I AM HOMELESS.

I am a homeless man.

Wearied by the vagaries of a hard ,

and cruel life on the street.

Sick and admitted into the hospital.

Moved in like I just rented a room in the hospital.

Do not call me homeless ,I know.

Moved in with all my belongings into the hospital.

A few ragged belongings in plastic bags.

Do not call me homeless,I know.

Two Nursing assistants brought my hospital supplies

toothpaste,toothbrush,lotion and gown.

One of the nursing assistants held her nose.

Ignored her, I know why.

Because I stink like a rotten egg.

Do not call me homeless,I know.

The Charge nurse walked in,

and pinched her nose.

I have not showered in weeks.

Do not call me homeless ,I know.

My primary nurse walked in ,introduced herself.

And started data collection immediately

It went well until she asked for my address.

No address to give.

Are you homeless she asked?.

Do not call me homeless I know.

I cannot recall my address I replied.

Gave ex-wife phone number and address.

Nurse made a phone call,no reply.

Are you homeless she asked again?.

“NO”,I am not homeless I replied.

Nurse called the Social Worker.

Social worker made a few search .

She came back and pronounced me homeless.

Do not call me homeless,I know.

Social worker gave a list of homeless shelters.

Do not call me homeless ,I know

I do not like Shelters..


I Finally Scheduled My Annual Physical.

What do I ask my doctor?

Assessment:Let the doctor do your physical assessment from your head to your toes.

Eyes sight examine

Check your vision(Known as eye Exam)

Check your hearing.

Check your mouth.

Vital Signs :The Nurse will check your blood Pressure.If you have

heart problems Cardiologist consult will be ordered.If you have kidney disease Urologist consult will be ordered.

Blood draw,pap smear .Referral for mammogram given if you are of age

or family history of cancer.

Happy doctor with drug and patient on bed at clinic

Weight loss: Inform the doctor of unintentional weight loss. Unintentional weight loss could be very serious and sometimes deadly.Speak up.

Possible chest Xray based on why you are there.

Medical, Social history and Surgical history should be provided to the Doctor and Nurses.Heath history and family history should be provided to

your Doctor so that they can take good care of you.

Vaccine : When was the last time that you have your flu and pneumonia vaccine?
Homelessness: Where do you live? Your living condition must be provided too.

If your condition is serious you might be referred for admission into the hospital for observation and treatment.

Be your own Advocate.

DIFFICULT PATIENT.

The Doctor and His Patient.

Doctor M.X walked into patient room ,introduced himself to the patient as his doctor.

He told the patient that he want to assess him and change his wound dressing.The patient replied no you are not.

Fuck out, get out of this room right now.

The doctor tried to explain again what he wanted to do .The patient said ,”get your ugly face out of my room now.Go, I said leave.

Doctor :” You do not want me to check you and see how you are doing?

Patient : No I said fuck out,get out of my room.This is my domain.And if you insist I will file assault charges against you.

Doctor : Okay thank you very much.

Patient : Yes fuck out ,go and eat shit and die,ugly bitch.

Doctor : Walked away quietly and documented his experience.


PATIENT EDUCATION.

Nurse and Patient Husband.

Foley catheter was inserted in a fifty years old female due to urinary retention based on the Emergency Room doctor’s order.Patient was having difficulty to urinate,all effort for her to urinate before placing the Foley catheter in her was impossible. Bladder scan was done and it showed that she had over one thousand, three hundred urine in her bladder.

Upon insertion of the Foley catheter, one thousand of amber colored urine was drained out.Patient said that she felt better.Then came patient husband,

he pushed the call light and the nurse walked into the room.”My wife does not need that thing inside her private part.I felt insulted and violated that you put that thing inside my wife without consulting me.”(Husband)

Nurse : Sir I understand that you do not want the Foley catheter.

But why do you feel insulted?

Husband : Kept quiet for few minutes and replied because she does not need the tube inside of her.

Nurse : You feel that her private part is your territory.

Husband : Exactly,nobody has the right to put that thing in my wife. Not even President Bush can tell me what to do with my wife.

Nurse : Mr C.S you wife is not able to urinate.

Husband : I do not like it when you guys act like you know everything.My wife can make urine.And she has been making urine for a long ,long time.

How can you say that because I brought her to the hospital. And because I wanted the doctor to change her blood pressure medication and pain medications. Now she cannot produce urine. Who the hell are you? Are you God?

Nurse : We are not God ,the doctor ordered some test on her to see what is going on with her.And she will be admitted to the Med/Surgical floor to monitor her ,give her some fluid, antibiotics and run more test.We will make her comfortable.

Husband : Okay I still need that thing out right away.Now.

Nurse : Okay sir, I will let the doctor know. Can I get you something to drink?

Husband : No I will be leaving soon. We live two hours away from the hospital.Thanks Nurse you know what you are doing.Nurses are great people.I will call you when I get home.What is your name?

Nurse : My name is Jenny.



PATIENT EDUCATION

Nurse and Patient Daughter:

Patient daughter called the Nurse to the room because her mother wanted to urinate(void)The doctor has ordered to ambulate patient three times a day(TID) So when the patient called that she wanted to urinate.The Nurse was happy because it is a great opportunity to start the ambulation.

So when the nurse came in ,she said that she will take the patient to the restroom.But Patient Daughter said,” I prefer her to use the bedpan instead of walking her to the restroom.

The Nurse explained that the Doctor wanted the patient to walk three times a day.The daughter was furious “,You nurses are so lazy and do not want to do a shit.I do not care what the doctor said.The nurse went further to explain that walking your mother is actually good for her,it will increase circulation,and make her recovery faster.Also will help to prevent DVT (Deep Vein Thrombosis)

The Nurse decided to do patient/family education .

Patient Daughter: I am not interested in any of that ,call the doctor.

Nurse : Called the doctor and over the phone the Doctor explained the need for patient to ambulation three times a day.

Patient : Apologized to the Nurse.

Patient Daughter : Whispered to the patient,” I do not like her”.


PATIENT CALL LIGHTS.

The call light is life alert or lifeline.It is a universal standard that demonstrates the quality of care.It should not be abused by anyone.

There are various types of call lights (Regular call lights,call lights for paraplegics and call light for quadriplegics.)

Who should answer the call light?

In my perspective everyone should answer the call lights ,from the Nurse Manager ,assistant Nurse Manager,Charge Nurse ,Registered Nurses and the Nursing assistants should all answer the call lights.Whoever that answer the call light Must notify the primary nurse immediately or assist the patient.

Not My Patient Syndrome must stop. We are members of the Medical Team.We should please work together as a team.Teamwork is the key. Our patients need our help.If your patient need a bedpan,give your patient the bedpan.Do not leave the room to call the nursing assistant.You have two hands .JUST DO IT. Prevent Falls,and provide Safety.Beds in low position at all times and call lights within reach.

Supervisor Notification: If a call light is not answered immediately the call should go directly to the supervisor.The supervisor should hold the Charge Nurse accountable because the Charge Nurse know the patients that need help more than the others .And must distribute the assignment fairly.And the Charge Nurse should hold the Primary Nurse accountable for not responding promptly to the call lights.

The Nurse On Cell Phone.Please put your cell phone away and take care of your patients.You cannot eat your cake and have your cake.If you do not want to work stay home.

Call Light Meaning: Call light means that someone needs help and should receive immediate response.Develop the habit of helping others because you never know when your favorite uncle is on the other side.

Distance of Room: The distance of one patient to the other can make a huge difference.For example Nurse Jenny has a patient in room 202,217,229A 229B and new admission in room 211. Three of those patients are in isolation.Do not set Jenny up for failure.Allow Jenny to fail based on her incompetent,laziness or unpreparedness.Unfair assignment leads to high turnover rate.

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Effective Communication:Communicate well with your patient.

Introduce yourself, for example.”My name is Jenny I will be your nurse from 07am to 3:30pm.Explain your role in the Medical Team to your patient. Write down your name on the chalk board.Update the chalk board.

Assess and Listen: Assess your patient from head to toe, and listen to their needs and concern.For example are they in pain,do they want to change position,use the urinal or use the bedpan.Or do they want to go to the restroom or make a phone call to family or friends.

Effective communication: Communicate well with your patient.Introduce yourself.For example “My name is Jenny I will be your nurse from 7am to 3:30pm”. Explain your role in the medical team to your patient.Write down your name on the board.Update the chalk board.Make the information on the boasess and Listen:Do your 5minutes head to toe assessment.Listen to their needs.What do your patient need ? Is he in pain,does he want to use the restroom,urinal or bedpan?Or does he want to change p

Show Empathy: Be compassionate to the needs and concern of your patient.Prevent falls,keep your patient safe and call light within his reach and the bed in a low position at all times.

Bedside Manner: Keep patient table clean and organized and what he/she needs within reach.For example glasses,earning aids,and denture.

Be knowledgeable: Know your stuff,if you are not sure tell patient that you will call the doctor or will find out and come back.Update them with their plan of care.

Validate Patient feelings: When you show that you understand and demonstrate that you care about what they are going through.It will allow them to trust you.And to discuss freely with you.

No defensive Mechanism:Do not use defensive mechanism.Nobody want or like defensive mechanism especially when you are sick.Tell the patient when you will be back after you finish with them.Be pro-active find out what they need before you leave.

Outside the Hospital: Ask them what they did before they became ill.

By doing so you are letting them realize that you recognize them as a human being that has life before hospitalization.

Involve patient in their care: Patient and his/her family should be involve in his/her plan of care.

Anticipation of Needs: Anticipate your patient needs and do hourly rounding on your patients to make sure that they are comfortable.We all want tender loving care.Will you want extra catch up or napkins from the Restaurants? So do your patient. Before leaving the patient always ask if there is any other anything that you can do for them.

Thank your patient and reassure them that you will be back in one hour.

Nurse Assessing, Communicating, and Changing Dressing.