Tuesday, September 13, 2011

Simplicity of success

After 3 long shifts as a med tech at my facility, I went and worked my once-a-week evening shift caregiving, and for the first time, it felt like a relief. We've got multiple residents on a lot of medications right now, many of which would normally be PRN's and therefore not my department. However, one of the nurses wrote them in our book as nursing orders, so for the first time we're giving medications that absolutely must be given at a certain time and that is really stressful with this population. You just never know if or when these people are going to cooperate with you.

So anyway, we've still got the Darth Vader Choker running around. He's a reasonably nice guy a lot of the time, but when he gets combative, it's scary. He's a big man (and remember, he lifted one nurse clear up off the ground by choking her). During report today we were told to "keep a close eye on him" and perform "frequent checks" because he's been peeing everywhere. And housekeeping is getting mad because he peed on the drapes and it's expensive to clean them. I'll file that under "not urgent". If it's that expensive to clean the place when he pees all over stuff, how about NOT ADMITTING people that we KNOW ahead of time are going to freak out when toileted and have a pattern of voiding inappropriately? Duh.

Anyway, Mr. Vader has been on a streak of bad days lately. So when we spotted him dozing on a couch in the hallway after dinner, I suggested to the other aide who was assigned to him that we go try to put him to bed right away, before his meds wear off. We got a wheelchair, because he was all zonked. We gently woke him up, told him we would help him get to bed, and plopped him in the wheelchair.

Once we had him in his room, I started with "Let's take a look at your feet." because apparently that's how his daughter would start his care. He was a contractor for years and years, and for all I know, he thinks he did it today. So I acted as though he had. I said "We want to make sure you didn't step on any nails or anything. Construction sites can be tricky." he was awake now, and agreed. I took off his shoes and socks. I continued "All right, those look good, no problems there. I think we better check your knees too, make sure they didn't get roughed up at all. Can you stand up?" He could, with our help. He didn't even notice that we were taking his pants off to check his knees, was just glad that his knees were okay. We continued like this until he had everything off, used the restroom, washed himself up with a washcloth, brushed his teeth and laid down in bed wearing only a brief. It was amazing. Such a change from his other days. I think if he could be appropriately medicated, he could be compliant like this all the time - he was aware of what we were doing, was doing most of the work himself, and was pleasant to be around.

It was the most successful moment I've had with this guy since he moved in.

And after all the stress of the last few days, it was a really pleasant change - sometimes it's nice to go back to basics.

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