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.