TO
SHOULDERS, BUT COVERS BOTTOM.

AND THEN YOU CAN TUCK IT AND
YOU CAN USE IT AS A PULL SHEET

OR IT CAN HELP HOLD
THE SHEETS ON.

ALSO IF YOUR CLIENT
IS INCONTINENT,

THE CHUX WOULD NEED TO BE
PLACED UNDER THE PULL SHEET.

OKAY, SO THE BLUE PAD'S'
NOT AGAINST SKIN.

NOW YOU CAN ALSO
DO IT ONE OTHER WAY.

AND THAT IS, IF YOU FOLD...

YOUR SHEET IN HALF...

RATHER THAN TUCK IT.

IT'S JUST GOING TO LAY ON TOP.
YOU CAN STILL USE
IT AS A PULL SHEET,

ESPECIALLY IF YOU'RE PULLING
YOUR CLIENT UP AND DOWN A LOT.

YOU CAN PUT YOUR CHUX IN
BETWEEN ESPECIALLY IF THEY'RE
USING BEDPANS A LOT,

THAT'LL HELP PROTECT
THE SHEETS.

AND THEN IT'S JUST THERE.

IF YOU'RE USING THESE SHEETS TO
PULL YOUR CLIENT UP
AND BACK A LOT,

YOU HAVE TO HAVE TWO PEOPLE
PULLING 'EM UP IN BED.

I LIKE TO DO IT THIS WAY BETTER
THAN I LIKE IT TUCKED IN

BECAUSE EVERY TIME
YOU UN-TUCK IT,

YOU UN-TUCK YOUR WHOLE BED
AND THAT ANNOYS ME.

ALRIGHT, IF YOU DO FOLDED SHEET,
YOU NEED TO HAVE A FOLD
AT THE TOP

AND THE TWO PIECES OF SHEET
AT THE BOTTOM

BECAUSE THIS WILL BE LESS
SEAMS AGAINST THE CLIENT

TO CAUSE PRESSURE SORES.

THE WHOLE REASON WE MAKE
BEDS WITHOUT WRINKLES

AND ALL OF THAT ISN'T
JUST SO THAT

WE CAN GO INTO THE ARMS SERVICES
AS A SECOND CAREER OPTION,

IT'S SO THEY DON'T GET PRESSURE
SORES FROM THE FOLDS

AND THE WRINKLES IN THE BED.

SO WE'RE TRYING TO DO
ALL WE CAN FOR OUR CLIENT.

ALRIGHT, SO THERE'S THAT.

I'M GOING TO PUT MY SIDE RAIL UP
AND ASK MY CLIENT.

I'M JUST GOING TO OBLIGE
TO HIS PRIVACY HERE.

CAN YOU ROLL OVER THIS BIG --
THERE'S A WAD OF LINEN
BEHIND YOU.

AND ROLL ALL THE WAY
OVER TO THE OTHER SIDE.

KEEP COMING. WHILE WE
REACHING OVER THERE.

AND I LIKE MY CLIENT AS MUCH
AS POSSIBLE TO BE CENTERED

IN THE MIDDLE OF THE BED
SO THAT WHEN THEY ROLL,

THEY ROLL COMPLETELY OVER
THE CENTER.

THAT GIVES ME MORE ROOM
TO WORK.

YOU KNOW, SPIN THE BED
AROUND OBVIOUSLY.

- YOU'RE PLUGGED IN.

- THAT WOULD BE ALL
THAT'S DRIFTING, ALRIGHT.

YOU WANT YOUR PILLOW? OKAY.

HOW YOU DOING OVER THERE? GREAT.

PULL OUT THE DIRTY LINEN.

WHEN YOU HAVE DIRTY LINEN,
COUPLE OF RULES
OF DIRTY LINEN.

ALWAYS AWAY FROM YOU, DON'T
PULL THEM INTO YOUR CLOTHING

AND NEVER ON THE FLOOR. EVER.

YOU CAN PUT IN ON A CHAIR,
BUT BETTER IN A HAMPER.

GET ANOTHER ONE THERE
WITH MY BEDSPREAD.

COS I'LL HAVE TO GO
GET A NEW BEDSPREAD.

ALRIGHT, HERE'S HOW MITER
LOOKS ON YOUR SIDE.

SWEEP ALL THE WAY UNDER SO
THAT IT GETS THE SWEEPING OF
THE SHEET UNDER THE TOP

THAT'S GOING TO HOLD IT
ON THE BED.

SO YOU'VE GOT TO GET
IT ALL THE WAY UNDER.

PULL THIS OUT ABOUT 12 INCHES,
LAY THAT NICE 45 DEGREE ANGLE.

DON'T DO THIS. I CAN'T FIGURE
OUT WHAT STUDENTS DO.
THEY DO LIKE THIS SOMETIMES

AND TUCK IT.
THERE'S NO MITER THERE.

IT'S JUST A WAD.

YOU GOT TO PULL IT. COME OUT
ABOUT12 INCHES THIS WAY

AND LAY IT SO THAT YOU'VE
GOT THAT 45 DEGREE CREASE.

TUCK THIS AND THEN SWEEP THIS.

NOW THIS IS WHERE WE'RE GOING
TO MAKE THE BED TIGHT.

ALRIGHT, THAT SIDE WE JUST TUCK,

THIS SIDE I WANT YOU TO
DO WHAT I CALL KNUCKLE DOWN.

YOU'RE GOING TO TAKE -- YOU GUYS
CAN STAND UP IF YOU CAN'T SEE.

TAKE 2 HANDS
AND PULL THIS DOWN TIGHT.

PULL WITH THIS HAND AND
STUFF WITH THIS HAND.

IF YOU JUST DO THIS,
YOU END UP PULLING IN AND OUT.

AND IT DOESN'T GET TIGHT.

SO. PULL AND STUFF.
THAT ONE LOOKS PRETTY GOOD.

PULL AND STUFF.
PULL AND STUFF.

THAT GETS YOU DONE.

OKAY, STRAIGHTEN THIS OUT.

AND YOU'RE OKAY. ALRIGHT, IF YOU
WANT TO LAY BACK ON YOUR BACK.

COS NOW EVERYTHING I DO...

OKAY.

A NEW, BRAND NEW,
CLEAN, BLANKET.

YOU DROP THINGS ALL THE TIME
IN LIFE. GET NEW ONES.

YOU CAN'T USE ANYTHING
OFF THE FLOORS.

SO IT'S JUST, I'LL BE BACK,
I'VE GOT TO GET YOU
A NEW BLANKET.

ALRIGHT, THIS IS WHAT I WAS
TALKING ABOUT FOR YOUR
TOP SHEET.

YOU'VE GOT THE 3 INCH SEAM.

THE 3 INCH SEAM GOES
ON THE TOP OF YOUR CLIENT.

AND AGAIN, NO SEAM AGAINST
CLIENT, SMOOTH AGAINST CLIENT.

SO THIS TIME WHEN YOU FOLD IT,
YOU WANT TO FOLD SEAMS INSIDE,
OKAY, SO.

WHEN YOU'RE FOLDING UP YOUR
LINEN OR MAKING SURE THAT IT'S
RIGHT...

YOU DO -- AND NO, YOU CAN'T DO
THIS ANY MORE AND MAKE THAT
TENT OF AIR.

THAT'S OUT.

WHAT YOU'RE FOLDING IS TWO
LONG SEAMS, TWO LONG FOLDS
FIRST, RIGHT?

AND THIS TIME, SEAMS
ARE ON THE INSIDE.

SO LONG, LONG
AND SHORT, SHORT, SHORT.

ALRIGHT, SO MAKE SURE THAT
THE SEAM IS IN THE MIDDLE.

NO SEAM AND TOUCHING CLIENT'S
SKIN AND YOU CAN OPEN
THAT UP TOWARDS YOU.

AS MUCH AS YOU CAN, MAKE ONE
SIDE OF THE BED AT A TIME.

SO YOU'RE NOT GOING BACK AND
FORTH AND BACK AND FORTH.

THEN YOU'RE GOING TO PUT THE
BEDSPREAD ON AND THIS TIME

THE SEAM GOES DOWN BECAUSE
IT'S AGAINST SHEET.

OTHERWISE IT WOULD BE INSIDE
OUT.

I LOVE THESE BEDSPREADS THAT
HAVE THE LITTLE STRIPE DOWN
THE MIDDLE.

I THINK I MENTIONED IT AT MY
STATIONS, WHEN YOU WERE
TURNING PEOPLE

I COULD TELL IF THEY WERE
STRAIGHT IF THEY MATCHED
THE SEAM.

BUT IT ALSO HELPS YOU TELL IF
YOU'VE GOT YOUR BEDSPREAD

IN THE MIDDLE OF THE BED.

SO WHAT YOU WANT TO DO IS PUT
THE BEDSPREAD RIGHT BELOW
THE SEAM

SO THAT YOU CAN
MAKE A LITTLE CUFF.

ALRIGHT, IT LOOKS
PRETTY CENTERED HERE.

DOWN HERE.

NOW, WHAT I WANT TO DO IS
I'M GOING TO GRAB THIS
AND SWEEP IT UNDER.

IT MENTIONS THAT YOU CAN PUSH
THE BED UP,

BUT THIS BED DOESN'T HAVE --
THERE'S A LITTLE BAR,

LOOK ON SOME OF THE MATTRESSES
AND THERE'S A BAR

THAT HOLDS THE MATTRESS UP.

THIS MATTRESS JUST DOESN'T
HAPPEN TO FIT THIS BED
VERY WELL.

SWEEP IT ALL UNDER, THAT'S
WHAT'S GOING TO HELP HOLD THE
SHEETS ON.

THEN YOU'RE GOING TO PULL THIS
UP, NICE 45 DEGREE ANGLE.

AND SEE IF MY BED'S
COME UN-TUCKED.

I'M JUST GOING TO SLIP THAT
UNDER AND LAY THAT FLAT.

OH, YES. IS THAT THE MOST
BEAUTIFUL MITER? I WOULD SAY.

THEY SHOULD ALL...

OKAY, BEAUTIFUL.

COME OVER HERE.

MAKE SURE YOUR SHEET'S PULLED
DOWN SO THAT IT'S GETTING
SWEPT UNDERNEATH.

THAT'S WHAT'S
GOING TO HOLD IT IN.

SWEEP IT UNDER.

PULL THE SHEET
AND THE BLANKET AT THAT 12 INCH,
45 DEGREE ANGLE.

LAY IT, SWEEP AND DROP.

ANOTHER PERFECT MITER CORNER.

DON'T JUMP OFF THAT SIDE OF
THE BED THERE, MR. SPADE.

I DON'T HAVE
THAT SIDE RAIL DOWN -- UP.

OKAY, PUT A NICE ONE INCH

FOLD ACROSS THE TOP.

AND THEN FOLD IT DOWN SO
THAT IT CUTS UNDERNEATH
THE SIDE RAIL.

NOW, I WOULD LEAVE ALL MY
CLIENTS IN THIS PRETTY LITTLE
TIGHT ENVELOPE.

COS I THINK THEY LOOK NICE.

BUT THEY CAN'T WIGGLE
THEIR TOES.

ALRIGHT, SO WHAT YOU WANT
TO DO IS COME GRAB A PLEAT.

AND GIVE THEM A TOE PLEAT SO
THAT THEY CAN WIGGLE THEIR TOES.

IT'LL BE GOOD IF YOU
REMEMBERED THE BATH BLANKET
UNDERNEATH THEM.

AND STRAIGHTEN UP THEIR GOWN.

SIDE RAILS UP.

HOW'S THAT FEELING,
MR. SPADE? BEAUTIFUL.

OKAY, I JUST NEED TO CHANGE
YOUR PILLOWCASE
AND WE'LL BE DONE HERE.

WORKING UP A SWEAT.

ELBOW CUSHION.

AND THEN YOUR PILLOWCASE.

TAKE IT OFF
AND IT'LL GO IN THE HAMPER.

THEN THERE'S TWO WAYS
YOU CAN PUT A PILLOWCASE ON.

THIS IS NOT ONE OF THEM.

OKAY? THE CHIN IS OUT. NO MORE.

ALRIGHT, I DO THE FOLD METHOD.

I JUST FOLD MY PILLOW IN HALF
AND THEN I JUST STUFF IT IN.

STUFF IT ALL THE WAY IN.

UNTIL IT GETS TO THE TOP.

AND THEN WHEN IT'S IN THE
CENTER, RELEASE BOTH ENDS

AND PULL YOUR PILLOWCASE
DOWN. THAT'S ONE WAY.

AND THE OTHER WAY IS...

WHEN YOU GET YOUR
PILLOWCASE, YOU GRAB IT ON
THE OUTSIDE IN THE MIDDLE.

AND THEN YOU FOLD IT INSIDE
OUT SO THAT YOUR HAND IS IN
THE MIDDLE.

AND THEN YOU GRAB IT IN THE
MIDDLE...

AND YOU STUFF IT AROUND.

I NEVER HIT IT EXACTLY RIGHT,
THAT'S WHY I DON'T DO THIS WAY

BECAUSE THEY USUALLY
LOOK KIND OF TWISTED.

BUT WHATEVER. IT DOESN'T
MATTER, IT'S JUST A
PILLOWCASE, WHO CARES?

GET IT ALL IN.

ALRIGHT, IN BED MAKING THEORY,

THINK ABOUT THAT FOR
A MINUTE.

ALRIGHT, THEY SAY THAT IT'S
BETTER IF YOU PUT
THE PILLOW --

THE OPEN END OF THE PILLOW AWAY
FROM THE DOOR.

- WHAT?

- THEY TOLD ME 25 YEARS AGO
THAT THAT'S SO THE GERMS WHEN
THEY OPEN AND SHUT THE DOORS

DIDN'T COME GUSHING IN.

SO FOR OUR PURPOSES IT JUST
CAUSES UNIFORMITY AND --

WHATEVER, WHO THOUGHT
THAT STUFF UP?

YOU THINK SOME PEOPLE HAVE TOO
MUCH TIME ON THEIR HANDS
OR WHAT?

I DON'T KNOW.
BUT THERE YOU GO.

BEAUTIFUL BED,
WASH YOUR HANDS.

THERE'S NOT MUCH TO DOCUMENT
OTHER THAN IN THE HOSPITALS,

IN THE GERIATRIC HOSPITALS,
THEY USUALLY HAVE A PLACE FOR
LINEN CHANGE,

JUST SO FAMILY MEMBERS KNOW
THE LINEN HAS BEEN CHANGED

BECAUSE THEY MAY QUESTION
OR ASK.

BUT MOST OF THE TIME, WE DON'T
DOCUMENT LINEN CHANGES.

SO WASH YOUR HANDS AND DOCUMENT.

AND THERE ENDS THE TIME CLOCK.

FO EVEY MINUTE LESS
THAN 11 MINUTES,

YOU GET AN ADDITIONAL POINT
ADDED TO YOUR SCORE.

I DON'T MEAN JUST 99, 98, I MEAN
A FULL POINT OF THE 18 OR 19

OR WHATEVER SO YOU GET MAYBE
2 OR 3 PERCENTAGE POINTS
PER POINT.

AND FOR EVERY MINUTE
MORE THAN 11,

YOU GET POINTS TAKEN OFF.
SO YOU WANT TO KEEP MOVING.

YOU DON'T HAVE TO EXPLAIN HOW
IT'S FOLDED AND SEAMED,
I'LL SEE IT.

LIKE I SAID, I DON'T NEED
TO WATCH THE WHOLE THING,

I JUST NEED TO LOOK
AT THE END PRODUCT.

AND I CAN TELL THAT THERE'S
NO WRINKLES, THAT THE --

PULL SHEET'S ON, THAT THERE'S
NO SEAMS AGAINST CLIENT,

THAT YOU GOT A CUFF,
THAT YOU GOT A TOE PLEAT,

THAT YOU HAVE BEAUTIFUL MITERS
AND THAT YOUR SHEETS
ARE STAYING ON.

AN AFTER THIS PLACE ON YOUR
BED IS THAT WHEN YOU TUCK,

SOMETIMES WHEN YOU LIFT THE BED,
THE SHEETS WILL COME OUT
DOWN HERE.

SO ALL I HAVE TO DO
IS LIFT AND GO.

IT'S ALL UNDONE.

SO TAKE A LOOK UNDERNEATH AND
MAKE SURE THAT YOUR BED'S
GOING

TO STAY TOGETHER
WHEN IT'S ALL SET.

ALRIGHT,
ARE YOU HOLDING UP OKAY?

SOME OF YOU ARE GETTING
A LITTLE NAUGHTY,
I CAN SEE YOU ALL.

I DON'T KNOW HOW YOU
CAN BE BORED WITH IT.

WHY DON'T YOU TURN YOUR DESK.
STAND AND STRETCH
LIKE 2 MINUTES.