Archive for June 12th, 2010

Posted on June 12, 2010 - by Nurse Virginia

CONFESSIONS OF A NURSING HOME NURSE, WHAT WERE WE THINKING?

(Part II)
When I look back twenty, twenty-five years ago at routine nursing practice then, my first thought is “What were we thinking?”  Thinking we were reorienting a confused person, looking for their mother, by saying “You are old, how old would your mother be? Your mother is dead.” We would physically tape elderly confused people to their side rails, to keep them in place, so we could do their wound treatments. Our practices certainly weren’t kind, why did we do it?

We thought we were there for our patients, in fact would have been very offended at any other suggestion. But the truth is we were there for the task. We were so task oriented, we talked about the jobs to be done and seldom talked about the person we were taking care of.

Routine wound treatment for bed sores -then:
Swabbing the open wound area with a betadine solution or some other solution to “dry” the area, which made the skin tough as leather – causing hard edges around the wounds that took long periods of time to heal.
Having the wound “open to air.” Which meant if the open wound was on your butt, (which it most likely was because we had you sit in the same position for long periods of time in a wet incontinent product) to have the area open to air every shift meant that you were laying in bed on your side with your bottom exposed for long periods of time.
If the elder had a deep open area – they routinely had an order for a “20 minute, heat lamp treatment every day.” This meant not only was your bottom exposed, we now highlighted that area by illuminating it, in case anyone passing your room walking down the hall missed what was going on in that room.  Privacy – no, no one has the time to sit with you and we need to check on you, so that door was staying open.
If you were confused or wouldn’t stay in place for your “treatment” we had an answer for that too – we just taped you to the side rail. Yes, we turned the elderly person on their side, bottom exposed, and propped them there with pillows. Then as extra insurance to get that job done, taped them on their bare skin, with long strips of paper tape to the side rail of the bed they were facing.
What were we thinking?

What if you had Alzheimer’s disease and woke up early every day looking for your Mother? The thinking of the time was to re-orientate the confused elder to the reality of the situation. So that elderly confused woman, was greeted each and every morning when looking for her mother, with the good news, “You are old, your mothers dead, how old do you think your mother would be if she were still living?” If the elder was insistent about looking for her mother, the kind caregiver would take the insistent elder to a mirror, to show her how old she was, and prove her point.  What were we thinking?

Virginia Garberding, R.N.
Director of Education, The Wealshire, Lincolnshire, Illinois
Author: Please Get To Know Me – Aging with Dignity and Relevance
www.plesegettoknowme.com