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...