Patient teaching: understanding how to communicate with the nursing staff

 I was thinking about some other things I can do when I become a nurse. One of the things I can do when I come on for my shift change is orient the patient to the communication tools. 

While some patients can certainly become overbearing, I also wonder if fear and anxiety can be relieved if the patients know how to get in touch with me and how to use the communication tools to get what they need? 

For example, we give them a call light and the nurses sometimes wear a phone that looks like a walkie talkie. 

The question I have is this: do they know how and when to use them? 

I don't think it would take more than 10 or 15 seconds to say go ahead and push the call light. Then, I can quickly hit the cancel button and say, "See, that was easy." 

Then I can show them how to get in touch with me on my phone.

 I can explain how each is answered. For example, in general, it is expected that the nurse assistants will respond to call lights before the nurses will. On the other hand, the phone number is directly to the nurse. So, if the patient just needs something like water or a simple comfort measure with their linens, that would be something for the nurse assistant and the call light is a good tool for that. 

On the other hand, if it's something more urgent and the patient is able to, calling the nurse is a better solution so that the nurse can respond more quickly and possibly put in orders or get in touch with a provider from the nurses station without having to first come to the room.

So far, one of the things I've noticed is that the nurses don't do a great job introducing themselves. This could be a great part of that process. I think I would immediately have more confidence in my care. 

Hemorrhoids and Capitalism

As I think I've said before, I'm a big fan of capitalism. Who was it who said something like, it's a terrible system, but it's the best system? Actually, they said it of democracy, but you can say it about capitalism, too. Innovation and self-determination drive improvement, among many other fine qualities. There is the long list of bad things, such as marketing, that contribute to capitalism's woes. I digress.

You know what's funny about capitalism? Preparation H. Instead of promoting a healthy diet to eliminate hemorrhoids and constipation, we market a med to relieve symptoms. 

The only capitalistic incentive to cure and prevent is money. For diseases keep getting passed, the cure will forever be needed; prevention is needed by new people and needs to be updated. But making a disease come to an end and never resurface is not in the best interest of medicine. Or rather, is not in the best interest of the bottom line.

I'll counter my Preparation H argument: isn't it great that someone came up with something for the inevitable number of people who, for whatever reason, suffer from hemorrhoids? And, how will those people find the product if not for marketing? From those who suffer from it to those who stock their shelves with such products, knowledge is the first step.

However, there's also no marketing for the relief of the causes, such as poor diet. Wouldn't it be nice to see information that we should get 2,000-3,000 mL of non-caffeinated water per day (both from liquid and solid sources)? That we should get at least 20g of fiber per day? That lack of physical activity is a contributing factor? That many meds and dietary supplements contribute?

What is the market for health promotion? I don't mean going to the gym - I mean going for a walk. There are no coupons for raw foods, only prepared foods. Just some of the challenges that our system faces. 

Looking ahead: Combating immobility

 I'm thinking about my future nursing practice. We're currently talking about mobility / impaired mobility. Could I carry a ball with me that I play a little catch with patients who are able? Everyone loves to play catch!

Could I have every patient who is able get up and walk a lap in their room every time I come in? For example, when I bring their meds, get up - even if just to stand up. Maybe walk 10 feet then back to bed. Just something to get them out and it may  not take a lot of time. 

What if they can't get up? Can I get them to roll side to side? Could they just dangle? Do some ROM and / or incentive spirometry as I prep their meds? I bet I could get some sort of board and / or bar to get them to do some leg presses or a sort of bench press while in bed. 

How about having an ongoing game like checkers, chess, or cards that I come and play for 5 minutes here and there? 

Can my patients text me instead of / in addition to call light? Teach them to send a text that begins with their initials and room#, then their need. Obviously, this only works if I have a work-issued communication device.

I'm just thinking a lot about what I'm seeing and experiencing as a nurse. I want to connect with my patients for the purposes of healing, not just get them in, get them out.