OKAY. JUST FEW THINGS.
YESTERDAY YOU GUYS DID GREAT JOB
AND THAT'S HOW THE LAB RUNS.

YOU COME IN EARLY,
YOU GET YOURSELF SETTLED
OVER HERE IN 182

AND THEN WE CALL YOU IN
AND YOU DO YOUR THING IN 179.

AND IT'S JUST AS SIMPLE AS THAT.
THERE IS NOT A LOT OF CHIT-CHAT.

WE JUST SEND YOU TO A STATION,
SHOW US WHAT YOU KNOW
AND THEN WE MOVE YOU ON.

WE'RE REALLY HELD
TO A TIGHT SCHEDULE

COS WE GOT TO MOVE
EVERYBODY EVERY 30 MINUTES.

AND YOU'LL SEE THE DIFFERENCE
IN THE NEXT FEW WEEKS

BECAUSE WE'RE GOING TO
RUN A LOT OF DRILLS.

THIS WEEK WE'RE GOING
TO RUN THREE STATIONS,

NEXT WEEK WE'RE GOING TO RUN
FIVE STATIONS AND SO FORTH.

SO, I JUST WANT TO EMPHASIZE,
IT'S NOT THAT ANYTHING

IS PARTICULARLY HARD,
EXCEPT THERE IS SO MUCH OF IT.

AND THERE IS JUST A LOT OF STUFF
YOU'VE GOT TO KNOW AND A LOT OF
STUFF WE'VE GOT TO GIVE YOU FAST

AND WE WANT YOU TO BE
REALLY GOOD AT WHAT YOU DO
AND WHAT YOU KNOW.

SO, WE DO IT. IT'S ALL BEEN
TIME-TESTED AND WE KNOW
IT'S A DOABLE THING.

YOU CAN GET DONE IN 30 MINUTES
AND WE'LL MOVE YOU ALONG.

IF YOU ARE LATE OR
IF YOU TAKE LONGER THAN
30 MINUTES, IT'S YOUR LOSS.

WE DON'T TAKE ANYONE
AFTER 10 MINUTES AFTER
THEIR APPOINTMENT TIME.

AND WE DON'T TAKE YOU
PAST YOUR APPOINTMENT TIME.

SO WE MIGHT LET YOU GET
ONE OR TWO STATIONS DONE
IF YOU'RE LATE,

AND IF YOU'VE TAKING 40 MINUTES.
YOU DON'T TAKE 40 MINUTES.

WE SAY YOUR TIME'S UP.
YOU GOT TO MOVE ON.
THIS IS AN UNEXCUSED LATE.

BECAUSE PART OF THE DRILLING
IS THAT YOU KNOW WHAT TO DO
AND YOU DO IT.

WE KNOW HOW LONG
THESE THINGS TAKE,
NOT THAT LONG!

SO THEY SHOULD BE ABLE TO BE
DONE IN PLENTY, PLENTY OF TIME.

ALSO I JUST WANTED TO EMPHASIZE
THAT YOU PRACTICE AND YOU KNOW
IT AND YOU HAVE IT IN YOUR HEAD,

BUT SOMETIMES WHEN YOU TEST,
IT DOESN'T COME OUT.

YOU KNOW WHAT I MEAN?
IT'S NOT ALWAYS PERFECT,
BUT LIFE'S NOT PERFECT.

AND YOU WISHED YOU'D HAVE DONE
SOME THINGS OR YOU'D SAY,
"I WOULDN'T DO THAT."

BUT YOU ALREADY DID IT.
YOU KNOW? YOU'LL DROP AND YOU'LL
GO, "I WOULDN'T DO THAT."

WELL, YOU JUST DID.
I MEAN, WE ALL DROP,
WE ALL SPILL, WE ALL FORGET.

AND WE ALL...WE ALL DO
BECAUSE WE'RE PEOPLE.

WE'RE PEOPLE
TAKING CARE OF PEOPLE.

THIS IS PEOPLE THING,
IT'S NOT ROBOT THING.

AND GOT THIS LITTLE SAYING FROM
A STUDENT AT THE END OF LAST
SEMESTER AND LOVED I IT.

AND I THINK IT CAPTURES THE
ESSENCE OF WHAT THE LAB IS

AND WHAT WE'RE TRYING
TO ACCOMPLISH HERE.

AND IT GOES LIKE THIS, IT'S
TITLED, THE VALUE OF MISTAKES.

"A MASTER CARPENTER IS LOOKING
TO TAKE ON A YOUNG APPRENTICE

TO HELP HIM WITH
THE WORK IN HIS SHOP.

ONE ABLE YOUNG MAN
INQUIRES ABOUT THE POSITION.

THE MASTER CARPENTER
ASKS THE YOUNG STUDENT,

"TELL ME, WHAT MISTAKES
HAVE YOU MADE?"

"I'VE NEVER MADE
A SINGLE ERROR,"

THE CONFIDENT YOUNG STUDENT
REPLIES, CERTAIN THAT
THE JOB IS HIS.

THE MASTER CARPENTER
THEN RESPONDS,

"IN THAT CASE,
I WOULD NEVER HIRE YOU."

WHEN YOU MAKE A MISTAKE,
YOU WON'T KNOW HOW TO FIX IT."

ISN'T THAT THE TRUTH?

AND IF YOU EXPECT TO JUST BE
PERFECT AND THEN THE WORLD IS
GOING TO BE PERFECT FOR YOU,

OH, WRONG THINKING.

SO, WE WANT TO
ANTICIPATE RIGHT SKILLS
AND RIGHT ENVIRONMENT,

BUT THERE ARE GOING TO BE A LOT
OF THINGS ALONG THE WAY

THAT WE'RE GOING TO HAVE TO
ADAPT TO AND BE FLEXIBLE ABOUT.

AND SO, WE'RE GOING TO TEACH YOU
THE PUREST OF NURSING AND THE
BEST WAY TO DO IT HERE

AND THEN THE READING
AND THE RATIONALES

ARE GOING TO HELP YOU BE ABLE
TO BE A LITTLE MORE FLEXIBLE

AND TO BE DETERMINED
TO NOT CHANGE SOME THINGS.

SOME THINGS SHOULD NEVER CHANGE
AND SOME THINGS CAN

BECAUSE OF CLIENTS AND
ENVIRONMENTS AND PREFERENCE.

BUT SOME THINGS SHOULDN'T EVER,
AND THAT IS HAND WASHING
AND YOUR SAFETY.

AND SO THE FOCUS FOR
THIS WEEK IS SAFETY
AND BODY MECHANICS

AND THAT'S WHAT OUR
EMPHASIS WILL BE.

I AM MORE CONCERNED RIGHT NOW
ABOUT YOU BEING SAFE THAN I AM
ABOUT PATIENT CARE, IF YOU WILL.

BECAUSE IF YOU'RE NOT SAFE
AND IF YOU'RE NOT CARED FOR,

HOW CAN YOU TAKE CARE
OF THE PATIENTS?

SO, I WANT YOU TO BE SAFE AND
WE'RE GOING TO BE WORKING ON --

FOCUS THIS WEEK
IN PARTICULAR IS ON
YOUR BODY MECHANICS,

NOT SO MUCH PATIENT CARE,
ALTHOUGH, I'M GOING TO TEACH YOU

SOME SYSTEMS THINGS
RELATED TO PATIENT CARE.

ALRIGHT, JUST A FEW
OTHER THINGS I WANTED TO
EMPHASIZE AFTER YESTERDAY,

COS I THINK NOW MAYBE YOU'RE
READY TO HEAR A LITTLE
BIT MORE, YOU KNOW?

IT'S A LITTLE OVERWHELMING
THAT FIRST DAY WHEN YOU
JUST GET PAGES OF INFORMATION.

BUT I DO WANT TO EMPHASIZE
THAT WE DO RUN AHEAD
OF SCHEDULE SOMETIMES.

PROBABLY NOT FOR
THE NEXT 4 WEEKS,

BUT AFTER THAT WE'LL RUN 5
OR 10 MINUTES AHEAD OF SCHEDULE

BECAUSE THE DRILLS DON'T ALWAYS
TAKE UP THE WHOLE ENTIRE TIME.

SO THOSE OF YOU THAT ARE MORE
TOWARDS THE END OF THE DAY

BE SURE TO COME HALF AN HOUR
EARLY, 45 MINUTES EARLY

BECAUSE WE WOULD RATHER BE ON
TIME THAN BE WAITING AROUND.

THE ONLY REASON YOU'RE
IN AN APPOINTMENT SCHEDULE

IS 'CAUSE WE CAN'T DO EVERYONE
AT THE SAME TIME. WE HAD
TO SPREAD YOU OUT.

BUT WHEN WE'RE READY TO GO,
WE WANT TO KEEP MOVING YOU.

BECAUSE WHEN WE GET DONE
WITH YOUR CLASS,

THEN WE HAVE TO QUICK
CLEAN UP AND RESET UP FOR THE
NEXT CLASS IN ONE HOUR

AND GO TO LUNCH AND ALL
THAT STUFF, SO WE NEED
TO KEEP MOVING.

I WANTED TO TALK A LITTLE BIT
ABOUT THE CHECKLIST.

THE CHECKLIST IS
A GREAT TEACHING TOOL.

AGAIN, IT'S PERFECT NURSERY.
NURSING, IVORY TOWER NURSING.

BUT THE IDEA IS THAT IT'S
TEACHING YOU HOW TO DO IT, NOT
TEACHING YOU HOW TO MEMORIZE.

YOU KNOW HOW TO MEMORIZE,
YOU'RE SMART.

I THINK I MENTIONED THAT
THE FIRST WEEK, BUT I WANT
TO RE-EMPHASIZE IT.

IT'S NOT ABOUT COUNTING THE
NUMBERS, IT'S NOT ABOUT EACH
AND EVERY PERFECT LITTLE STEP,

IT'S ABOUT LEARNING WHAT
IT MEANS TO DO THE SKILL.

SOMETIMES -- MANY TIMES
YESTERDAY, PEOPLE DID THINGS
OUT OF SEQUENCE.

LIKE SO WHAT IF YOU PUT YOUR CAP
ON BEFORE YOU PUT YOUR GOWN

OR SO WHAT IF YOU TAKE
YOUR CAP OFF BEFORE --
SOME THINGS DON'T MATTER.

WHAT MATTERS IS THAT YOU DON'T
TAKE YOUR GLOVES, YOUR DIRTY
GLOVES UP TO YOUR FACE.

THAT MATTERS.
THAT'S BIG.

AND SO SEQUENCE -- WE DIDN'T
PUT ALL THE VARIABLES
IN THE CHECKLIST,

WE HAD TO GET EVERYTHING
DOWN AND SOMETHING HAD TO
GO FIRST, SOMETIMES.

BUT SOMETIMES SEQUENCE IS
CRITICAL. SO, I WANT YOU
TO APPRECIATE THAT.

AND IT'S TO HELP YOU CREATE
A RIGHT PICTURE IN YOUR MIND

TO DO THE RIGHT THING,
NOT JUST MEMORIZE IT.

WHICH MAKES ME WANT TO SAY,
"I'M NOT GOING TO BE PERFECT
EVERY WEEK. I WISH WERE."

BUT I'M NOT.
AND I MAY FORGET A STEP.

I MAY SAY SOMETHING WRONG JUST
BECAUSE I AM A PERSON,

AND SOMETHING MAY JUST COME OUT
THAT'S JUST WRONG

THAT I DON'T EVEN KNOW ABOUT
TILL A DAY LATER ON
AND I GO, "I SAID THAT?"

I DON'T EVEN KNOW
WHERE IT CAME FROM.

SO, I NEED TO SAY THAT SO THAT
YOU APPRECIATE THAT EVEN THOUGH
I MAY LEAVE A STEP OUT

OR I MAY SAY SOMETHING WRONG,
THAT YOUR CHECKLIST IS WHAT
YOU'RE GOING TO BE GRADED BY.

SO BE ACCOUNTABLE TO THE
CHECKLIST, BE ACCOUNTABLE
TO YOUR TEXTBOOK.

AND IF I'VE SAID
SOMETHING WACKO --

I HAVEN'T DONE THAT FOR QUITE
A WHILE, BUT I STILL MAY.

THEN COME SAY SOMETHING TO ME.
BUT THAT MEANS, "OH GOOD,
THEY'RE READING THEIR BOOK

AND THEY'VE CHECKED THEIR
CHECKLIST AND THEY'RE NOT
JUST MEMORIZING ME."

YOU KNOW WHAT
I AM SAYING? OKAY.

ONE OF THE THINGS WE WANT
YOU TO DO AFTER YOU TEST,

AS SOON AS YOU TEST,
TO LEAVE THE ROOM.

WE DON'T WANT YOU SITTING
AROUND STARING AT EACH OTHER.

WE JUST HATE THAT AND YOU HATE
BEING STARED AT AND ALL OF THAT.

SO JUST DO YOUR THING AT YOUR
STATION, MOVE ON AND GO AND WAIT
FOR THEM IN THE NEXT ROOM.

WE ALSO DON'T WANT YOU TO TALK
TO US DURING TESTING.

LIKE, -- I MEAN, YOU CAN SAY,
"HOW WAS MY GRADE?" AND "HI, HOW
ARE YOU?" THAT KIND OF THING.

BUT WHAT I MEAN IS COME IN AND
SAY. "CAN I CHECK OUT A BOOK?"

"CAN I TALK TO YOU
ABOUT MY GRADE?" AND THIS,
THAT AND THE OTHER THING.

'CAUSE WE DON'T HAVE TIME TO
REALLY TALK DURING TESTING DAYS

'CAUSE WE'RE WATCHING
TWO PEOPLE AND WE'RE
TRYING TO DO LOT OF STUFF.

SO, E-MAIL US. SEE US, YOU KNOW,
ANY TIME, MONDAY, WEDNESDAY,
FRIDAY, WE'RE JUST SO FREE,

BUT NOT ON TUESDAYS AND
THURSDAYS, CAN WE SETTLE
A LOT OF PROBLEMS.

WHEN YOU'RE TESTING, WE JUST
ALSO WANT YOU TO APPRECIATE

THAT EACH STATION IS A NEW
PATIENT AND A NEW EXPERIENCE.

SO EVERY TIME YOU GO
TO A DIFFERENT STATION,
YOU'RE GOING TO NEED TO SAY,

"I WASHED MY HANDS.
I PROVIDED PRIVACY."

YOU'RE GOING TO DO THE SAME
THINGS AT EACH STATION.

AND DON'T ASSUME
'CAUSE I DID IT OVER HERE,
IT'S A DONE DEAL OVER HERE.

IT'S NOT, BECAUSE YOU WOULD
WASH YOUR HANDS FOR EVERY
CLIENT YOU TOUCH.

YOU'RE GOING TO DO CERTAIN CARE
THINGS FOR EVERY SITUATION.

SO YOU HAVE TO DO IT
AND YOU HAVE TO SAY IT.

AND THE LAST THING
TO REMIND YOU,

NO PRACTICING ON TUESDAYS
AND THURSDAYS IN HERE
AS FAR AS SKILLS,

BUT YOU CAN DO THE COMPUTERS,
THE VIDEOS AND THAT
SORT OF THING,

BUT WE JUST DON'T
HAVE THE SPACE.

ALL RIGHT. ANYTHING? ANY
QUESTIONS? ANY COMMENTS? ANY?

ALL RIGHT, I THINK
WE'RE GOOD TO GO.

I WANT TO DO THE DEMO TODAY
OF THE THREE SKILLS AND THEN
AFTERWARDS CONNIE AND I ARE --

DEPENDING ON THE TIME.
I HAVE A DOCTOR
APPOINTMENT TODAY.

SO, DEPENDING ON HOW WE'RE
DOING, ONE OF US OR BOTH OF US

WILL TAKE YOU ON QUICK LITTLE
TOUR AND SHOW YOU WHERE SOME
MORE SPECIFIC THINGS ARE.

BOOKS FOR CHECK OUT,
BOOKS THAT ARE IN RESERVE,

WHERE SOME THINGS ARE
TO HELP YOU JUST KNOW
YOUR WAY AROUND LITTLE BETTER.

SO, YOU MADE IT HERE
AND THAT'S GOOD.

YOU KNEW RIGHT WHERE TO COME.
YOU WENT THROUGH THE RIGHT DOOR.

WE'RE GETTING THERE,
SO IN A WEEK OR SO
YOU'LL BE JUST GOOD TO GO.

I DID WANT TO MENTION
AGAIN ABOUT PRACTICE.

COME IN AND PRACTICE
AND IT'S GREAT IF YOU CAN
COME IN IN GROUPS.

AFTER CLASS IS A GREAT TIME
TO PRACTICE 'CAUSE EVERYONE
IS HERE

AND IT'S A GOOD TIME
TO WORK WITH EACH OTHER.

AND THIS WEEK IN PARTICULAR,
I AM GOING TO PUT YOU
IN YOUR GROUPS.

SO YOUR TIMETABLE,
YOUR TIME GROUPS ARE GOING TO
HAVE TO DO AN ACTIVITY TOGETHER.

SO, BECAUSE OF THAT,
I AM GOING TO HAVE YOU
GO AROUND THE ROOM TODAY,

AND AGAIN, I NEVER TAKE ROLL,
BUT I AM GOING TO, KIND OF,
TODAY.

AND WHAT I WANT YOU TO DO
IS AS WE JUST GO AROUND,

I WANT YOU TO SAY WHAT TIME
YOUR -- YOUR NAME,

WHAT TIME YOUR APPOINTMENT'S AT
AND THEN JUST TELL US
SOMETHING ABOUT YOU.

I KNOW YOU DID IT FOR LOUISE
BECAUSE SHE LOVES THAT.

SO NOW YOU HAVE TO TELL US
SOMETHING DIFFERENT.

ANYTHING, I DON'T EVEN CARE,
JUST SOMETHING -- WELL, YOU
DON'T AIR YOUR DIRTY LAUNDRY,

BUT MAYBE WHY YOU WANT TO BE
A NURSE? WHAT YOU'RE DOING NOW?
HOW MANY KIDS YOU HAVE?

JUST SOMETHING THAT HELPS US
KNOW A LITTLE BIT ABOUT YOU.

SO WE WILL START OVER HERE
AND LET'S START.

- I'M SANDRA PIERCE AND I...

- THE FOCUS IS BODY MECHANICS,
BODY SAFETY.

SO WHAT WE WANT TO EMPHASIZE
TO YOU AND WHAT WE'LL BE
WATCHING FOR AS INSTRUCTORS

IS HOW THAT YOU'RE MANAGING
YOUR BODY WHEN YOU'RE DOING
THE CARE YOU'RE GOING TO GIVE.

YOU'RE GOING TO BE
PULLING UP PATIENTS BY YOURSELF
AND TURNING THAT CLIENT,

SO YOU CAN PRACTICE GOOD
BODY MECHANICS FOR THAT CLIENT.

THEN YOU'RE GOING TO BE
TRANSFERRING A CLIENT
THAT CAN WALK,

BUT IT'S NOT GOING TO HELP YOU
TONS, TONS AS STUDENTS,

SO YOU'RE GOING TO BE
WORKING TOGETHER

AND TRANSFERRING A STUDENT
FROM A BED TO A WHEELCHAIR.

AND THEN YOU'RE GOING TO
BE TRANSFERRING A CLIENT
FROM A BED TO A GURNEY.

AND THAT'S WHAT YOU NEED
TO DO IN A GROUP.

SO, THREE ACTIVITIES
THAT HAVE TO DO WITH

LIFTING, PULLING, PUSHING,
UPS, DOWNS THAT KIND OF THING.

SO WE WILL TEACH YOU
SOME INFORMATION RELATED
TO PATIENT SAFETY,

BUT AGAIN, THE FOCUS
IS REALLY YOUR SAFETY.

SO WHAT WE'RE WATCHING FOR IS
HOW YOU'RE HANDLING YOUR BODY.

YOU SHOULD BE HAVING
A STRAIGHT BODY.
GOOD, NICE STRAIGHT BACK.

YOU SHOULD BE DOING
YOUR WORK FROM YOUR THIGHS.

SO WE SHOULD SEE YOU MOVING
LIKE THIS AND NOT LIKE THIS.

A BIG HUGE DIFFERENCE
IN WHAT YOU'RE DOING
WHEN YOU HANDLE A CLIENT.

YOU WANT TO USE THOSE SAME
BODY MECHANICS FOR LOADS
THAT YOU MIGHT CARRY.

SO IF YOU HAVE TO
CARRY SOMETHING,

YOU WANT TO CARRY SOMETHING
CLOSE TO YOUR CENTER OF GRAVITY
AND CLOSE TO YOU.

NOT OUT HERE.
NOT WHERE YOU HAVE TO BEND

AND YOU'RE CARRYING THE WEIGHT
BETWEEN YOUR SHOULDER BLADES OR
IN THE SMALL OF YOUR BACK.

WELL, THERE IS NOT MUCH
THAT WE CAN CARRY
THAT DOESN'T MAKE US LEAN.

SO WHENEVER POSSIBLE,
PUT IT ON SOMETHING THAT ROLLS.

ON A CART, ON A TABLE,
LIKE THIS,

SO THAT YOU'RE NOT, AGAIN,
STRAINING YOUR BACK.

I PUT A WONDERFUL ARTICLE,
ACTUALLY TWO WONDERFUL
ARTICLES IN YOUR SYLLABUS.

ONE IS ABOUT THE
MYTHS OF INJURIES

AND ONE IS ABOUT SOME EQUIPMENT
AND BETTER WAYS TO HANDLE
SOME OF THE EQUIPMENT.

BOTH ARTICLES CONFIRM THAT FOR
NURSING, THE NUMBER ONE INJURY,

INTERNATIONALLY, NOT JUST
HERE IN THE UNITED STATES,
BUT AROUND THE WORLD.

YEAH, THAT WILL
BE INTERNATIONALLY,
IS BACK INJURIES.

- WHAT?

- BACK INJURIES.
TO THIS DAY AND IT'S ALWAYS
BEEN OUR NUMBER ONE INJURY.

SO THEY'VE BEEN DOING RESEARCH
ON WHAT'S THE DEAL WITH THAT.

AND PART OF IT IS THEY'VE
COME TO APPRECIATE THAT
EDUCATION ISN'T ENOUGH.

SO I CAN STAND UP HERE
AND I CAN TALK TO YOU,
BUT IT'S NOT ENOUGH.

AND THEY CAN GIVE YOU RIGHT
EQUIPMENT, BUT IT'S NOT ENOUGH.

WHAT THEY WANT YOU TO
APPRECIATE, WHAT I WANT
YOU TO APPRECIATE

IS YOU NEED TO KNOW HOW TO
USE THE EQUIPMENT CORRECTLY,

YOU NEED TO KNOW WHAT EQUIPMENT
BEST WORKS FOR YOUR CLIENT
IN A CERTAIN SITUATION

AND YOU NEED TO MAINTAIN
RIGHT BACK CARE FOR YOURSELF.

THE NUMBER ONE THING THAT
WE DO WRONG IS WE DON'T
GET ENOUGH HELP.

WE TEND TO JUST DO IT OURSELVES.
"OH, PEOPLE ARE BUSY!
OH, I CAN DO IT!"

AND WE HURT OURSELVES MOVING
AND MANIPULATING CLIENTS.

I WANT YOU TO HEAR THAT
STRAIGHT OUT OF THE GATE AS
NURSING STUDENTS, GET HELP.

THINGS CAN WAIT,
THEY CAN WAIT FIVE OR TEN
MINUTES FOR THE MOST PART.

SO THAT YOU CAN GET
THE HELP THAT YOU NEED.

AND SOME PEOPLE JUST NEED
MORE HELP IN MANAGING THEM,

AND WE NEED TO SUPPORT
EACH OTHER IN THAT.

SO, GET ENOUGH HELP
TO DO THE CARE.

ALRIGHT, THE FIRST THING
I WANT TO DO TODAY,

KEEPING IN MIND SOME OF THESE
BODY MECHANICS ISSUES,

I'M GOING TO BE KEEPING
A STRAIGHT BACK.

I'M ALSO GOING TO BE KEEPING
A WIDE BASE OF SUPPORT.

I'M NOT GOING TO HAVE MY LEGS
TOGETHER BECAUSE THEN I'M AT
RISK OF TILTING AND FALLING.

SO A GOOD WIDE BASE OF SUPPORT,
A LITTLE BIT WIDER THAN
MY SHOULDERS,

BENDING AT THE KNEES AND NOT
SO MUCH LEANING LIKE THIS,

KEEPING THAT GOOD
STRAIGHT BALANCE.

SO, WHEN WE DO THAT WITH
OUR CLIENT, BE WATCHING
FOR THOSE THINGS.

I AM GOING TO WORK ON
BOTH SIDES OF THE BED TODAY,
SO YOU'LL BE ABLE TO SEE GOOD.

SOMETHING'S BETTER ON YOUR SIDE
AND THEN SOMETHING'S BETTER
OVER HERE.

ONE OF THE STATIONS YOU'RE GOING
TO COME, BEDS ONE AND TWO.

YOUR CLIENT IS
FALLING OUT OF BED.

AND SO YOU'RE GOING TO
COME TO YOUR CLIENT

AND REALIZE THAT THIS CLIENT
NEEDS TO BE PULLED UP

AND BECAUSE YOU'RE
AN EFFICIENT NURSE,

AND WE ARE EFFICIENT.
WE'RE GOING TO GO AHEAD
AND TURN OUR CLIENT.

CLIENTS NEED TO BE
REPOSITIONED AND TURNED
EVERY TWO HOURS MINIMALLY,

IF THEY CAN'T DO
IT FOR THEMSELVES.

WE NEED TO PREVENT
PRESSURE SORES FOR THEM
SO WE NEED TO TURN THEM.

I COULD'VE CREATED A CHECKLIST
THAT JUST SAID, "PULL HIM UP."

AND I COULD HAVE
CREATED A CHECKLIST

THAT SAYS, "JUST TURN."
BECAUSE SOMETIMES YOU ARE.

YOU'RE JUST GOING TO PULL HIM UP
TO GET HIM READY FOR A MEAL,

TO GET HIM READY FOR
A BATH OR WHATEVER.

AND THEY JUST WANT TO BE ON
THEIR BACK FOR A WHILE.

OR THE CLIENT IS IN THE PERFECT
POSITION FOR A TURN AND
YOU JUST TURN HIM.

BUT WE'RE GOING TO DO
TWO THINGS IN ONE

AND APPRECIATE WHAT THAT MEANS
AND THAT'S WHAT YOU HAD TO DO.

SO, I WANTED TO INTRODUCE THE
CONCEPT OF HIGH FIVE TODAY,

FOR THE REST OF THE SEMESTER
YOU'RE GOING TO BE DOING

WHAT WE LOVINGLY REFER
TO AS THE HIGH FIVE.

EVERY CLIENT HAS FIVE THINGS
THAT WE'RE GOING TO DO
BEFORE WE EVER REALLY --

WE'RE GOING TO DO BEFORE WE EVER
REALLY LAY HANDS ON THAT CLIENT.

AND THAT IS WE'RE GOING TO
CHECK THE DOCTOR'S ORDERS
AND OR THE NURSING CARE PLAN,

AS TO WHAT IS THE BEST CARE
TO GIVE THIS CLIENT.

NOW THE DOCTOR'S NOT GOING TO
WRITE IN A DOCTOR'S ORDER,

"PULL THE CLIENT UP EVERY
TIME THEY SLIDE OUT OF BED,
AND TURN THEM EVERY TWO HOURS."

BUT THE DOCTOR IS GOING TO
WRITE AN ACTIVITY ORDER,
IN THE DOCTOR'S ORDER.

SO WHEN YOU START LOOKING
AT CHARTS FOR WHERE IS
THAT ACTIVITY ORDER,

AND THEY WILL WRITE,
IS THE CLIENT AMBULATORY?

AND THEY MAY JUST
SAY UP AD-LIB.

IF I WENT INTO THE HOSPITAL
TODAY FOR SOMETHING

THEY'D JUST SAY UP AD-LIB.

I DON'T HAVE ANY ISSUES
GOING ON AND I'M MOBILE,

MAYBE I JUST NEED AN
ANTIBIOTIC OR SOMETHING.

SO LET HER GET UP
AND GO MOVE AROUND.

BUT IF SOMEONE IS WEAK,
MAYBE THEY'VE HAD A STROKE,

MAYBE THEY'VE HAD A TEST,
THEY MAY SAY BED REST,

THEY MAY SAY BATHROOM
PRIVILEGES ONLY,

OR SOMETHING THAT GIVES YOU A
CLUE THAT THEY'RE LESS MOBILE
THAN THE AVERAGE PERSON.

SO THAT'S WHERE YOU ARE
GOING TO GET A CLUE AS TO
THEIR ACTIVITY LEVEL.

BUT THE NURSING CARE PLAN,
WHICH IS ANOTHER SHEET OF PAPER
INCLUDED IN THE CHARTS

SHOULD TELL YOU WHAT WE'RE
REALLY GOING TO DO WITH THEM.

AND IT'S GOING TO SAY,
"TURN CLIENT EVERY 2 HOURS.

GET FOUR PEOPLE,
USE A HOYER LIFT."

IT'S GOING TO GIVE
YOU INFORMATION TO
HELP YOU BE SAFE.

AND IF IT'S NOT ON THERE
THEN YOU GET IT ON THERE.

SOMEBODY SHOULD COMMUNICATE
WITH THE REST OF THE STAFF

WHAT'S GOING ON AND WHAT ARE
THE NEEDS OF THIS CLIENT.

SO YOU'RE GOING TO CHECK
THE DOCTOR'S ORDERS,
THE CARE PLANS.

YOU'RE GOING TO GATHER UP
THE APPROPRIATE EQUIPMENT FOR
THE ACTIVITY THAT YOU NEED.

THERE'S NO SENSE GOING IN
AND DOING A BUNCH OF STUFF

AND HAVING TO GO BACK AND FORTH.
WE WANT TO BE EFFICIENT.

SO I AM ALREADY ANTICIPATING,
IT'S TWO HOURS, IT'S TIME
TO TURN THAT CLIENT.

I'M GOING TO MAKE SURE
I HAVE TWO PILLOWS READY

BECAUSE I NEED TO
PROP MY CLIENT UP.

THEY MAY NEED MORE PILLOWS,
BUT I'M PRETTY CONFIDENT

TWO WILL BE ADEQUATE
FOR MY ACTIVITY TODAY.

I'M GOING TO WASH MY HANDS
AND THEN I AM GOING TO
GO IN TO SEE MY CLIENT,

IDENTIFY MY CLIENT
AND PROVIDE PRIVACY.

I'M GOING TO COME IN.

GOOD MORNING, MR. SPADE,
HOW ARE YOU DOING TODAY?

YOU ARE SLIDING OUT OF THIS BED.
ARE YOU JUST MISERABLE?

WHY DON'T WE GET
YOU PULLED UP?

YOU CAN HELP ME CATCHING,
PULL YOURSELF UP A LITTLE BIT
IN THE BED,

AND THEN WE WILL GO AHEAD
AND TURN YOU.

YOU WANT TO TURN THAT WAY
TO WATCH YOUR SOAP OPERA
THIS MORNING, GREAT?

OKAY, WE'LL TURN THAT WAY
AND THAT WILL BE OUR PLAN.
SO, TALK TO THEM.

GET SOME INFORMATION ABOUT,
YOU KNOW, HOW THEY'RE FEELING
AND SO FORTH.

OKAY, I ALSO WANT YOU TO GET IN
THE HABIT OF JUST, KIND OF,

GOING LIKE THIS WHEN YOU SAY,
"I'M GOING TO PROVIDE PRIVACY."

GIVE ME A GESTURE THAT YOU'RE
REALLY GOING TO DO IT.

AND WHAT I AM DOING IS
I AM PULLING THE CURTAIN.

BUT I DON'T REALLY WANT YOU TO
PULL THE CURTAINS COS THEN I
COULDN'T SEE WHAT YOU'RE DOING.

BUT I WANT YOU TO APPRECIATE
THAT YOU'VE GOT TO PROVIDE
PRIVACY.

THERE'S TWO REASONS
THAT YOU'VE GOT TO.

ONE, YOU WON'T GET ENOUGH POINTS
IN YOUR CLINICAL ENVIRONMENT.

THEY'LL TAKE OFF POINTS
FOR THE DAY IF YOU'RE
NOT PROVIDING PRIVACY.

AND THE REASON THAT
IT'S EMPHASIZED IS

BECAUSE IF JOINT COMMISSION CAME
THROUGH OR OSHA CAME THROUGH

AND THEY SAW THAT
THE CLIENT WAS EXPOSED,
THEY'LL FINE THEM $10,000.

BECAUSE YOU'RE NOT PROVIDING
PRIVACY AND THEY'RE EXPOSED.

IT'S A BASIC HUMAN
CONSIDERATION.

WOULD YOU WANT TO BE EXPOSED
IN YOUR, YOU KNOW? NO.

SO WE WANT TO PROVIDE
PRIVACY WHENEVER POSSIBLE.

SO HIGH FIVE. THE MINIMUM THINGS
WE DO EVERY SINGLE TIME
WE SEE A CLIENT.

YOU DON'T REALLY HAVE TO WASH
YOUR HANDS TO DO MANNEQUIN CARE.

I MEAN, I'D LOVE YOU TO WASH
YOUR HANDS AS SOON

AS YOU COME IN THE LAB AND THEN
YOU'RE RELATIVELY CLEAN.

BUT WE'RE AT THIS POINT
JUST GOING TO SAY IT,

I'VE ALREADY CHECKED YOU OFF
ON HAND WASHING.

ALRIGHT. I'VE IDENTIFIED
MY CLIENT, I HAVE MY PILLOWS
HERE WITHIN REACH,

BUT I'M GOING TO GO TO
THIS SIDE OF THE BED

BECAUSE WHAT I WANT TO DO,
IS I WANT TO PULL HIM UP,
TURN HIM THAT WAY

AND IT WILL BE EASIER FOR ME
TO ACCOMPLISH ALL OF THAT
FROM THIS SIDE OF THE BED.

KEEPING IN MIND GOOD BODY
MECHANICS, THE FIRST THING
I WANT TO DO IS I WANT TO

ELEVATE THIS BED TO A HEIGHT
THAT KEEPS ME FROM HAVING
TO BEND TO GET HIM.

I WANT HIM UP HERE LIKE THIS SO
I'M NEVER HARDLY MOVING AT ALL.

TO DO THAT, ON BOTH SIDES OF
THE BED, ON THE OUTSIDE
OF THE HAND RAIL,

IS A BUTTON THAT
MOVES THE BEDS UP.

AND SO YOU GUYS JUST FAMILIARIZE
YOURSELF WITH THE BEDS
WHEN YOU GO TO PRACTICE.

AND I AM GOING TO
ELEVATE THIS BED TO
THE TOP OF MY HIP.

IT'S NOT HIGH ENOUGH TILL
YOU GET IT TO YOUR HIP.

I MIGHT HAVE --
DID I ASTERISK THAT?

- YEAH.
- YES. IT'S THAT IMPORTANT.

I WANT THE BEDS HIGH COS PEOPLE
USED TO SAY COMFORTABLE HEIGHT,

PEOPLE DIDN'T KNOW WHAT
WAS COMFORTABLE AND I DID.

THEY WERE BENDING TOO MUCH.
SO YOU GOT TO GET IT UP
HIGH HERE TO YOUR HIPS.

SOME OF YOU ARE REALLY TALL
AND THE BEDS GO ONLY
AS HIGH AS THEY GO.

TO THE TOP THEY GO,
AND YOU'RE JUST GOING TO HAVE

TO MAKE A WIDER BASE OF SUPPORT
SO THAT YOU HAVE LESS BEND.

OKAY, THE NEXT THING
THAT I WANT TO DO,

KEEPING IN MIND THAT MY CLIENT
IS GOING TO BE PULLED UP

IS THAT I DON'T WANT TO
WORK AGAINST GRAVITY.

THE HEAD OF THE BED IS UP
AND THAT'S PROBABLY WHY
HE SLID DOWN SO QUICKLY.

SO I WANT TO PUT THE
HEAD OF THE BED FLAT,

SO THAT I'M NOT HAVING
TO PULL HIM UPHILL.

SO INSIDE YOUR HAND RAILS
HERE, IS THE HEAD UP AND DOWN
AND A FOOT UP AND DOWN.

IT'S ON BOTH SIDES
AND WE'RE GOING TO GO AHEAD
AND PUT THE HEAD DOWN.

I'M GOING TO PUT THE HEAD DOWN
SO THAT WE CAN PULL YOU
UP A LITTLE EASIER.

AND I AM GOING TO MOVE THE
PILLOW TO THE TOP OF THE BED.

SO THAT IF I WAS REALLY STRONG,
I'M NOT, BUT IF I WAS,

I WOULDN'T WHACK HIM
INTO THE HEADBOARD.

OKAY. THE OTHER THING
THAT'S GOING TO HELP ME

IS, THIS ISN'T GOOD BODY
MECHANICS EITHER, RIGHT?

SO I NEED TO GET THIS
SIDE RAIL OUT OF THE WAY,

TO WORK THE SIDE RAILS,
AND YOU WILL SEE ME DO
THEM ON THE OTHER SIDE,

BUT YOU GUYS CAN,
KIND OF, SEE OVER HERE.

I'M GOING TO PUSH THE BUTTON
AND, KIND OF, JIGGLE IT
AND IT GOES ALL THE WAY DOWN.

AND IT -- SOMETIMES IT STICKS AT
THIS MID-SECTION. OF COURSE, IT
WON'T DO IT WHEN I NEED TO,

BUT IF IT DOES JUST HIT
THE BUTTON AND WIGGLE IT
ALL THE WAY DOWN

COS THEN IT WILL RECESS
UNDERNEATH THE BED, AND
BE TOTALLY OUT OF YOUR WAY.

AND THAT'S AN IMPORTANT
THING TO KNOW ESPECIALLY
WHEN YOU'RE MAKING BEDS

COS YOU WANT THAT SIDE RAIL
OUT OF YOUR WAY.

ALRIGHT.

BOY.

I'M GOING TO PROVIDE PRIVACY
AND CAN YOU APPRECIATE --
HE IS A MESS.

THIS GOWN'S UP AROUND HIS WAIST
AND IT WOULD BE BECAUSE
OF HOW HE SLID DOWN.

SO, I AS UNCOVER HIM AND EXPOSE
HIM A LITTLE BIT HERE,

I'M GOING TO MAKE SURE
THAT HE'S COVERED.

YOUR SHEET SAYS
TO FANFOLD THE LINEN.

AND WHAT THAT MEANS IS YOU, KIND
OF, MAKE A FAN BACK AND FORTH.

AND THE POINT IS, IT DOESN'T
HAVE TO BE BEAUTIFUL AND
PERFECT,

IT'S THAT THE TOP OF THE SHEET
IS AT THE TOP OF THE PILE

SO THAT YOU CAN EASILY GET IT
TO PULL IT UP FOR YOURSELF.

MR. SPADE, COULD YOU BEND
YOUR KNEES FOR ME?

WE NEED TO GET YOU OFF OF
THE FOOTBOARD COS YOU'RE,
KIND OF, STUCK HERE.

SEE, HE'S OVER THE FOOT OF
THE BED AND HE'S HANGING OFF

SO IF YOU COULD JUST BEND YOUR
KNEES THAT WOULD BE GREAT.

NOW, THIS ONE HAS FOLEY CATHETER
AND YOUR PULL-UP CLIENTS WON'T.

SO I'M JUST IGNORING
IT FOR THIS ONE,

I WILL TALK ABOUT IT
FOR YOUR GURNEY ONE.

SO IGNORE THAT TUBING
FOR THE MOMENT.

OKAY. OH! THERE YOU GO.
CAN YOU BEND THAT?

THERE. PRIVACY.
[LAUGHTER]

YOU GUYS HAVE QUITE THE DEAL.
AND BE THINKING ABOUT THAT
BECAUSE THAT'S THE SAME VIEW

I HAVE WHEN I AM WATCHING YOU,
AND I DON'T WANT TO
BE THINKING...

ALRIGHT. THERE YOU GO.

OKAY. HOW IS THAT? GOOD.

THE MANNEQUINS WEIGH
35 TO 40 POUNDS.
THEY'RE ALL ELECTRONIC.

WE'LL DO SOME THINGS
WITH THE ELECTRONICS

A LITTLE MORE TOWARDS
THE MIDDLE OF THE SEMESTER,

BUT THAT'S ABOUT,
HOW MUCH THEY WEIGH.

SO WHEN YOU'RE THINKING ABOUT A
MANNEQUIN VERSUS A REAL CLIENT,
TOTALLY DIFFERENT.

IF YOU WERE TO INJURE YOUR BACK
AND YOU WENT TO WHATEVER,
EMPLOYEE HEALTH,

THEY WOULD MAKE SURE
THAT YOU HAD NO PAIN WITH
LIFTING UP 50 POUNDS.

SO IT'S PRETTY CLOSE TO THIS.

THEY WANT YOU TO BE SAFE
AND COMFORTABLE WITH ABOUT
THIS MUCH WEIGHT.

ALRIGHT. I TOLD YOU WE WANT TO
STAY LIKE THIS, RIGHT?
AND NOT LIKE THIS.

SO IF I'M MOVING HIM IN
THE MIDDLE OF THE BED,

I'M STILL BENDING MORE THAN
I REALLY SHOULD BE BENDING.

SO WHAT I'D LIKE TO DO
IS MOVE HIM CLOSER TO
MY CENTER OF GRAVITY.

AND TO DO THAT, I'M JUST
GOING TO SLIDE MY HANDS
UNDERNEATH HIS SHOULDERS.

GOOD, WIDE BASE OF SUPPORT.
SHOULD WATCH YOUR BACK HERE.

AND MR. SPADE -- I'M USED
TO HIM BEING MR. SMITH,

AND WE CHANGED THE MANNEQUIN.

MR. SPADE, I'M GOING TO MOVE YOU
A LITTLE CLOSER TO ME

BEFORE WE MOVE TO THE TOP
OF THE BED, OKAY?

SO, ON THE COUNT OF THREE I'M
JUST GOING TO SLIDE YOU OVER.

SO, I'M GOING TO MOVE,
ONE, TWO, THREE.

THE TOP SECTION CLOSE TO ME,

AND BECAUSE HE HAS THE CATHETER
WHICH WE'RE REALLY NOT
PAYING ATTENTION TO,

I WOULD CHECK UNDER...
BEFORE I...

[LAUGHTER]

OKAY. ON THE COUNT THERE, I'M
GOING TO MOVE YOUR HIPS CLOSER.

ONE, TWO, THREE,
AND THEN THE LEGS ALSO.

ALRIGHT, NOW WHAT I WANT TO DO
IS HAVE YOU HELP ME PULL YOU
TO THE TOP OF THE BED.

SO IF YOU COULD PUT YOUR
CHIN TO YOUR CHEST,

AND CROSS YOUR HANDS
OVER YOUR CHEST,

AND THEN PUT YOUR HEEL OF
YOUR FEET DOWN

AND THEN PUSH WITH YOUR FEET
AND THEN I'LL PULL YOUR
BODY UP TO THE TOP.

IN YOUR BOOKS AND ON THE VIDEOS
THEY TALK ABOUT GRABBING
THE CLIENT LIKE THIS,

ALL THE WAY TO THE THIGHS
AND ALL THE WAY UNDER.

I HAVE ABSOLUTELY NO STRENGTH.
SEE HOW FAR I'VE DEPARTED
FROM MY CENTER OF GRAVITY?

AND WHEN I TRIED THAT,
MY CLIENT MOVES ABOUT HALF
AN INCH, MAYBE A QUARTER.

I MEAN, THERE IS,
LIKE, NO MOVEMENT.

SO I FOUND THAT IF I COULD GET
TO THE CENTER OF MY GRAVITY

AND TO HIS HEAVIEST WEIGHT PLACE
WHICH IS THE TORSO,

I GOT MUCH BETTER PROGRESS
TOWARDS THE TOP OF THE BED.

SO, I GO UNDER THE SMALL
OF THE BACK SO I CAN LIFT

AT THE BUTTOCKS AND I GO
UNDER THE SHOULDERS.

YOU COULD PROBABLY STAY UNDER
THE BED. GOOD, WIDE BASE
OF SUPPORT.

MY THIS FOOT IS POINTING
TOWARDS THE WALL.

THIS FOOT IS, KIND OF, STRAIGHT.

SO THAT WHEN I ROCK,
I ROCK TOWARDS MY FOOT.

ON THE COUNT OF THREE, WOULD
YOU PUSH WITH YOUR FEET?
AND I WILL PULL.

OKAY.

ONE, TWO, THREE, PULL.

I STILL COULD TAKE HIM UP
A LITTLE BIT HIGHER.

IF YOU HAVE CLIENT THAT'S
SLIDING IN BED,

TAKE HIM TO THE TOP
BECAUSE THEY'RE GOING
TO BE DOWN PRETTY FAST.

OKAY, SO BEND THOSE KNEES,
WE NEED THAT ACCORDION EFFECT

COS WE DON'T WANT
TO GET FRICTION

AND WE DON'T WANT TO SCRAPE UP
THEIR HEELS AND THEIR SKIN.

SO BEND THE KNEES
AND ONE MORE TIME.

DON'T PUSH THIS HARD
COS WE'RE ONLY ABOUT SIX INCHES
FROM THE TOP OF THE BED.

SO JUST A LITTLE PUSH THIS TIME.
ONE, TWO, THREE.

AND WE'RE THERE.

OKAY, IF THIS CLIENT NEEDED
TO JUST BE IN BED,

THIS IS WHAT WE CALL
SUPINE OR SEMI-FOWLER'S.
AND I WANT TO --

YOU MAY HEAR THOSE NAMES
BECAUSE POSITIONS IS HUGE.

THEY'RE GOING TO TEST ON IT
WHEN YOU TAKE YOUR INCLEX.

THEY WANT YOU TO
KNOW THOSE POSITIONS,
SO START LEARNING THEM NOW.

OUR CLIENT RIGHT NOW,
IS WHAT WE CALL SUPINE.

HE IS FACE UP, SU-UP-INE.

WE HAVE ANOTHER CATEGORY CALLED
SEMI-FOWLER'S AND HIGH-FOWLER'S.

SEMI-FOWLER'S BEING SOMEWHERE
BETWEEN 25 AND 45 DEGREES.
HEAD OF THE BED SLIGHTLY UP.

AND FOWLER'S, HIGH-FOWLER'S
BEING ALMOST 90 DEGREES,
SITTING LIKE IN A CHAIR.

WE DON'T WANT TO PUT OUR CLIENT
IN A SIDE-LYING POSITION.
WELL, LET ME BACK UP.

THE WHOLE REASON I STARTED THAT
WAS BECAUSE IF YOU JUST WANT HIM
TO BE IN A SEMI-FOWLER'S,

IN THE MIDDLE OF THE BED,
WHAT I NEED TO DO NOW IS
PUT THE SIDE RAIL UP.

GO TO THAT SIDE OF THE BED
AND PULL HIM BACK TO THE MIDDLE.

WE DON'T PUSH.

YOU DON'T HAVE CONTROL
AND IT CAUSES SHEARING
AND FRICTION ONTO THEIR SKIN.

SO YOU WANT TO PULL,
YOU HAVE BETTER CONTROL.

BUT I DON'T WANT HIM
IN THE MIDDLE.

I WANT TO TURN HIM AND I WANT
HIM TO LAND IN THE MIDDLE.

SO, I WANT HIM TO BE
CLOSER TO THE EDGE

SO THAT WHEN I TURN HIM, HIS
FACE ISN'T IN THE SIDE RAIL.

AND THAT'S IMPORTANT. YOU DON'T
JUST PULL A PERSON UP
AND THEN TURN THEM

AND YOU'LL FIND THAT
THEY'RE ON THAT EDGE
AND THAT'S NOT COMFORTABLE.

ALRIGHT, WELL, HE'S PERFECT
FOR I WANT -- FOR WHAT I WANT.

SO, I GOING TO GO AHEAD
AND SET THE PILLOW HERE

COS I KNOW HE'S GOING
TO ROLL THAT DIRECTION

AND BECAUSE I WANT
GRAVITY TO HELP ME,

I'M GOING TO CROSS THE LEG,
KIND OF, LIKE YOU DID IN CPR.

WHEN YOU PUT HIM IN
THE RESTING POSITION.

SAME THING CROSS THE LEG OVER.

PUT THEIR ARM HERE.
I'M GOING TO GO AHEAD
AND PUT THE SIDE RAIL UP.

OH, SORRY. ABOUT
THE TROUBLE THERE.

AND THEN I'M GOING TO GO
TO THE OTHER SIDE OF THE BED.

IT'S HARD TO STUFF PILLOWS
IN FROM BEHIND,

BUT I'M GOING TO GO AHEAD
AND GET MY PILLOWS READY HERE.

SO, I CAN GRAB THEM.
THIS ONE IS GOING TO GO
IN BETWEEN THE LEGS

AND THAT ONE'S GOING TO
GO AT THE BACK. OKAY,
SIDE RAILS, PRESS.

AND SOMETIMES - IT'S NOT DOING
IT WHEN I WANT IT TO.

THEY STICK HERE, AND
YOU JUST PRESS AGAIN
AND WIGGLE THEM DOWN

AND THEN RECESS THEM
UNDERNEATH THE BED,

AND THEN TO PUT
THE SIDE RAIL BACK UP,

YOU GOT TO PULL IT OUT
TO COME UP.

SO IF IT'S NOT GOING UP,
YOU HAVEN'T PULLED IT OUT
FAR ENOUGH.

ALRIGHT, MR. SPADE, WHAT I WANT
TO DO, IS ON THE COUNT OF THREE,

I'M GOING TO PUT MY HANDS
ON YOUR SHOULDER
AND ON YOUR LEG

AND IF YOU WOULD JUST ROLL
TOWARDS ME,

REACH TOWARDS ME
WITH THIS UPPER HAND,
THAT WOULD BE GREAT.

SO, GOOD, WIDE
BASE OF SUPPORT -

I HAVE TO SACRIFICE MY BACK
A LITTLE COS HE'S PRETTY FAR,

BUT HOPEFULLY HE'LL DO
SOME OF THE WORK FOR ME.

SO, ON THE COUNT OF THREE.
ONE, TWO, THREE.

HE JUST ROLLS RIGHT OVER
AND THERE'S JUST HARDLY
ANY WORK WHATSOEVER.

ALRIGHT, I'M GOING TO
GET HIM SETTLED.

I CAN'T REACH
THAT PILLOW VERY WELL.

I KNOW HE'S FLASHING
THE BACK THERE.

OH, DEAR, HIS GOWN
IS STUCK IN HIS LEG.

YOU KNOW, MR. SPADE,
CAN YOU JUST HOLD ON

TO THIS SIDE RAIL FOR ME?
THAT WOULD BE GREAT.

SO, I'LL PUT HIS ARM
RIGHT HERE.

[LAUGHTER]

OKAY. THERE.
HANG ON, HANG ON.

ALRIGHT, YOU GUYS
CAN'T SEE VERY WELL,

BUT YOU CAN SEE
MY LITTLE LOG ROLL HERE.

WHAT I WANT TO DO IS I WANT
TO PUT A PILLOW BEHIND HIM
TO SUPPORT HIM.

AND SO WHAT I LIKE TO DO
IS TAKE MY PILLOW AND STUFF IT

SO IT'S A NICE SOLID ROLL
AND HARD LIKE A LOG.

AND THEN HAVE HIM
LEAN BACK INTO IT.

AND THAT'LL HOLD THAT SOLID.

WHAT I DID BEHIND HIS BACK,

I TOOK THAT PILLOW
THIS IS TOO FLUFFY.

AND I MAKE IT INTO A ROLL,
THAT'S A HARD ROLL.

DON'T JUST TRY
TO STUFF IT IN LIKE THIS

OR THEY FALL BACK FLAT ON IT
AND THEY WIGGLE IT OUT.

THEY'LL BE FLAT IN
30 MINUTES AND YOU'LL
BE REPOSITIONING THEM.

THEN I LIFT

AND I LIKE TO PUT THE PILLOWS IN
LONG WAYS BETWEEN THEIR LEGS.

YOU CAN -- IT'S A
PATIENT PREFERENCE,

YOU CAN PUT THEM THIS WAY, BUT
SEE HOW THEIR LEGS HIT TOGETHER

AND THEY DON'T GET
GOOD BODY ALIGNMENT.

BUT IF YOU PUT THEM THIS WAY,

THEN THEY'RE NICE
AND STRAIGHT AND THAT'S
WHAT YOU'RE LOOKING FOR.

THAT THEY HAVE GOOD
BODY ALIGNMENT AS WELL.

WHAT I DID WHEN I TURNED HIM
WAS WHAT WE CALL A LOG ROLL.

HE ROLLED AS ONE UNIT
TO THAT NEW POSITION.

LIKE A LOG WOULD
JUST ROLL ALL TOGETHER

SO THAT WE DON'T
COMPROMISE THE BACK,

IF THEY WERE A
BACK INJURY CLIENT.

ALRIGHT, THE LAST THING
I WANT TO DO IS -

YOU GUYS CAN'T SEE, SOMETIMES
YOU JUST GOT TO STAND UP
AND MOVE A LITTLE BIT.

BUT UNDERNEATH HIS ARM,
HIS GOWN IS SO TIGHT,

THAT I'VE TRAPPED IT AND I WOULD
CUT OFF THE CIRCULATION.

SO THERE'S TWO THINGS
I NEED TO DO.

I NEED TO GET THIS
GOWN LOOSENED UP

AND I NEED TO GET HIM
OFF OF HIS SHOULDER.

SO, THAT HE'S JUST NOT
LAYING ON HIS SHOULDER,

COS HE'LL BE UNCOMFORTABLE
IN FIVE MINUTES.

OKAY. HOW DOES THAT FEEL?

THE OTHER THING I'D LIKE TO DO
IS MAKE SURE THAT THIS GOWN

IS OUT FROM UNDERNEATH
THE BOTTOM. ESPECIALLY IF
THEY'RE INCONTINENT.

THEY JUST SOIL IT AND THEN
YOU'RE CHANGING LINEN.

SO, GET EVERYTHING LOOSE.

NOT COMFORTABLE THIS WAY,
YOUR LEG'S NOT STAYING UP.

OKAY, GO AHEAD AND PUT
THE SIDE RAILS UP.

COVER HIM BACK UP.

MAKE SURE THAT THEY HAVE
A CALL LIGHT WITHIN REACH,
IF IT'S NOT IN THE SIDE RAILS.

AND I'M GOING TO AHEAD
AND PUT THE BED BACK
IN THE LOW POSITION.

YOU WANT TO PUT THE TABLE
AND ALL OF THEIR PERSONAL
BELONGINGS WITHIN REACH.

A LOT OF GOOD IT'S GOING TO DO
TO TURN THEM ON THEIR SIDE

AND LEAVE THEIR TELEPHONE
OVER THERE.

THEY WILL SCRAMBLE TO GET THAT
AS SOON AS IT RINGS

AND THEY'LL BE ALL OUT
OF THAT WONDERFUL POSITION
YOU'VE JUST GOT THEM IN.

SO, GET THE CALL LIGHT, THEIR
WATER, THEIR BOOK, TELEPHONE,

EVERYTHING THEY WOULD NEED
ON THIS SIDE OF THE BED
WITHIN REACH OF THEM.

KLEENEX, BAGS,
ALL THAT STUFF.

THEN ONCE I'VE GOT HIM SETTLED,
I'M GOING TO WASH MY HANDS

AND DOCUMENT THAT
I'VE TURNED HIM.

WE KEEP A TURNING SCHEDULE
IN ALL THE CHARTS.

IT'S EVERYWHERE
IN EVERY INSTITUTION.

THEY JUST DO IT DIFFERENTLY
AT EVERY INSTITUTION, YOU
JUST HAVE TO FIND IT.

SO, IF HE WERE TO GET
A PRESSURE SORE,

AND THEY'D SAY,
"OH, NURSING DID THAT."

WELL, IF WE HAVE
A TURNING SCHEDULE

AND WE HAVE PROOF THAT
WE'VE TURNED HIM EVERY
HOUR AND A HALF, TWO HOURS,

THEN THERE MAY BE
OTHER ISSUES INVOLVED HERE.

MAYBE NUTRITION, LAB WORK,
STUFF LIKE THAT.

AND SO IT'S NOT RELATED
TO OUR NEGLECT.

VERY CRITICAL.
ALRIGHT?

THAT'S YOUR FIRST STATION.

MY VOLUNTEER.

CAN YOU COME VOLUNTEER?
ANYBODY?

ANYBODY WANT TO VOLUNTEER
TO BE A PATIENT?

THIS IS WALKING SLOWLY.
WHO WANTS TO? WHO SAID THAT?

- I'LL BE A PATIENT.
- COME.

NOW, DON'T GIVE ME
TOO MUCH DRAMA.

YOU WERE THE DRAMA QUEEN
YESTERDAY.

- OUCH.
- THERE'S ONE IN EVERY CLASS.

ENERGY.

- LIE DOWN RIGHT HERE?
- LAY RIGHT HERE.

WE'RE GOING TO PUT A BATH
BLANKET ON TWO OF THE BEDS.

BEDS 3 AND 4 ARE GOING
TO BE OUR TRANSFER BEDS.

AND SO WE WOULD ASK THAT
YOU DON'T CRAWL IN BEDS.

ONE YEAR ALL THE STUDENTS,
THEY JUST REALLY GOT INTO IT.

THEY WERE CRAWLING
IN THE BED AND GOING, "AH!"

DON'T MESS UP
ALL OUR SHEETS.

SO, JUST GET ON TOP OF THE BEDS
WITH YOUR SHOES ON

AND WE'LL PRETEND
YOU'RE SHOELESS, OKAY?

THE GOAL HERE IS THAT YOU'VE
MAYBE HAD SURGERY, LET'S SAY.

AND I DON'T WANT TO
MAKE YOU A STROKE PATIENT
BECAUSE IT'S TOO MUCH WORK.

ALL WE WANT TO DO IS
PRACTICE GOOD SAFETY,

BUT I WANT YOU TO APPRECIATE
THE SIGNIFICANCE OF SOMEONE
THAT'S HAD A STROKE

AND THEY HAVE ONE SIDE
THAT'S WEAKER THAN THE OTHER.

IF WE HAD SOMEONE THAT HAD A
WEAK SIDE, WHICH SIDE WOULD YOU
TURN THEM TO?

- THE STRONG SIDE.
- THE STRONG SIDE. AND
THAT'S VERY IMPORTANT.

SO, UNDERSTAND WHICH SIDE
IS WEAK, WHICH SIDE IS STRONG.

IF THIS WERE -
YOU'RE CHRIS, RIGHT?

IF THIS WERE CHRIS'
STRONG SIDE

THEN HAVING THE CHAIR HERE
AND MOVING HIM TOWARDS THE CHAIR
IS ABSOLUTELY RIGHT.

IF THIS WERE HIS STRONG
SIDE, THEN I'D HAVE TO PUT
THE CHAIR OVER HERE.

BECAUSE YOU WANT TO MOVE
TOWARDS STRENGTH,

YOU DON'T WANT TO MOVE TOWARDS
WEAKNESS OR YOUR CLIENT'S
AT RISK OF FALLING.

RIGHT. HELP EACH OTHER,
YOU CAN WALK.

WE DO MANNEQUINS,
BUT MANNEQUINS CAN'T STAND.
SO, THAT'S A PROBLEM.

OKAY, I'VE CHECKED
MY DOCTOR'S ORDERS.

I -- THE DOCTOR DIDN'T SAY
GET 3 OR 4 NURSES.

IT JUST SAYS, PATIENT UP IN
CHAIR 4 TIMES A DAY

OR -- OR SOMETHING RELATED
TO THEIR ACTIVITY.

SO, I KNOW THAT MY CLIENT
NEEDS TO GET UP IN A CHAIR.

IT IS HIS FIRST TIME
SO I'M GOING TO VERY CAREFUL.

I'M GOING TO CONSIDER A GAIT
BELT WHEN I GET MY EQUIPMENT.

SO, THAT I HAVE SUPPORT AND I'M
ALSO GOING TO CONSIDER TAKING
VITAL SIGNS TO MAKE SURE

THAT HE'S STABLE AS FAR AS HIS
BLOOD PRESSURE AND PULSE

WITH MOVEMENT
AND CHANGE OF POSITION.

SO, I'VE BEEN GATHERING UP
ON MY EQUIPMENT.

I HAVE GATHERED UP A WHEELCHAIR.

WELL, WHEELCHAIRS OUT THERE.

YOU SPREAD THEM OUT AND THEN YOU
WANT TO MAKE SURE THAT WHEN YOU
SET YOUR WHEELCHAIR

IN THE POSITION THAT
YOU'RE GOING TO PUT IT,
THAT YOU LOCK IT.

SO, ON THE WHEELS ARE
LITTLE STANDS RIGHT HERE
AND THAT LOCKS IT IN PLACE.

COS WE DON'T WANT THE PERSON
FLYING. WE DON'T.

WE ALSO ARE GOING TO BRING PROPS

BECAUSE I JUST NEED PROPS WHEN
I'M TESTING COS IT'LL
HELP ME REMEMBER.

IF YOU'RE GOING TO GET A CLIENT
OUT OF BED, MOST TIMES THEY'RE
IN, RIGHT, A HOSPITAL GOWN.

SO, PRIVACY IS, KIND OF,
AN ISSUE.

YOU GOT TO PROVIDE PRIVACY
FOR THE BACKSIDE.

SO, YOU'RE GOING TO GET
A BATHROBE OR ANOTHER GOWN
TO COVER UP THE BACK,

SLIPPERS AND THESE NEED
TO BE NON-SKID.

THEY'RE NOT GRANDMA'S
FAVORITE CROCHETED SLIPPERS.

OH, THEY DO BRING THOSE
IN THE NURSING HOMES,

THEY LOVE TO CROCHET
THEIR LITTLE SLIPPERS.

BUT YOU NEED SOMETHING
THAT DOESN'T SKID ON
THESE TILE FLOORS.

SO, SOME NON-SKID SHOE
AND THEN I'M GOING TO BRING
A GAIT BELT FOR ME.

I WANT YOU TO PRACTICE WITH
THE GAIT BELT ON THIS CLIENT

JUST SO THAT YOU WILL
UNDERSTAND HOW TO WORK IT.

ALRIGHT, SO I'VE GATHERED UP
MY SUPPLIES, I HAVE MY CLIENT,
INTRODUCE MYSELF.

HI, I'M DIANA,
I'LL BE YOUR NURSE TODAY,

AND WE NEED TO GET
YOU UP INTO A CHAIR.
ARE YOU UP FOR THAT?

- OKAY.
- AND YOU ARE?

- CHRIS.
- MAKE SURE YOU IDENTIFY
YOUR CLIENT.

I WASH MY HANDS AND I'M GOING
TO PROVIDE PRIVACY.

SO, I THINK, WHAT I'D LIKE
TO DO TO GET YOU UP

IS I'M JUST GOING TO ELEVATE
THE HEAD OF THE BED

AND LET THAT DO
THE WORK FOR ME.

WHY SHOULD I WORK
IF THE BED CAN?

SO, LET THE EQUIPMENT DO
AS MUCH WORK AS POSSIBLE.

LET THE CLIENT DO
AS MUCH WORK AS POSSIBLE.

WHY WOULD I TURN A CLIENT
IF THEY CAN TURN THEMSELVES?

I'D GO IN AND SAY,
"YOU KNOW, IT'S TIME TO TURN.
CAN YOU TURN OVER? GOOD GO.

YOU KNOW, IT'S ABOUT DOING
WHAT THEY CAN FOR THEMSELVES
INSTEAD OF HURTING YOU.

SO, I MIGHT JUST TAKE
A LITTLE REST HERE.

AND I'M GOING TO PUT
THE HEAD OF THE BED UP.

AND YOU'LL GET THE FEEL
OF WHAT A BED DOES AND
HOW IT SQUINCHES YOU.

NOTICE ON THIS BED
WHEN I PUT THE HEAD UP --

I LIKE THIS SITTING THING,
THIS IS GOOD.

OH, IT'S NOT DOING IT.
ON BEDS 3 AND 4, I BELIEVE
IN THE OTHER ROOM,

WHOO! THIS IS A BIRTHING BED, I
FORGOT TO TELL YOU THAT
LITTLE DETAIL, SO.

[LAUGHTER]

OH, AND CHRIS GOES UP
REALLY TALL.

BUT ON THE BEDS IN THE
OTHER ROOM, THE KNEE
AUTOMATICALLY GATCHES.

IT AUTOMATICALLY GOES UP
WHEN THE HEAD GOES UP.

AND THAT'S WONDERFUL WHEN
SOMEONE'S JUST SITTING IN BED

COS IT'S, KIND OF, LIKE,
A SPEED BUMP,

IT KEEPS HIM FROM GOING DOWN
SO FAST IN THE BED.

BUT WHEN YOU'RE TRYING
TO GET A CLIENT TO SIT
AND IF THE KNEES HAVE GONE UP,

YOU NEED TO FLATTEN
OUT THE KNEES, SO THAT
THEY'RE SITTING FLAT.

INSTEAD OF, WHEN YOU TURN UP TO
SIT ON THE EDGE, THEY'RE NOT,
LIKE, TILTED OUT, OKAY?

SO LOOK TO SEE
WHAT YOUR BEDS ARE DOING
WHEN YOU PRACTICE WITH THEM.

AND ALL YOU DO
TO GET THE KNEE GATCH OUT
IS TO PUT THE FEET FLAT.

THIS BED IS BEAUTIFUL, AND YOU
WON'T HAVE A BED LIKE THIS,
BUT I JUST NEED A MOMENT.

ALRIGHT. I'M GOING TO PUT
THE SIDE RAIL DOWN.

AND PERSONALLY, I LIKE TO AT
THIS POINT PUT THE SHOES ON.

BECAUSE I DON'T HAVE TO BEND
SO FAR IF HE CAN'T PUT
HIS OWN SHOES ON.

SO PUT THE SLIPPERS ON.
THEY'RE JUST PROPS. YOU
DON'T REALLY PUT THEM ON.

I'M GOING TO PUT THE GOWN ON IN
A MINUTE AFTER HE'S SITTING,

BUT IT'S NOT EASY
TO DO AT THIS POINT.

I'M GOING TO MOVE
THIS PILLOW. I THINK
IT'LL BE A LITTLE EASIER.

ALRIGHT, CHRIS, WHAT I WANT YOU
TO DO, CAN YOU SCOOT TOWARDS
THE EDGE OF THE BED?

BUT BEFORE YOU DO THAT, I WANT
TO MAKE SURE THAT THE BRAKE
IS ON ON THE BED.

COS I DON'T WANT THE BED
GOING FLYING OUT EITHER.

SO MAKE SURE THE BRAKE IS ON.
AND THE BRAKE IS ON --

YOU CAN SEE ON EACH SIDE OF THE
BED, RED DOWN.

AND YOU CAN TELL BY SHOVING IT.
BUT BEDS ONE, TWO --

ONE, TWO AND THREE IN ROOM 179
ARE OLD BEDS AND THEIR BRAKES
ARE ON THE WHEELS.

SO YOU HAVE TO HIT
THE LITTLE WHEEL STOPS,
I THINK, TO SET THOSE BRAKES.

ALRIGHT. MY BRAKES ARE ON
SO I'M GOOD.

CAN YOU JUST SCOOT TOWARDS
TO EDGE? YOUR WHOLE BODY.

LET HIM DO THE WORK,
JUST COACH HIM THROUGH.

NOW, CHRIS, THE NEXT THING
I'D LIKE TO DO IS I JUST WANT
YOU TO DANGLE, WHAT WE CALL.

AND THAT MEANS I JUST WANT YOU
TO SIT ON THE EDGE OF THE BED,

AND JUST MAKE SURE YOUR NOT
GOING TO GET DIZZY FROM SITTING
AND GETTING UP, OKAY?

SO TO DO THAT I'D LIKE FOR YOU
TO JUST SPIN AROUND
FROM THE SIDE,

BUT I'M GOING TO HELP.
AND YOU'RE GOING TO HELP HIM.

OKAY, TO DO THAT. GOOD
WIDE BASE OF SUPPORT.

I'M GOING TO PUT MY HAND --
THIS PILLOW'S IN THE WAY.

I'M GOING TO PUT MY HAND
BEHIND HIS SHOULDERS

AND I'M GOING TO PUT THIS HAND
OVER HIS KNEES.

SO THAT WHEN I PULL HIM
AROUND, AND HE'S GOING
TO HELP ME A LITTLE,

BUT WITHOUT FALLING OUT
OF THE BED. YOU CAN
SUPPORT YOURSELF HERE.

HE'S GOING TO BE SET.
NOW, SCOOT BACK.

THIS IS HOW I DON'T WANT
YOU TO DO IT.

DOESN'T IT SEEM LIKE YOU'D
HAVE MORE CONTROL OF THE LEGS

IF YOU WENT UNDER, LIKE THIS
AND YOU CAN PULL HIM.

NOW WATCH WHAT HAPPENS
TO MY BACK. HERE WE GO. UP.

- THAT LOOKS NOT GOOD.
- THIS IS NOT GOOD.
NOT GOOD AT ALL.

SO, STAY ON TOP. YOU'RE JUST
GIVING A LITTLE BIT OF PULL
TO HELP HIM MOVE.

HE SHOULD BE ABLE TO MOVE. IF HE
CAN WALK AND SIT IN A CHAIR, HE
SHOULD BE ABLE TO MOVE HIS LEGS.

SO YOU'RE NOT DOING ALL THE WORK
FOR THEM. THEY'RE DOING
WHAT THEY CAN DO.

ALRIGHT. TRY TO SUPPORT
YOURSELF UP HERE INSTEAD.

I WANT YOU TO SIT NICE AND TALL.
HEAD UP. LOOK STRAIGHT FORWARD.

BREATHE IN AND OUT OF YOUR NOSE.
HOW ARE YOU FEELING?
- WELL.

- ARE YOU DIZZY?
- NO.

- GREAT. I'M GOING TO GO AHEAD
AND PUT THE GOWN ON. HE'S GOT
HIS SHOES ON. NON-SKID GOWN.

AND AT THIS POINT, I MIGHT
WANT TO CHECK HIS PULSE
AND HIS BLOOD PRESSURE.

WHAT WE'RE LOOKING
FOR IS WHAT'S CALLED
ORTHOSTATIC CHANGES

AND I WANT YOU TO LOOK
THAT UP IN YOUR BOOK.

BUT ORTHOSTATIC CHANGES
MEANS ORTHOSTATIC, ORTHO,
HAVING TO DO WITH POSITION.

SO WHEN YOU'RE LAYING DOWN, IS
YOUR BLOOD PRESSURE GOING TO BE
AT ITS HIGHEST OR ITS LOWEST?

- LOWEST.
- HIGHEST.

BECAUSE IT IS THE EASIEST FOR
THE BODY TO MOVE THE BLOOD.

SO IT'S GOING TO BE
AT IT'S HIGHEST.

SO WHEN YOU SIT UP,
WHAT'S GOING TO HAPPEN
TO YOUR BLOOD PRESSURE?

IT MIGHT GO DOWN A LITTLE,
BUT MOST OF US

WILL RECUPERATE THAT REALLY FAST
IF OUR SYSTEMS ARE WELL.

AND SO WE MIGHT HAVE A SHIFT
OF FIVE MILLIMETERS OF MERCURY.

LIKE, YOU KNOW, BLOOD PRESSURE
IS 120 OVER 80, IT MIGHT GO TO
115 OVER 78 AND NO BIG DEAL.

BUT SOMEONE THAT'S BEEN LAYING,
AND THAT'S BEEN UNDER ANESTHESIA
MAY GO FROM SITTING --

I MEAN LYING TO SITTING,
WHO HAS BEEN 120 OVER 80
AND IT MAY DROP TO 90 OVER 60.

THAT'S NOT GOOD. ANYTHING OVER
25 MILLIMETERS OF MERCURY CHANGE
AFTER ONE MINUTE

MEANS THEY'RE HAVING SOME
ORTHOSTATIC CHANGES

AND THEY MAY NOT BE AT GOOD
RISK FOR GETTING UP
AND MOVING AROUND.

SO THAT'S WHY WE WOULD CHECK
THE BLOOD PRESSURE.

WHAT ABOUT THE PULSE? IS IT
GOING TO GO UP OR GO DOWN
WHEN THEY SIT UP?

- IT'S GOING TO GO UP.
- IT'S GOING TO GO UP,

KIND OF, LIKE, IF SOMEONE IS
SHOCKY, IT MAY GO FASTER.

SO THAT'S WHAT WE'RE
CHECKING FOR, ESPECIALLY
IF THEY HAVE A COMPLAINT.

YOU WANT IT TO DANGLE FOR
ABOUT A MINUTE, CHECK THEIR
VITALS AS NECESSARY.

THE OTHER THING I WANT TO DO
WHILE YOU'RE UP IS I WANT TO
PUT THIS GAIT BELT ON.

GAIT BELTS ARE LONG. AND ON THE
WHITE ONES, THE SEAM GOES
ON THE INSIDE.

ON THE PINK ONE, THE SEAM GOES
ON THE OUTSIDE.

YOU'LL FIGURE IT OUT WHEN YOU
GET THERE. JUST DON'T ASSUME
THEY'RE ALL THE SAME.

TO WORK A GAIT BELT, YOU PUT
IT AROUND THEIR WAIST

AND THE FIRST PLACE IT GOES
THROUGH IS THE TEETH

AND THEN IT GOES THROUGH
THE NEXT PART OF THE BUCKLE
TO LOCK IT TIGHT.

SO, WE'RE GOING TO PUT THIS
AROUND YOUR WAIST, CHRIS.

SO THAT I HAVE SOMETHING TO GRAB
ON TO. TO HELP YOU TO STAND COS
I DON'T WANT YOU TO FALL.

AND YOU WANT IT TO BE
WITHOUT WRINKLE AND YOU
WANT IT TO BE FAIRLY TIGHT.

COS IF YOU HAVE A LOT OF SLACK
THEN YOU DON'T HAVE MUCH CONTROL
OVER YOUR CLIENT'S STATE.

HE GETS A LITTLE TIPSY.

SO BRING IT AROUND HERE.

PUT THE TEETH IN,

AND THEN PUT THE BELT ON.

COULD EVERY CLIENT
HAVE A GAIT BELT?

IT'S A GOOD TESTING TECHNIQUE.
ANYTIME YOU SEE THE WORD ALL,
EVERY, FLAGS SHOULD GO UP.

THERE IS NOT MUCH THAT
EVERYONE AND ALL SHOULD DO.

AND THE ANSWER TO THAT
QUESTION IS NO.

WHAT ABOUT SOMEONE THAT'S
HAD RIB INJURIES?

WHAT ABOUT SOMEONE WITH
A BACK INJURY?

WHAT ABOUT SOMEONE
THAT'S PREGNANT?

THEY'RE NOT A GOOD CANDIDATE
FOR THE GAIT BELT.

BUT MOST PEOPLE THAT ARE
AMBULATORY, IT WOULD BE FINE.

YOU WANT TO MAKE SURE THAT THEY
CAN BREATHE SO THAT THEY'VE GOT
SOME FINGERS HERE.

BUT IT SHOULDN'T HANG
AND BE SLOPPY.

ALRIGHT, CHRIS, WHAT I'M GOING
TO DO IS JUST HAVE YOU STAND.

I AM GOING TO, KIND OF, ROCK YOU
A LITTLE BIT. ON THE COUNT OF
THREE, GO AHEAD AND STAND.

PUSH UP WITH YOUR HANDS.
KEEP YOUR HANDS ON THE BED
AND THEN AFTER YOU STAND,

AND WE MAKE SURE YOU'RE OK AND
NOT GOING TO BE DIZZY,

THEN WE'RE GOING TO WALK
TO THE CHAIR.

I DON'T WANT YOU TO JUST
PLOP IN THE CHAIR.

I WANT YOU TO WALK TOWARDS THE
CHAIR AND THEN BACK UP TO IT.

AND THEN WHEN YOU FEEL THE CHAIR
AT THE BACK OF YOUR LEGS,
THEN STOP WALKING OBVIOUSLY.

AND THEN I WANT YOU
TO TAKE YOUR HANDS, AND
PUT THEM ON THE HAND REST,

SO THAT YOU CAN LOWER YOURSELF
DOWN TO THE CHAIR.

NOTICE IN THOSE DIRECTIONS, NONE
OF THEM WERE HANG ON TO ME, PUT
YOUR ARMS AROUND MY NECK.

THEY'LL PULL YOU DOWN.
SO, HERE WE GO.

THIS IS THE OTHER THING
I DO FOR MY FEET.

I WAS TAUGHT ONE WAY
AND THE BOOK SHOWS
A COUPLE OF OTHER WAYS.

THERE'S ALL KINDS OF WAYS.
THE MAIN THING IS A GOOD
WIDE BASE OF SUPPORT.

BUT I LIKE TO KEEP MY KNEES IN
FRONT OF THE CLIENT'S KNEES,

SO THAT IF THEY BUCKLE I'M
GOING TO SHOVE HIM BACK.

I'M IN CONTROL HERE
AS WELL AS HERE.

SO THEY DON'T KNOW WHAT
YOU'RE DOING HERE, BUT I DO.

OKAY, SO I'M READY FOR HIM.
GOOD WIDE BASE OF SUPPORT.

SOMETIMES THEY HAVE YOU
GO SPREAD, AND PUT YOUR
LEG BETWEEN THEIR LEG

SO THAT IF THEY FELL, YOU COULD
SLIDE THEM DOWN YOUR LEG.

BUT WHEN I'M SO CLOSE TO A
CHAIR, I'D LIKE TO BE ABLE TO
PUSH HIM BACK INTO THE CHAIR.

THAT'S JUST FINE.
OKAY, ARE YOU READY?
ON THE COUNT OF THREE.

ONE, TWO, AND THREE
AND UP.

STAND STRAIGHT UP,
NICE AND TALL.

LOOK STRAIGHT AHEAD
AND GOOD DEEP BREATHS
IN YOUR NOSE, OUT YOUR MOUTH.

HOW ARE YOU FEELING? DIZZY?
OKAY, I WANT YOU TO WALK
TOWARDS THE CHAIR.

AND AROUND, WALK BACK
TOWARDS THE CHAIR.

WHEN YOU FEEL THE CHAIR, I
WANT YOU TO GO REACH BACK
TOWARDS THE SIDE RAIL.

YOU'RE GOING TO HAVE TO BEND
A LITTLE COS YOU'RE NICE
AND TALL.

AND AGAIN, SEE WHERE
MY KNEES ARE?

AND WHEN HE GOES DOWN, I'M
SHOVING HIM TO THE BACK
OF THE CHAIR.

BECAUSE I NEED GOOD
BODY POSITION FOR HIM
AS WELL IN THE CHAIR

BECAUSE IF HE'S, KIND OF,
SLID HALF OUT THE CHAIR

THEN I GOT TO PULL HIM
BACK UP IN THE CHAIR.

AND THAT'S JUST TOO MUCH
WORK FOR MY LOWER BACK.
HOW DOES THAT FEEL?

COMFORTABLE? OKAY,
I CAN GO AHEAD AND TAKE
THE GAIT BELT OFF.

AND SITUATE HIM -- I HOPE
I TOOK THIS UP OFF HERE.

IT SAYS PUT A RESTRAINT
ON IF NECESSARY.

SOMETIMES CLIENTS SLIDE OUT OF
CHAIRS SO WE MIGHT NEED TO PUT
SOME KIND OF BELT OR SOMETHING

BUT THAT'S CONSIDERED A
RESTRAINT AND WE'RE GOING TO
TALK ABOUT THAT NEXT WEEK.

AND YOU CAN'T RESTRAIN EVERYONE
JUST COS YOU FEEL LIKE IT.
YOU HAVE TO HAVE AN ORDER.

SO I'M GOING TO RESTRAIN YOU,
I THINK WE'RE PRETTY
GOOD THERE.

AGAIN, YOU WANT TO MAKE SURE
THAT THE CLIENT HAS ALL OF
THEIR PARAPHERNALIA,

THEIR WATER PITCHER,
THEIR TABLE, THEIR
CALL LIGHT, EVERYTHING.

YOU'RE GOING TO STRAIGHTEN UP
THE LINEN BECAUSE YOU CAN,

WHILE THEY'RE OUT OF BED,
THAT'S THE EASIEST TIME
TO DO IT.

SO GET EVERYTHING STRAIGHTENED
UP AND WITHIN REACH.

TAKE THE GAIT BELT OFF, I'M
GOING TO GO, I'M GOING
TO WASH MY HANDS

AND THEN DOCUMENT THAT
THE CLIENT IS UP IN THE CHAIR,

HOW LONG HE STAYED UP
IN THE CHAIR

AND HOW HE TOLERATED
BEING UP IN THE CHAIR.

AGAIN IT'S A POSITION CHANGE
AND WE WANT TO TAKE CREDIT

FOR WHAT HAS BEEN ACCOMPLISHED
DURING OUR SHIFT.

I'M NOT GOING TO MAKE YOU PUT
THE CLIENT BACK INTO BED,

BUT I AM GOING TO SHOW YOU
HOW TO DO THAT ANYWAY.

- WHEN DO YOU PUT THE GOWN ON?
- HUH?

- WHEN DO YOU PUT THE GOWN ON?
- I PUT THE GOWN ON WHEN
HE SAT ON THE EDGE.

WHEN HE DANGLED BECAUSE
IT'S EASIEST THEN AND
THAT'S BEFORE HE STANDS UP

SO I CAN GET TO HIS ARMS
AND HIS BACK A LITTLE BETTER.

- SO WAS I NAKED
IN THE BED BEFORE THIS?

- YOU HAD A FRONT GOWN.
- OKAY.

BUT I PUT, LIKE, A GOWN ROBE.
THIS IS YOUR ROBE, PROP ROBE.

SO THAT'S HOW YOUR BACKSIDE
WASN'T SHINING.
- THAT'S GOOD.

- I THOUGHT YOU'D
APPRECIATE THAT.

OKAY. HOW DID YOU SIT UP?
- I FEEL FINE.

- GREAT, IT'S BEEN A COUPLE
OF HOURS. YOU READY
TO GO BACK TO BED?

- OKAY.

- OKAY, WE'RE GOING TO
PUT YOU BACK TO BED.

AND THE PROCESS IS REALLY THE
SAME AS GOING OUT OF BED,

COS YOU'RE GOING TO GO
BACKWARDS, BUT THIS TIME I'M
NOT GOING TO USE A GAIT BELT

BECAUSE THE TRUTH OF IT IS WHEN
YOU GO TO THOSE NURSING HOMES,

YOU'RE GOING TO NEVER BE ABLE
TO FIND A GAIT BELT.

THE NURSE'S AIDES CARRY THEM
WITH PRIDE AND
THEY WON'T SHARE.

IT'S THE WEIRDEST THING
I HAVE EVER SEEN.

SO, YOU WILL HAVE A
HARD TIME FINDING THEM.

IF YOU REALLY WANT A GAIT BELT
AND YOU NEED A GAIT BELT,

YOU CAN GET THEM FROM
PHYSICAL THERAPY.

SO CALL PHYSICAL THERAPY
AND SAY, "I NEED A GAIT BELT."

AND IF THAT DOESN'T WORK CALL
CENTRAL SUPPLY AND SAY,
"I NEED A GAIT BELT."

GET ONE IF THE AIDES DON'T
SHARE. THEY WON'T SHARE.

ALRIGHT, SO WE'RE GOING TO
PRETEND I DON'T HAVE ONE.

WHAT I AM GOING TO DO THIS TIME
IS -- I'VE DONE MY HIGH FIVE.

YOU NEVER GET TO SAY THAT.
YOU ALWAYS HAVE TO SAY ALL FIVE,
BUT FOR SPEED, I'M GOING TO.

OKAY, WHAT I WANT YOU TO DO IS
I WANT YOU TO PUT YOUR HANDS
ON THE HAND RAILS,

AND I WANT YOU TO PUSH YOURSELF
UP AND THEN JUST STAND FOR A
SECOND TO MAKE SURE.

I'M GOING TO GRAB HERE BEHIND
HIS SHOULDERS UNDER HIS ARMS

AND ON THE COUNT OF THREE
I WANT YOU TO STAND.

ONE, UP, TWO, THREE.

OKAY. HE'S WAY TALL FOR ME.

SO TO STABILIZE HIM I AM GOING
TO PUT MY HAND UNDER HIM.

- AND JUST SAY, ARE YOU OKAY?
- I'M OKAY.

- OKAY. I WANT YOU TO WALK
TOWARDS THE BED AND THIS TIME
WHEN YOU SIT,

I WANT TO GET YOUR BOTTOM AS
CLOSE TO THAT BEND AS YOU CAN
BEFORE YOU SIT DOWN.

YOU KNOW WHAT? I'M GOING
TO MOVE THIS AND GET IT
OUT OF THE WAY HERE.

YOU OKAY?
YOU NEED ANYTHING?

OKAY. DON'T SIT QUITE YET.

JUST GET YOURSELF ALL THE WAY
BACK, FEEL THE BED.

NOW I WANT YOUR BOTTOM
AS CLOSE TO THAT BEND
AS POSSIBLE.

WHEN YOU SIT, USE YOUR HANDS
TO SUPPORT YOURSELF.

OKAY, NOW SCOOT YOURSELF BACK
BEFORE YOU PULL YOUR LEGS UP.

NOW HERE'S AN
INTERESTING THING,

ABDOMINAL SURGERIES.

THEY DON'T MOVE SO GOOD.

AND IT'S HARD BECAUSE YOU
USE YOUR STOMACH MUSCLES
TO PULL UP YOUR LEGS.

AND SO THEY DON'T WANT TO PULL
UP THEIR LEGS, BUT YOU HAVE GOT
TO GET THEIR LEGS UP.

SO WHO'S GOING TO DO
ALL THE WORK HERE?

THERE'S TWO WAYS TO DO IT.
THIS IS MY FAVORITE.

IF YOU WOULD GO DOWN ON YOUR
SIDE AND IF I LIFT THE LEGS,

THEN HE CAN ROLL BACK AND
I HAVE HARDLY DONE ANYTHING.

SO DON'T FLOP THEM ONTO THEIR
BACK AND THEN TRY TO MANEUVER
THEIR LEGS THE WHOLE WAY.

COME BACK.

OH, THIS BED DOESN'T HAVE IT,
BUT THIS BED DOES.

IF HE WERE IN THIS BED,
YOU DON'T WANT TO BE HERE

AND I DIDN'T WANT TO DO ALL
THE WORK, I WOULD TEACH HIM
TO USE THE BED FOR HIMSELF.

SO WHY NOT USE THOSE SIDE RAILS
TO HELP YOURSELF UP

INSTEAD OF ME HAVING
TO DO ALL THE WORK?

SO USE THE SIDE RAILS AS A
STAIRCASE TO WALK UP THE SIDE
OF THE BED AND THEN SCOOT OVER.

OKAY. SO LET'S DO IT.
JUST GET ON YOUR SIDE.

AGAIN GOOD WIDE BASE
OF SUPPORT. I LIFT.

HE'S SET.

AND THEN I JUST GO AHEAD
AND LOWER THE BED.

HE MAY LAND IN THE MIDDLE OR HE
MAY BE DOWN A LITTLE BIT,

IT'S SO HARD TO GET
HIM UP HIGH ENOUGH,

BUT IF YOU CAN GET THAT BUTT
AS CLOSE AS POSSIBLE
TO THAT BEND...

..IT'LL BE BEAUTIFUL.

ALRIGHT. THERE YOU GO.
THANK YOU, CHRIS.

YOU'RE A WONDERFUL CLIENT
AND I'LL TAKE MY BELT OUT.

- YEAH.

- YEAH, I KNOW.

AND THAT'S MY BELT
AND I AM NOT SHARING.

ALL RIGHT, I THINK WE WROTE
N.R.C. ON ALL OF OURS BECAUSE
THEY ARE PRECIOUS TO US.

- AM I'M DONE?
- YOU'RE DONE.

THANK YOU VERY MUCH.
GIVE HIM A HAND. WONDERFUL.

OKAY, SO YOU ARE GOING TO
HELP EACH OTHER.

WE WILL PAIR YOU UP SO DON'T
ASSUME THAT YOU ARE GOING
TO DO SOMEBODY.

YOU'RE GOING TO DO WHOEVER
WE TELL YOU TO DO.

COS WE DON'T WANT YOU TO JUST
GET SO FIXED THAT THIS IS
THE ONLY WAY OUT,

BUT IT WILL BE SOMEONE
IN YOUR GROUP.

OKAY. I NEED A GROUP
TO VOLUNTEER.

OR I'LL PICK ONE.

OKAY, I WILL PICK
THE EIGHT O'CLOCKERS.

EIGHT O'CLOCKERS, SINCE
YOU'RE ALL TOGETHER.

COME ON DOWN.

OUR LAST...

..AND FINAL DRILL.

AND THIS WILL WORK GOOD TO --

WITH ME THERE'LL BE FIVE AND ALL
THE REST OF YOU HAVE FIVE.

YOU GUYS WILL ONLY HAVE FOUR
BUT YOU'LL BE OKAY.

ALRIGHT. TWO OF YOU GO OVER
HERE. TWO OF YOU COME OVER
HERE WITH ME.

AND OUR GOAL TODAY IS TO
TRANSFER THIS CLIENT -

HE'S ALL TURNED IN A MESS.

WE ARE GOING TO TRANSFER
THIS CLIENT FROM THE BED
TO THE GURNEY.

HE'S TO GO TO X-RAY
AND I NEED HELP BECAUSE HE
CAN'T HELP HIMSELF AT ALL.

OKAY. HE ALSO HAS
A FOLEY CATHETER.

YOU MIGHT AS WELL KNOW
THAT STRAIGHTAWAY.

A FOLEY CATHETER, SOME OF YOU
DON'T KNOW WHAT THAT IS.

WHEN I WAS IN NURSING SCHOOL -
I THINK I TOLD YOU.

I -- DID I TELL YOU
WHY I WANTED TO BE A NURSE?

COS I LIKED TO DISSECT FROGS
AND I THOUGHT, "OH, I SHOULD
BE A NURSE."

AND I WENT TO NURSE'S SCHOOL
AND I WAS SHOCKED,

EVERYDAY I WAS SHOCKED, JUST
SHOCKED ABOUT EVERYTHING.

I DIDN'T KNOW ANYTHING
ABOUT PATIENT CARE.

I DIDN'T KNOW ANYTHING
ABOUT PEOPLE. I DIDN'T KNOW
ANYTHING ABOUT MEDICINE.

EVERY TIME THEY TOLD ME THEY
WOULD PUT A TUBE IN SOME
ORIFICE, I WAS LIKE...

..NO WAY.

I WAS JUST SHOCKED.

AND A TUBE THAT
MAY SHOCK YOU --

AND I'LL TELL YOU EVERYTHING SO
DON'T BE AFRAID TO ASK,

BECAUSE EVERY WORD
AND EVERYTHING WAS A SHOCK.

EVERYTHING. I WAS SHOCKED.

A FOLEY CATHETER
IS IN A CLIENT'S BLADDER.

IT'S A TUBE THAT WE PUT IN
AND IT GOES UP LIKE THIS.

SORRY, MOST PEOPLE CAN'T DO
THEIR GENITALIA,

BUT WE'RE GOING TO
JUST MOVE IT FOR HIM.

COS I NEED YOU TO SEE
HOW THIS IS HELD IN PLACE.

YOU DON'T WANT TO LET
GO OF THAT STUFF.

THE TUBE GOES UP
INTO THE BLADDER. UP.

AND THEN IN THE BLADDER IT'S
HELD IN PLACE BY A BALLOON.

OKAY, SO THE TUBE GOES IN,
ONCE URINE COMES BACK,

THEN WE FILL THIS BALLOON
WITH STERILE WATER.

AND THAT'S ALL THAT KEEPS
IT FROM FALLING OUT.

KEEP THAT IN MIND.

OKAY, DOES YOUR CLIENT HAVE --

MANNEQUINS ARE WONDERFUL,
THERE WILL BE A BOY ONE
AND A GIRL THE NEXT.

WE CAN MAKE THEM NEUTRAL,
WE CAN MAKE THEM WHATEVER WE
NEED THEM TO BE.

OKAY SO, OUR CLIENT
HAS A FOLEY CATHETER.

AND FOLEY CATHETERS
DRAIN URINE.

AND BECAUSE THEY DRAIN URINE
WE ARE NOT GOING TO TOUCH IT.

THE REASON IS --
AT LEAST NOT WITH OUR HANDS.

IF IT IS INTO THE PERENNIAL
AREA, THE GENITALIA,

MOST TIMES THEY'RE
NOT WEARING UNDERWEAR.

OFTEN THEY ARE INCONTINENT.

SO IF THERE'S ANY LEAKAGE AROUND
THE TUBE, THAT'S GOING TO BE ON
THE OUTSIDE OF THE TUBE.

THIS BAG THAT'S ON THE BED
WHICH I WOULD NEVER TOUCH
WITHOUT GLOVES,

BUT IT'S JUST OUR FAKE URINE.

THIS BAG WE EMPTY EVERY EIGHT
HOURS OR WHEN IT GETS FULL
AND IT SPLASHES

AND THEN WE PUT THIS LITTLE
SPLASHY END BACK UP INTO
HERE AND SO PEE...

SO WHY WOULD YOU
WANT TO TOUCH THIS?

THEY CHANGE THE BAGS
EVERY SEVEN DAYS.

ONCE A WEEK THE BAG SHOULD BE
CHANGED. BUT THE CATHETER
INSIDE THE CLIENT

ISN'T CHANGED BUT EVERY 30 DAYS
UNLESS THERE IS A PROBLEM.

SO...

YEAH, YOU'RE
WITH ME HERE ON THIS .

SO YOU WANT TO
DESIGNATE A PERSON AS
A FOLEY CATHETER HANDLER.

SOMEONE THAT'S GOT
THE GLOVES. OKAY?

YOU'RE CLOSEST TO GLOVES.
THEY ARE RIGHT THERE.

YOU WANT TO START SEARCHING
FOR YOUR SIZE AND GET GLOVES.

THE OTHER THING I WANT TO POINT
OUT IS THEY HAVE ALWAYS SAID
WHEN YOU ARE HANDLING A CATHETER

THAT SHE'S SHOULDN'T GET THE
CATHETER ABOVE THE BLADDER.

AND THAT'S TRUE
FOR DRAINING PURPOSES.

IT NEEDS --
THE BAG NEEDS TO BE LOW -

STAND THIS WAY, THE ONLY --
AND IF YOU GUYS CAN'T SEE
JUST MOVE.

YOU GOT IT TOGETHER THERE.

IT NEEDS TO BE DOWN HERE BELOW
THE BLADDER SO THAT GRAVITY
WILL DRAW THE URINE OUT.

SO WE DON'T WANT TO KEEP
IT UP ABOVE THE CLIENT
FOR ANY LENGTH OF TIME

BECAUSE THEN THAT WON'T
DRAIN UP THE BLADDER.

BUT IT DOESN'T MEAN THAT
FOR A SHORT PERIOD OF TIME

WE CAN'T PICK THIS UP AND MOVE
IT WITH THE CLIENT TILL WE GET
HIM IN POSITION.

THE OTHER THING THEY SAID IS YOU
DON'T WANT TO GET OLD URINE

BACK INTO THE BLADDER BECAUSE IT
WILL BACK FILL. BUT IT WON'T.

THEY HAVE GOT
A BACK CHECK VALVE IN HERE
AND SO THIS ISN'T GOING TO -

OH, LOOK AT ME.

THE NEW ONES DON'T.
THIS MUST BE AN OLD ONE.

BUT THE NEW ONES DON'T.
OH, BUT THEY DO LOOK LIKE THIS.

SO WHAT YOU WOULD WANT TO DO IS
DRAIN OUT THE OLD URINE DOWN
INTO THE BAG AND THEN -

WE GOT TO DO BETTER AND GET RID
OF SOME OF THESE OLD ONES.

BUT THEY HAVE A BACK CHECK VALVE
AND THEY REALLY DON'T
WHEN YOU TURN THEM OVER.

THEY DON'T COME BACKWARDS
INTO THE CLIENT. OKAY?

KEEPING THAT IN MIND YOU JUST
PUT THIS ON THEIR CHEST
OR ON THEIR STOMACH,

SO THAT WE DON'T GET
IT CAUGHT. ALRIGHT?

YOU JUST NEED THAT LITTLE HEADS
UP BEFORE WE DO OUR THING.

OKAY, SO HERE WE ARE, WE ARE
GOING TO DO THE HIGH FIVE.

FIRST THING?
- CHECK DOCTOR'S --

- CHECK DOCTOR'S ORDERS
OR CARE PLAN ACTIVITY.

WHY DOES HE HAVE TO BE IN A
GURNEY, WHY CAN'T WE LET HIM
WALK OVER THERE?

YOU KNOW, OR WHEELCHAIR
OR SOMETHING.

BUT WE CAN'T SO WE ARE GOING
TO PUT HIM IN A GURNEY.

WE'RE GOING TO GATHER UP OUR
EQUIPMENT WHICH IS THE GURNEY
AND THE PILLOW

AND A BATH BLANKET FOR PRIVACY.
I HAVE GATHERED UP PEOPLE
TO HELP ME.

I NEED AT LEAST FOUR.
AND FIVE IS BEAUTIFUL.

COS THEN YOU HAVE
THE FIFTH PERSON FOR THE FEET.

I HAVE IDENTIFIED MY CLIENT.

HI, MR. SPADE,
HOW ARE YOU TODAY?

WE NEED TO TAKE YOU TO X-RAY AND
I'VE BROUGHT SOME FRIENDS
HERE TO HELP ME.

AND WE ARE GOING TO MOVE YOU
OVER TO THAT GURNEY.

I'VE EXPLAINED THE PROCEDURE
AND PROVIDED PRIVACY.

ALRIGHT. THIS IS WHAT
WE NEED TO DO.

FIRST THING I WANT TO DO
IS PROVIDE PRIVACY FOR HIM,

SO IF YOU COULD PASS ME
THAT BATH BLANKET.

AND WE'RE GOING TO PROVIDE
PRIVACY EVEN FROM MY CO-WORKERS.

AND TO DO THAT, I AM GOING
TO TAKE THE BATH BLANKET
AND I AM GOING TO COVER HIM UP

BEFORE I EVER UNCOVER HIM
SO HE'S NEVER EXPOSED.

SO, STACY, IF YOU
COULD GRAB THIS?

AND I'M GOING TO GRAB THIS.

ACTUALLY, LET'S GET RID
OF THIS WHEELCHAIR.

NOW, MARY, WHY DON'T YOU GRAB
THAT BLANKET AND THEN WE'RE
GOING TO PULL --

LISA, GO AHEAD.
THAT'S RIGHT.

OKAY, WE ARE GOING TO PULL
THIS DOWN

SO THAT HE IS REALLY
NEVER EXPOSED.

WE ARE GOING TO GET OUR SHEETS
AND FANFOLD THEM.

I NEVER WANT TO SEE THIS.

UNACCEPTABLE, YOU CANNOT HAVE
YOUR LINEN ON THE FLOOR.

SO PROTECT YOUR LINEN. FANFOLD,
SO THAT THE TOP IS HERE.

AND AGAIN, IT DOESN'T HAVE
TO BE, LIKE, PERFECT.
JUST NEEDS TO BE -- OKAY.

SO THAT LOOKS GOOD.
WE WANT TO BE SURE
AND CHECK FOR TUBES.

YOU WANT TO CHECK
FOR LINES, IV TUBINGS,
FOLEY CATHETERS, OXYGEN,

ANY KIND OF LINES THAT MIGHT AS
YOU ARE PULL HIM -- CATCH HIM.

AND THEN WE WANT TO SET HIM
IN A GOOD POSITION FOR US.

SO I AM, KIND OF,
SIZING THIS UP.

AND IT LOOKS LIKE CHAD AND MARY
ARE -- OH, MY GOD, YOU'RE PRETTY
TALL ACTUALLY, SO.

I AM GOING TO, KIND OF,
PUT IT IN THE MIDDLE

FOR ALL OF US SO NONE
OF US ARE REALLY STRAINING.

AND THAT COULD BE, KIND OF,
A CHALLENGE IF GOT, YOU KNOW,
FROM, LIKE, 5'2" TO 6'4".

YOU MAY WANT TO PUT
YOUR SHORTEST PERSON,
LIKE, ON FEET,

SO THAT YOUR TALL PEOPLE
ARE THE PULLING PEOPLE.

THEN I AM GOING TO FLATTEN
THE BED OUT IF I CAN.

IF I CAN'T FLATTEN THE HEAD,
THEN I'M GOING TO PUT THE HEAD
UP ON THE GURNEY

SO THAT WE MAKE AN EVEN
EXCHANGE AS FAR AS HEIGHT.

ALRIGHT.

GLOVES. HERE, GLOVE LADY,
YOU JUST TOUCH THAT THING.

WHAT YOU WANT TO MAKE SURE ON
YOUR FOLEY CATHETER IS THAT THE
TUBING IS OVER THE LEG,

THAT IT DOESN'T GET WOUND AROUND
THE LEG AND THAT IT'S NOT
CAUGHT ON THE BED.

SO JUST SET IT RIGHT HERE
AND THAT WILL BE BEAUTIFUL.

YOU GUYS, GO AHEAD AND PUT YOUR
SIDE RAIL DOWN, PUSH THE LEVER
AND THEN ROTATE IT BACK.

OKAY, WE ARE GOING TO DO --
THIS IS A FOUR PERSON MOVE

AND WE ARE GOING TO DO IT WITH
A PULL SHEET OR A DRAW SHEET
VERSUS US JUST LIFTING A PERSON.

I HAVE BEEN SHOWING YOU LIFTS,
BUT NOW WE ARE GOING TO
DO DRAW SHEET.

SO IF YOU GUYS WILL PULL YOUR
DRAW SHEET OR PULL SHEET OUT.

MY PULL SHEET IS ACTUALLY
A LITTLE LOW,

IT SHOULD BE FROM ABOUT THE
BUTTOCKS TO THE SHOULDERS.

BUT BECAUSE WE HAVE SO MANY
PEOPLE, WE ARE GOING
TO USE OUR HANDS

AT THE SHOULDERS
AND ONE HAND ON HERE.

OKAY, AND I WILL SHOW
YOU HOW TO DO THAT.

I WANT YOU TO ROLL THE DRAW
SHEET RIGHT UP TO THE CLIENT.

I WANT YOU TO BE FEET
AND I WILL DO THE TALKING.

YOU, BE DOWN HERE WITH OUR
FOLEY CATHETER. GUARD THAT.

IT'S YOURS TO GUARD.

OKAY, WE WANT TO MAKE SURE
THE BRAKE IS SET

SO WE DON'T GO FLYING
AND WE ARE GOOD TO GO.

WHAT I WOULD LIKE TO DO
FIRST IS I WOULD LIKE US
TO JUST LIFT THE CLIENT

AND TAKE HIM TO THE EDGE
OF THE BED AND THEN WE WILL
SET THE GURNEY HERE SO.

ON THE COUNT OF THREE,
GOOD WIDE BASE OF SUPPORT,
NICE STRAIGHT BACKS.

YOU AND I ARE GOING
TO GRAB ONE PLACE.

DON'T WORRY ABOUT THAT.
I'LL BE FINE, YOU GRAB HERE.

GRAB, YEAH.
YOU ARE GRABBING, RIGHT?

GRAB THIS WAY THE DRAW SHEET.
DON'T GRAB THIS WAY.

YOU DON'T HAVE GOOD SUPPORT ON
YOUR WRISTS, SO GRAB THIS WAY.

I'M GOING TO GRAB LIKE
THIS AND WE ARE GOING
TO TAKE HIS SHOULDER

AND WE ARE GOING TO ASK
OUR CLIENT TO KEEP HIS HANDS IN
AND HIS CHIN TO HIS CHEST.

IF HE CAN'T HOLD THE SET,
WE'LL HOLD THAT TOO.

SO ON THE COUNT OF THREE,
GOOD WIDE BASE OF SUPPORT.
ARE YOU GUYS WIDE?

- WIDE.
- KNEES BEND? BACK STRAIGHT.
YOU'RE NOT BENT.

THANK YOU. I'M IN CHARGE.

AND IT'S MY RESPONSIBILITY
TO TAKE CARE OF MY WHOLE TEAM.

SO ACTUALLY, WHAT I WANT YOU TO
DO IT'S EASIER IF YOUR FOOT
PERSON JUST GOES LIKE THIS.

AND JUST TAKES FEET
THIS WAY INSTEAD OF THAT...

OKAY.

ON THE COUNT OF THREE
TO THE EDGE OF THE BED.

WIDE.

BEND.

YEAH, HERE WE GO.

ONE, TWO, THREE. TO THE EDGE.

OKAY.

NOW...

..ACTUALLY, WE NEED
YOUR SIDE LIKE THIS.

AND YOU'RE GOING TO HAVE TO HOLD
THAT KNEE UP HERE -- FROM HERE,

COS I'M, KIND OF,
TEACHING YOU.

THEY ARE GOING TO HOLD OUR
CLIENT IN WITH THE DRAW SHEET

WHILE THESE TWO PEOPLE MOVE OUT
AND COME TO THE GURNEY.

YOU NEED TO TAKE
THE BRAKE OFF THE GURNEY.

AND IT'S DOWN HERE
AT THE BOTTOM.

AND WE ARE GOING TO ROLL THE
GURNEY TO THE EDGE OF THE BED.

THIS IS A PERFECT
HEIGHT, REALLY.

YOU WANT THE GURNEY TO BE A
LITTLE BIT LOWER THAN THE BED

AGAIN SO THAT YOU ARE NOT
FIGHTING GRAVITY.

SO IT'S ABOUT AN INCH,
INCH AND A HALF BELOW THAT.

THEN WE WANT TO LOCK
THE BED OF THE GURNEY
SO IT DOESN'T GO FLYING.

AND ALL YOU NEED TO DO IS THE
ONE AT THE FOOT OF THE BED.

ALRIGHT, HERE'S WHERE
IT GETS A LITTLE TRICKY.
GET YOUR POSITIONS BACK AGAIN.

NOW ACTUALLY, CHAD, I'LL DO
OVER HERE FOR JUST A DEMO.

I'M PRETTY SHORT.
CHAD'S PRETTY TALL AND HE'S
STRONGER COS HE'S A GUY,.

HE'S GOT BIGGER MUSCLE STRENGTH,
GREATER MUSCLE STRENGTH,

WHICH IS ALSO ONE OF
THE RESEARCH PROPOSALS
THAT THEY ARE DOING

BECAUSE THEY ARE TEACHING BODY
MECHANICS AS UNIVERSAL.

WHEN GUYS HAVE A DIFFERENT
MUSCLE MASS AND A DIFFERENT
STRENGTH THAN FEMALES DO

AND WE ARE HAVING INJURIES THAT
ARE DIFFERENT FOR THE SEXES

AND SO THEY NEED TO HELP US
THERE RELATE TO OUR BODY MASS.

SO ANYWAYS, I'M SHORT,
YOU'RE SHORT, COME OVER HERE.

YOU GUYS, GRAB YOUR SHEET.

AND WHAT I WANT TO DO IS I WANT
TO PUT ONE KNEE UP. I DON'T
WANT TO DO THIS.

BECAUSE IF I GO UP ON
THE BED AND I PULL,

I GO FLYING.
THIS IS NOT GOOD FOR ME.

SO IF I KEEP ONE LEG HERE,
I STILL HAVE MY CENTER
OF GRAVITY CLOSE.

AND IF I WERE TO FALL,
I'VE GOT A LEG TO CATCH ME.

SO...ROLL UP.

AND ACTUALLY, CHAD, I'LL
MOVE YOU TO THE FEET.

GRAB HERE ON YOUR PILLOW.

WHY DIDN'T YOU SAY, MR. SPADE,
THAT WE HAVE THAT PILLOW AND
THAT YOU WEREN'T COMFORTABLE.

THANK YOU.
OKAY.

SO THERE WE GO. WE GOT HIM
NICE AND STRAIGHT.

ON THE COUNT OF THREE, LET'S
JUST GO TO THE EDGE
OF THE GURNEY

COS WE'RE, KIND OF, SHORT HERE
TO DO THIS. SO, ONE, TWO, THREE.

OH, THAT'S BEAUTIFUL.

NOW THESE GUYS CAN COME
HELP US A LITTLE BETTER.

WE'LL GRAB THIS AND HOLD HIM,
KEEP HIM FROM FALLING OUT.

YOU ARE GOING TO NEED TO EITHER
TAKE THE BRAKE OFF OF HERE OR
TAKE THE BRAKE OFF OF THE BED,

SO THAT YOU CAN GET IN
TO THIS SIDE.

YEAH, AND JUST PUT IT STRAIGHT,
IF YOU PUT IT SWIVELED,
IT WON'T MOVE.

STRAIGHT AND PULL.

YEAH.

OH, THE PILLOW FELL,
WHAT DO YOU DO?

CLEAN UP. LAUNDRY. OKAY.
NEW PILLOWCASES.

ALRIGHT. WE ARE, KIND OF,
PULLING ON THAT CORD THERE

SO IT'S PROBABLY NOT GOING TO GO
MUCH FURTHER.

IF YOU GUYS CAN SHIMMY IN THERE
AND WE WILL GET HIM CENTERED.

OKAY. IF YOU COULD BEND YOUR
KNEES HERE A LITTLE BIT,
MR. SPADE?

TALK TO YOUR CLIENT. HAVE HIM
HELP YOU. PUT YOUR CHIN
TO YOUR CHEST.

ON THE COUNT OF THREE,
WE ARE GOING TO PUT YOU
IN THE MIDDLE OF THE GURNEY.

ONE - YOU'RE FEET.

ONE, TWO, THREE.
WONDERFUL.

OKAY, NOW WE ARE GOING TO
STRAIGHTEN OUT THE DRAW SHEET.

THE FOLEY CATHETER PERSON IS
GOING TO PUT THE FOLEY CATHETER

ON A STABLE PART OF THE
GURNEY, LIKE, ON THE FRAME,
NOT ON THE HAND RAILS.

CAN YOU IMAGINE, WITH THE PIN
ROLLED UP, WHAT THAT WILL DO?

I'VE SEEN CONFUSED CLIENTS
PULL THOSE OUT.

I'VE WALKED IN THE ROOM
AND THAT AND THE CATHETER
IS LAYING ON THE FLOOR

WITH SOME BLOOD AROUND IT AND
THE BALLOON COMPLETELY INTACT.

All: AH!

- I DO JUST THE SAME THING.

"I'M HURT. WHY DID
YOU DO THAT? OH!"

OKAY. PUT THE SIDE RAILS UP,
REMIND YOUR CLIENTS TO
KEEP THEIR HANDS IN.

AND IF THERE'S A SAFETY BELT FOR
TRAVEL, YOU PUT THE BELT
ON FOR TRANSPORT.

YOU TAKE THE BRAKE OFF AND THEN
MOVE THEM WHERE EVER
THEY NEED TO GO.

IN THE MEANTIME, WE WOULD
STRAIGHTEN UP THE LINEN.

ANYTIME THE CLIENT'S OUT OF THE
BED, FIX THE BED.

IT'S SO MUCH EASIER WHEN THEY
ARE OUT THAN THEY ARE IN.

ALRIGHT. WELL,
HE'S HAD A WONDERFUL TIME.

NOW THIS IS WHAT
WE DON'T WANT TO DO.

WE WANT TO MAKE SURE THAT
WE ARE NOT AGAIN CAUSING
TOO MUCH GRAVITY HERE.

SO ACTUALLY, PUT IT DOWN HERE
ON THE END, I THINK.

YEAH.

AND HOOK IT DOWN HERE.

PERFECT. I LIKE IT.

- NOW IF YOU WERE THE
CATHETER PERSON, WOULD
YOU TAKE OFF YOUR GLOVES

BEFORE YOU STARTED MESSING
WITH THE BED OR WOULD YOU --

- IT'S HIS BED.
SO AGAIN, IT'S TO PROTECT YOU.

IF THEY'VE BEEN INCONTINENT,
SO NO, IF THE BED'S WET,
I'D LEAVE THE SAME GLOVES ON.

IT'S HIM, GLOVES ARE
TO PROTECT ME FROM HIM.

HE'S HIM. THEY DON'T
PROTECT HIM FROM HIM.

THAT'S WHERE I SAW A HAND?

- DO THEY USE ROLLING
BOARDS TOO?

- YES, THEY DO. A LESSON.
THERE'S ROLLING BOARDS
AND SLIDE BOARDS.

AND WHAT IT IS,
IT'S HARD TO EXPLAIN,

BUT IT'S A BOARD LIKE THIS
THAT HAS ROLLS OF WHEELS

AND YOU PUT THE BOARD RIGHT
UNDERNEATH THEM

AND IT REACHES FROM
THE BED TO HERE AND ONCE
THEIR BOTTOM IS ON --

IT STILL TAKES THE SAME AMOUNT
OF PEOPLE TO, KIND OF, SHIFT
THEM BUT THEY JUST GO.

AND THEY ROLL ACROSS.
THE SLIDE BOARD IS NICE,
NOT QUITE AS NICE,

I LIKE THE ROLLING BOARD BETTER
COS THEY JUST, OVER.

BUT THE SLIDE BOARD AGAIN STILL
GIVES YOU A LITTLE BIT OF
TRACTION TO SLIDE DOWN

RATHER THAN THE FULL LIFT
AND PULL, AND THAT WILL
HELP WITH MANEUVERS.

AND IF YOU WANT TO GET A SLIDE
BOARD OR A ROLLING BOARD,

YOU GET THEM FROM SURGERY
AND TRANSPORT TEAMS.

THEY ARE THE ONES THAT
HAVE THE MARKET ON THEM.

YOU JUST USUALLY DON'T FIND THEM
ON THE FLOOR. ALRIGHT, WELL, OUR
CLIENT'S BEEN --

THIS IS REALLY AN HOUR AND A
HALF DAY AND NEXT WEEK'S REALLY
AN HOUR AND A HALF DAY

SO IT IS WHAT IT IS.

ALRIGHT, WE ARE GOING TO PUT OUR
CLIENT BACK SO GO AHEAD
AND LOCK THE BED.

AND NOW ON THIS PARTICULAR
GURNEY WE WANT, AGAIN, WE WANT
TO GO DOWNHILL GRAVITY-WISE.

SO WE CAN PUMP IT ON THE GREEN
TO BE HIGHER THAN THE BED,

BUT WE DON'T WANT TO BE TOO HIGH
BECAUSE IT WILL BE TOO HIGH FOR
US OR WE CAN LOWER THE BED.

SO IF YOU WOULD LOWER THE BED,
WE'D APPRECIATE IT.

I AM GOING TO COME IN HERE
AND LOWER THIS SIDE RAIL.

AND TO LOWER THE SIDE RAIL,
THERE'S A BUTTON THAT SAYS
PUSH. SO YOU PUSH IT.

I DON'T KNOW, BUT LET'S SEE.

DON'T JUMP OUT YET, MR. SPADE,
WE GOT TO GET YOU SET.

WHAT DO YOU GUYS THINK?
THAT IS IT LOWER?

YES, YOU'RE RIGHT. GOOD.

GOOD.

YOU WANT TO PRESS
THAT SIDE RAIL DOWN.

FOLEY CATHETER LADY.

OF COURSE AFTER
THEY TRANSPORT --

I THINK I DIDN'T FINISH
MYSELF UP, BUT YOU NEED
TO TAKE YOUR GLOVES OFF

AND WASH YOUR HANDS ONCE YOU ARE
TOTALLY DONE, EVERYBODY
WASH YOUR HANDS.

SO WE HIGH FIVE, WASH OUR HANDS,
WE'RE GOING PUT OUR CLIENT BACK.

SO, MR. SPADE, WE'RE GOING
TO PUT YOU BACK IN THE BED.

IF YOU PUT YOUR HANDS ACROSS
YOUR CHEST, PUT YOUR KNEES TO --

PUT YOUR KNEES TO YOUR CHEST.
YOUR CHIN TO YOUR CHEST.

AND BEND YOUR KNEES
A LITTLE BIT.

ALRIGHT, YOU GOT THE DIRECTIONS,
THIS TIME I AM GOING TO LET YOU
BE THERE, I'M GOING TO BE FEET.

YOU GUYS GET ON THE BED.
ALL BRAKES ARE SET.

YOU WANT TO ROLL THIS
UP AND AGAIN JUST ONE KNEE IN
THE BED, ONE LEG HANGING DOWN,

GOOD WIDE BASE OF SUPPORT,
BOTH OF YOU, KNEES BEND.

BEND.

ALRIGHT.

HERE WE GO. LET'S JUST GO --
WHERE DO YOU WANT TO GO?

TO THE EDGE OF THE GURNEY
AND THEN THE EDGE OF THE BED.

OKAY, MAKE LIKE THE EDGE
OF THE GURNEY ON THE COUNT
OF THREE. ONE, TWO, THREE.

OH, MR. SPADE COULD YOU PUT YOUR
CHIN TO YOUR CHEST,

YOUR HEAD'S, KIND OF, DRAGGING
THERE A LITTLE BIT.

OKAY. THIS TIME, LET'S JUST
GO TO THE EDGE OF THE BED
ON THE COUNT OF THREE.

YOU GUYS MAY NEED TO PUT
A KNEE IN THE GURNEY.

IT DEPENDS, BECAUSE YOU DON'T
WANT TO STRAIN YOUR BACK.

OKAY, ON THE COUNT OF THREE,
GOOD WIDE BASE OF SUPPORT.

- KNEES IN?
- YEAH.

(LAUGHING)

ONE, TWO, THREE.

OH, OKAY.

NOW, YOU GUYS, HOLD THIS.
YOU GUYS, GET RID OF THE GURNEY.

AND THEN WE'LL GET HIM SET.

IF YOU'LL NOTICE HE'S WAY
TOO FAR DOWN IN THE BED.

I WANTED HIM TO BE -- I DID IT
ON PURPOSE. I PULLED HIM DOWN.

BUT IT WOULD HAVE BEEN NICE
IF THEY'D HAVE PULLED HIM
TO THE TOP.

RIGHT? SO WE WOULDN'T HAVE
TO DO ONE MORE MANEUVER.

SO WHAT WE ARE GOING TO DO ON
THIS MANEUVER IS WE ARE GOING TO
PULL HIM UP AND TO THE MIDDLE.

AND THAT'S HOW YOU CAN
USE A DRAW SHEET WITH
A GROUP OF PEOPLE

RATHER THAN HAVING JUST TO JUST
PULL HIM UP YOURSELF IF YOU DID
TWO TO FOUR PEOPLE. GO.

YOU CAN GIVE THEM THIS
BACK WHEN THEY'RE READY.

GO AHEAD HAVE THEM BEND HIS
KNEES. PUT YOUR CHIN
TO YOUR CHEST.

ON THE COUNT OF THREE I WANT
YOU TO PULL HIM UP AND OVER

SO HE'S IN THE MIDDLE OF THE
BED. READY, ONE, TWO, THREE.

VERY NICE.

AND HE'S ALL SET, SO.

FOLEY CATHETER PERSON --
DON'T TOUCH, DON'T TOUCH.

OKAY, YOU GUYS CAN GO AHEAD AND
STRAIGHTEN OUT YOUR SHEET AND
GET YOUR DRAW SHEET SITUATED.

AND, CHAD, WHILE YOU'RE,
KIND OF, WAITING --

YEAH, HOOK IT RIGHT THERE.

YOU COULD PULL THE BLANKET
UP OVER THE BATH BLANKET.

AND THEN WE ARE GOING TO PULL
THE BATH BLANKET DOWN

UNDERNEATH THE BLANKET
SO HE'S NEVER EXPOSED.

YOU'VE NEVER SEEN HIM.

THE ONE THING WE WANT
TO CHECK AFTER WE DO THIS

IS IF MAYBE YOUR FOLEY CATHETER
PERSON TOOK ONE MORE
PEEK UNDER THERE

TO SEE HOW THE
FOLEY CATHETER LANDED.

BECAUSE AFTER A GROUP WOULD
COME, THE NEXT GROUP WOULD COME

AND THEN FOLEY CATHETER WOULD BE
ALL THE WAY AROUND THE LEG.

AND IT'S LIKE,
"HOW DID THAT HAPPEN?"

SO, TAKE A PEEK.

AND MAKE SURE THAT THE
LINEN IS STRAIGHT AND THE
DRAW SHEET'S TUCKED IN.

AND THAT YOUR FOLEY CATHETER
IS OVER THE LEG,

NO TWISTY TIES AND THEN
ON TO THE SIDE OF THE BED.

GO AHEAD AND TUCK YOUR DRAW
SHEET IN. AND THEN HE'S SET.

WE ARE GOING TO AHEAD AND
PUT THE BED, SIDE RAIL IS
UP, BED IN LOW POSITION.

PULL THEM OUT AND
UP THE OTHER WAY.

OKAY, NOW THE BED NEEDS
TO GO IN THE LOW POSITION.

WHAT POSITION IS OUR CLIENT IN?

IT'S DECLINE.

YOU HAVE TO MOVE IT SO THAT
WE CAN ERECT THE BED.

SOMETIMES WE SMASH TRASH CANS
AND TABLES AND SO FORTH. OKAY.

MOVE THIS UP. SET THE
BRAKE AND PUT HIM LOW.

WASH YOUR HANDS AND DOCUMENT
THE TRANSFER AND HOW
WELL HE DID.

OKAY, I WANT TO SHOW YOU
ONE LITTLE QUICK THING.

THAT'S THE THINGS THAT YOU NEED
-- WHAT YOU NEED TO DO
FOR NEXT WEEK.

THREE STATIONS, WE ARE GOING
TO START YOU OUT, WE ARE GOING
TO CALL YOU ALL IN EARLY.

SO IF YOU ARE 8 O'CLOCK,
AT 10 TILL 8 WE ARE GOING
TO START YOU ON THE TRANSFER.

AND THEN WE WILL PUT EVERYONE
AT THEIR STATIONS.

SO THAT AT ABOUT 20 AFTER 8,
WE ARE GOING TO PULL
IN THE 8:30 PEOPLE

AND START YOU WITH YOUR GURNEY
TRANSFER AS ONE GROUP

WHILE THEY'RE FINISHING UP
THEIR STATIONS ALL OVER THERE.

AND THEN WE ARE GOING
TO KEEP YOU MOVING.

SO WE WILL PROBABLY START
10 MINUTES AHEAD OF YOUR
APPOINTMENT TIME AS A GROUP.

SO YOU GUYS WILL WANT TO
PRACTICE ON THE GURNEY, WE WILL
PUT THE GURNEY DOWN ON BED 5

AND YOU CAN WORK WITH IT THERE

IF YOU WANT TO TAKE
IT AFTER CLASS, YOU ARE
WELCOME TO DO THAT.

SO FIND YOUR PEOPLE.

ALRIGHT, LAST BUT NOT LEAST.

REMEMBER, I TALKED TO YOU
ABOUT A CD-ROM AND IN
ALL OF YOUR READING,

I'LL SAY CIA DELMAR CD-ROM BASIC
OR INTERMEDIATE OR SOMETHING
LIKE THAT.

THESE ARE THE CD-ROMS
THAT I AM REFERRING TO.

ON THESE CD-ROMS,
THERE'S ACTUALLY FOUR OF THEM.

AND THEY HAVE ALL THE SKILLS.

WHAT I LOVE ABOUT THESE CD-ROMS
IS FOR EXAMPLE, THIS WEEK YOU
HAVE A VIDEO THAT'S --

WHAT IS IT?

I THINK IT IS BODY MECHANICS
AND RANGE OF MOTION.

IT'S, LIKE, 55 MINUTES
LONG OR AN HOUR AND
50 MINUTES, PRETTY LONG.

SO IF YOU'RE GOING TO WATCH THE
WHOLE THING, YOU'VE GOT TO
INVEST IN THAT AN HOUR OF TIME

OR YOU GOT A FAST FORWARD TO
FIND WHAT YOU WANT OR WHATEVER.

BUT ON THESE CD-ROMS
THEY BROKE EVERYTHING DOWN
INTO SMALL INCREMENTS.

SO THEY HAVE, PULLING
A PATIENT UP, ONE THING.

THEY HAVE, TURNING
A CLIENT, ONE THING.

INSTEAD OF HAVING IT ALL
ON ONE VIDEO, THAT'S
WHAT I LIKE ABOUT IT.

THE VIDEOS --

THE CD-ROMS, IF YOU WANT
TO KNOW WHAT'S ON EACH ONE,

WE'VE PRINTED OUT THE MENUS
SO THAT YOU CAN SEE
WHICH ONE YOU NEED

AND WHAT YOU MIGHT WANT
TO WATCH OF THAT CD-ROM.

AND WE KEEP THOSE POSTED IN THE
MIDDLE ROOM WHERE CONNIE'S DESK
IS WHEN YOU COME IN 180.

YOU WILL SEE THESE, SO YOU'LL GO

"OKAY, SO TODAY SHE SAID
LOOK AT THE BASIC CD-ROM.
WHAT ARE WE DOING?.

OH, RANGE OF MOTION,
I COULD REVIEW THAT.

I COULD REVIEW CRUTCHES,
CANE, WALKER,

I COULD REVIEW TURNING,
SAFE LIFTING."

ALL OF THAT IS ON HERE
AND YOU CAN LOOK AT THOSE.

WHICH IT REMINDS ME,
THIS IS A TWO WEEK MODULE.

IN OTHER WORDS, THERE'S SO MANY
THINGS TO DO RELATED TO BODY
MECHANICS AND SAFETY,

I COULDN'T TEST YOU
ON ALL OF IT IN ONE WEEK.

SO YOU NEED TO DO ALL OF THE
READING SO THAT YOU CAN PASS
YOUR BLACKBOARD.

BLACKBOARD WILL
ONLY BE THIS WEEK.

SO IT WILL INCLUDE QUESTIONS
RELATED TO CANE, CRUTCHES,

WALKERS, RESTRAINTS,
RANGE OF MOTION,

BUT YOU ARE NOT GOING TO GET
TESTED ON THAT UNTIL THE
FOLLOWING WEEK,

BUT THAT WEEK THERE IS
NO BLACKBOARD. SO YOU DO
ALL YOUR READING UPFRONT

WHICH MAKES YOU A LITTLE
BIT BETTER PREPARED FOR
LECTURE NEXT WEEK

COS YOU'VE DONE ALL THE READING.
OKAY? SO WHEN YOU SEE THOSE
QUESTIONS ON CRUTCHES,

YOU GO, "SHE DIDN'T TALK ABOUT
CRUTCHES, WHAT'S THIS?"

WELL, WE ARE GOING TO DO IT NEXT
WEEK. SO TWO WEEK MODULE,

BUT ONLY ONE BLACKBOARD
WHEN YOU DO A TWO WEEK MODULE.

ALRIGHT, ON THE COMPUTER
I JUST WANT YOU SEE THIS
ONE WONDERFUL PROGRAM.

WE HAVE THEM ALL INSTALLED, YOU
JUST HAVE TO GET THE DISC SO
THAT YOU CAN GET THE VIDEOS.

GO TO DELMAR'S NURSING
AND WE HAVE THEM ALL
BUT BASIC CARE NURSING.

YOU CAN GET THIS ON ALL OF THEM.

SOMEONE WANT TO GET
A COUPLE OF LIGHTS.

THANK YOU.

YOU HAVE ALL OF THESE THINGS
TO CHOOSE FROM AND YOU CAN
GO DIRECTLY TO SKILLS MENU.

AND THIS IS WHERE ALL
OF THE SKILLS ARE.

I'M GOING TO CUT STRAIGHTAWAY
TO MOVING A CLIENT.

ALL OF THE MENUS ARE THE SAME,
ONCE YOU GET TO THE SKILL.

AND IT LISTS THINGS LIKE
OVERVIEW AND ASSESSMENT
AND SO FORTH.

AND OVER HERE IS A FREE TEST.
THERE'S FIVE QUESTIONS.

LET'S SEE AFTER TODAY'S
DEMO WHAT WE KNOW.

GENERALLY, CLIENTS CAN MOVE
THEMSELVES IN BED AND DON'T
NEED MUCH HELP WITH THIS.

TRUE OR FALSE?

I HEARD A LOT OF TRUES.
SO WE'RE GOING TO PICK TRUE.

YOU PICKED TRUE, YOU WANT TO
GO WITH THAT CHOICE STILL?

YES? THE ANSWER IS FALSE.
THAT'S TRUE TO SOMEONE.

OKAY, THEN WE GO
TO THE NEXT ONE.

MOVING A CLIENT UP IN BED
MAY REQUIRE MANY AS FOUR NURSES?

TRUE.

WANT TO GO WITH THAT CHOICE?
NO BACKING OUT.

OH, YEAH. IT'S TRUE. OKAY.

THAT'S NO.3. THERE'S ONLY FIVE.
WE CAN DO IT QUICK.

CLIENTS SHOULD BE ENCOURAGED TO
HELP WHEN BEING MOVED IN BED.

- YES.
- OH, YES.

AS MUCH AS THEY WILL
POSSIBLY DO, YES. WE WANT
TO GO WITH THAT CHOICE, YES.

NO.4, ALWAYS PUT THE HEAD ON
THE BED DOWN WHEN PULLING
A CLIENT UP IN BED.

I HEARD MOSTLY YES.
OH, I HEARD ONE NO.

- NOT TRUE. NOT ALWAYS TRUE.

- AND WE'RE GOOD. WHEN PULLING A
CLIENT, IT'S DEFINITELY FALSE

BECAUSE THERE'S NEVER
ANY ALLS HARDLY, YOU KNOW.

OKAY, PEOPLE THAT HAVE
RESPIRATORY PROBLEMS, SOME
HEAD INJURIES AND SO FORTH,

YOU CAN'T PUT THE HEAD OF
THE BED DOWN, IT'S JUST
EASIEST IF YOU CAN.

CLIENTS ARE AT RISK OF INJURY
WHEN BEING MOVED IN BED.

- TRUE.
- TRUE?

YOU MIGHT RUN THEIR HEAD INTO
THE HEADBOARD, YOU MAY DROP
THEM, YOU MAY SHEAR THEIR SKIN.

THERE'S A LOT OF INJURIES THAT
CAN HAPPEN. YOU WANT TO GO WITH
THAT CHOICE, YES, WE DO. TRUE.

OKAY, AND IT SAYS WE GOT THREE
OUT OF FIVE CORRECT.

AND THAT'S THE FREE TEST, IT
GIVES YOU FEW MORE QUESTIONS

JUST TO, KIND OF, SEE WHERE
YOU'RE AT. WE DON'T
WANT TO REPEAT.

THE PROGRAM GIVES YOU AN
OVERVIEW OF WHAT THE SKILL IS.

IT'S, KIND OF, LIKE, TEXTBOOK
THEORY, BUT IT'S SHORT.

THEN YOU CAN MOVE
ONTO ASSESSMENT.

THINGS THAT YOU WOULD WANT TO
ASSESS ABOUT YOUR CLIENT BEFORE
YOU JUST GO AND MOVE THEM.

SKIN INTEGRITY, HEAD INJURIES,
VITAL SIGNS,

THEIR ABILITY TO HELP, HOW MANY
PEOPLE WE NEED AND SO FORTH.

SO IT GIVES YOU
SOME ASSESSMENT CLUES.

YOU HAVEN'T REALLY DONE
CARE PLANNING YET,
BUT YOU'RE GOING TO.

AND YOU'RE GOING TO NEED
TO MAKE NURSING DIAGNOSIS
BASED ON YOUR ASSESSMENT.

AND THIS IS GOING TO GIVE
YOU SOME IDEAS FOR A
NURSING DIAGNOSIS.

THIS IS GOOD TO KNOW BECAUSE
YOU'RE GOING TO HAVE TO HAVE

TWO OR THREE REFERENCES
FOR A CARE PLAN.

THESE COUNT. THIS PROGRAM
COUNTS AS A REFERENCE FOR
YOU, SO REMEMBER THAT.

NEXT, PLANNING, THINGS YOU
WANT TO DO, OUTCOMES, EQUIPMENT,
PATIENT EDUCATION AND SO FORTH.

YOU CAN READ IT LATER.

STEP BY STEP PROCEDURE.
LET'S LOOK AT TWO NURSES.

THIS GOES THROUGH ALL THE STEPS
JUST LIKE OUR CHECKLIST DOES.

SO YOU CAN VERIFY STEPS
AND IT HAS PICTURES.

BUT WHAT I LOVE OVER
IN THE PROCEDURE ARE THE VIDEOS.

SO WE'RE GOING TO WATCH -
OH, I FORGOT. I THINK IT'S NO.2.

A VIDEO, YOU CLICK ON IT,
AND YOU GET LITTLE VIGNETTES.

THEY'RE MOVING A CLIENT
UP IN BED.

- ONE, TWO, THREE.

LET'S GO UP ONE MORE TIME. OKAY?

ONE, TWO, THREE.

[PATIENT SCREAMING AND CRYING]

- THAT WAS REAL.

THE WAY THIS PARTICULAR
SET WAS MADE WAS,

THEY GOT A CONTRACT WITH THE
HOSPITAL TO JUST TAKE A CAMERA
AROUND AND VIDEOTAPE THINGS.

SO WHENEVER THEY SEE AN ACTIVITY
GOING ON AROUND OR A SKILL,
THEY VIDEOTAPE IT.

SO NOTHING IS SCRIPTED.
NOTHING

SO THESE NURSES WERE
TRANSFERRING THIS CLIENT,
IT TOOK FOUR OF THEM.

THEY HAD A LOT OF PEOPLE, YOU
COULD TELL SHE WAS VERY HEAVY.

THEY DIDN'T CHECK
FOR THE FOLEY CATHETER.

THEY MOVED HER, AND THAT'S WHEN
SHE YELLED, "MY BLADDER, MY
BLADDER. OH, OH, OH, OH!"

THE BALLOON. "UH, UH, UH!"

SO IF THAT DOESN'T LEAVE
A MEMORY IN YOUR MIND

ABOUT CHECKING FOR A TUBE,
I DON'T KNOW WHAT WILL.

THE THING I LOVE ABOUT THIS
PARTICULAR SET, AND IT'S
THE FIRST EDITION,

IS THERE IS A LOT OF MISTAKES
AS WELL AS RIGHT TECHNIQUE.

DON'T YOU LEARN AS MUCH
FROM A MISTAKE AS YOU
DO FROM THE RIGHT?

AND I THINK THESE ARE WONDERFUL.

WELL, THEY MADE A
SECOND EDITION.

I'VE BEEN PUTTING THIS ON
MY RECOMMENDED PURCHASE LIST
FOR A LONG TIME.

AND LAST SEMESTER THEY
SWITCHED IT TO A NEW EDITION

AND SOMEWHERE BETWEEN
HERE AND THERE, THESE NURSES,

I DON'T THINK THEY LIKE SEEING
THEMSELVES MAKING MISTAKES

AND THEY CUT THEM ALL AND THEY
DID THEM IN SCRIPTED LITTLE
ROOMS LIKE WE DO HERE.

ALL PERFECT.

SO IF YOU BUY THIS NOW, IT'S
ALL PERFECT AND IT'S STILL
THE SKILL DONE CORRECTLY

WITH ALL OF THE SAME TEACHERS
THAT THIS PROGRAM HAS.

BUT IF YOU ARE ABLE TO GET TO
MINE, IT HAS THE MISTAKES IN IT

AND I THINK THE MISTAKES ARE
JUST AS TEACH WORTHY AS THIS IS

WHICH IS WHY I LET
TOM VIDEOTAPE.

BECAUSE IF I GOOF UP, WE'LL
LEARN FROM ME JUST AS WELL.

OKAY, SO YOU HAVE THOSE,
THERE'S OTHER VIDEOS TO WATCH.

WE CONTINUE ON, HOW TO EVALUATE?
HOW TO DOCUMENT,

VARIATIONS LIKE A GERIATRIC
PERSON, HOMECARE, LONG-TERM
CHILDCARE --

WE DON'T HAVE TIME. CRITICAL
THINKING SKILLS, THEY'RE
WONDERFUL.

NURSING TIP NUMBER
ONE, POSITION IN BED TO BE
MAINTAINED USING THE BED GATCH.

I TALKED TO YOU ABOUT
THAT KNEE GATCH,

KIND OF, LIKE THAT SPEED BUMP TO
KEEP HIM FROM SLIDING WHEN YOU
PUT THE HEAD OF THE BED UP.

NURSING TIP TWO, HAVE THE CLIENT
TAKE A DEEP BREATH AND THEN
BREATHE OUT AS HE IS BEING MOVED

TO KEEP HIM FROM PERFORMING
VALSALVA'S.

IF YOU HAVE HIM RELAX AND
BREATHE RATHER THAN GO...

COS HE IS SCARED OF MOVING. WHEN
THEY BREATHE LIKE THAT, THEY PUT
SOME PRESSURE ON THEIR VAL --

IT'S CALLED THE VALSALVA
MANEUVER. AND IT PUTS PRESSURE
ON THE SCIATIC NERVE

AND IT CAUSES THE
BLOOD PRESSURE TO DROP.

YOU'LL HEAR MORE ABOUT IT LATER,
BUT IT JUST HELPS.

THE MOST COMMON ERROR?

WHAT DO YOU THINK IT IS
WHILE MOVING CLIENTS?

- NOT CHECKING FOR CATHETER?

- I TOLD YOU EARLIER.

I ALWAYS GIVE YOU ALL THE
ANSWERS ALMOST IN CLASS.

NOT GETTING ENOUGH HELP.

THE NURSE IS NOT GETTING
ENOUGH HELP.

YOU GOT TO GET ENOUGH HELP TO
PROTECT YOUR BACK, SO.

IT WILL GIVE YOU SOME TIPS
AND THIS IS MY OTHER
FAVORITE SECTION.

THE VIDEOS, TIPS
AND MOST COMMON ERRORS,

SO THAT YOU CAN AVOID THE MOST
COMMON MISTAKES.

REAL WORLD --
OH, THESE ARE SO GOOD.

I'VE DONE EVERYTHING OR
SEEN EVERYTHING THAT'S
IN THESE REAL WORLDS.

THEY'RE WONDERFUL AND THEN
BACK TO THE MENU.

SO EVERY SKILL HAS ALL THOSE
FEATURES ON THAT CHECKLIST.

OKAY, SO I HOPE YOU WILL TAKE
ADVANTAGE OF THESE.

THEY'RE IN THE DESK IN THE
MIDDLE AREA WITH THE
COMPUTERS, JUST ASK CONNIE.

AND THEY'RE AVAILABLE ANYTIME
YOU WANT. WE HAVE THREE OR FOUR
SETS OF THEM FOR YOU.

ALRIGHT, THAT IS IT FOR TODAY.
MAKE SURE YOU TOUCH BASE
WITH YOUR GROUP.

AND IF YOU WANT A TOUR,
I'LL HAVE CONNIE COME IN AND
GIVE YOU A LITTLE TOUR OF THE...