Does and don’ts in nusing THAT MIGHT SAVE MONEY AND PREVENT A LOT OF SUFFERING

Te following are some experiences in nursing that proved helpful or detrimental when applied, even though very common practiced.

Don’t:

1.) Use of soap in elderly patients removes the acidic (oily) layer from the skin. The loss of this protection will cause drying out of the skin, and create micro fractures of the skin allowing bacteria’s and fungus to enter and cause irritation/itch and leads to scratching leading to infections and sore of the skin. Elderly persons can be washed with plain water using a small towel to mildly massage the skin. Hairs can be washed with a mild (baby) shampoo.

2.) Use of body powder in elderly particular bed ridden patients adds to drying out of the skin and blocks the skin from sweating, reducing natural re-oiling of the skin. It is better to use a moisturizing Lotion for dry skin to make and keep the skin soft and smooth.

3.) Use Donut ring popular with many, causes an impairment of blood circulation in the region of application and adds to the discomfort to the patient.

4.) Use Plastic/rubber sheets to prevent the soiling of the bed are very detrimental to the skin as they do not allow the free flow of air to the skin and trap moisture, which leads to the softening and damage of skin on the back and subsequently to bed sore.

5.) Use Multiple coverage of ripple mattress is obstructing the circulation of free airflow reaching the skin of the patient, and prevents the subtle massaging effect it gives to the skin stimulating improved blood circulation. These ripple mattresses are washable and can be easily cleaned.

6.) Over cover when patients having fewer will lead trapped temperature affecting the sense of wellbeing and stress to the cardio vascular system. Only when the patient has ragger(shivering) should he be covered well to help heat up the body. After this the patient should be covered with a light sheet (sarong) to allow the body temperature to escape.

7.) Talk about the patient but with the patient. Its common practice that the people surrounding tend to talk about the patient instead with the patient particular when the patient is in an impaired state of mental consciousness. It is vital that the patient is included in anything that has to do with his welfare. Keeping him informed and getting his consent re-establishes his self worth, thrust and confidence to his environment.

8.) Isolate the patient wither physically or socially but have them exposed to as much as “normal” life participation as possible. If feasible the bedridden patient should have his bed near the family’s main activity area.


Do:

1) Communicate in a normal way with the patient particular when the patient seems to be none aware of his surrounding. Keep him informed of pleasant family matters, news etc. this will stimulate his mental faculty and help to get out of a state of stupor.

2) Stimulate the patients by speaking to him, offer radio and TV. program to get his attentiveness reactivated. Small children should be allowed to be as much as possible be near him as this will act as a very subtle attention stimulant.

3) Activate the patient to do whatever he can do for himself (washing his face etc. Do assist as much as needed but encourage self reliance in all spheres of activities of daily life (ADL’s).

4) Mobilize as much as is medically allowed, to avoid the development of muscle atrophy and gradual disabilities to perform even simple task. The patient should be constantly encouraged to do some form of activity whether walking or moving his limbs, turning his body parts ect. Within his ability. If needed solicit an outside mobilization therapist as support service.

5) Nourish the patient correctly according to consideration of medical requirements. In particular sufficient intake of liquid is of utmost importance, as a liquid deficit (dehydration) can lead to serious health problems and detoriation of well feeling. The patients is well hydrated when his urine does not give a strong odor and the color is light, the opposite is always an indication of dehydration. Food should be served in a manner as the patient is most comfortable in eating. When chewing becomes a problem, soft food is optimal and meat etc. can be minced or blended to soft consistence. Ensure that patient gets regular fruits as this will ensure sufficient vitamin and mineral intake.

6) Expose to light having a patient to long in a gloomy room and not sufficiently exposed to sun light can add to depressive feeling. If taking a patient to outside the house is difficult his head should be near a window to allow regular sunlight (indirect) contact.

7) Regular medication control elderly patients often respond very different to medication as their body has a slowed down metabolism and tends to accumulate medication substance in the blood leading to over dosing and serious side effects. Especially patients with hearth and hypertension medication are affected. Have the doctor to review the medication dosage regularly.

8) Checking and recording of vital data’s will help the doctor to improve monitoring the patient’s medication. Patients react generally with anxiety end tension when in the presence of a doctor. This can lead to a higher as “normal” (in the home) reading of the blood pressure and pulse, and subsequently incorrect doses of medication. (“A stitch in time saves nine”.)

9) Activate your muscle There prevails a misconception that “part of aging is that the muscles will lose their strength and volume and are bound to deteriorate”. Muscles are developed by exerting them and the more they are used the more they will grow in volume and strength. The problem is that older people do not use their muscles as much as they did in the younger years and this causes them to diminish. To avoid this, patients should have regular exercise move as much as possible, do some physical activities and keep themselves busy and occupied. Swimming is one of the safest forms of sports to keep fit and does not cause undue strain on joints.

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