Hey guys! Forgive me if this is not the right forum section, mods feel free to move it.
On Monday I have the opportunity to speak to nursing school students about my injury (c6 quadriplegic) and my experiences with nursing care in the hospital. I wondered what you guys think is important for future nurses to know about caring for someone with an sci?
i think this will be a good opportunity to have some of our voices to be heard and help shape some future nurses!
thanks!
Wash your hands. Wash your hands. WAS YOUR HANDS. Do it properly. Hot water and for at least 2 minutes. I had a wound and received home health care. I got skin infections from the nurses that came. I filmed them and showed them what a bad job most did on keeping things clean.
If your in nursing just for a pay check, your likely to do more harm than help.
Attack life, it's going to kill you anyway
Steve Mcqueen (Mr Cool)
I used to teach a class in our hospital orientation program about "what to do if you have a SCI patient on your unit". I included the following information:
- What is autonomic dysreflexia, how to identify it, and how to manage it.
- How to do a "quad cough" and when it is needed.
- The basics of a bowel program and how it needs to be done as closely as possible to how the patient does it at home, including how to do dig stim.
- When getting patient out of bed for mobilization, use their own wheelchair and cushion (not a hospital wheelchair or "geri" chair), and assist as necessary with weight shifts.
- That all people with SCI/D are high risk for pressure injury development, and should be on a specialty mattress and have a turning schedule implemented.
- That people with SCI/D who use long-term indwelling catheters should not have hospital protocols for removal of indwelling catheters implemented.
- That their patient knows much more about SCI/D and their body and care needs than the nurse, and that they need to listen to and follow the directions of the patients for such care.
(KLD)
The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.
I wish you had trained our nurses. Which type of Dr. should we go to that would have nurses with training in these issues? ( not , neurologist, surgeon, GP, PT, OT )
Thanks for your help,
Hospital nurses don't work for the doctor. They are employed by the hospital, which also employs or contracts with physicians and other health care professionals. You might find nurses with such training working in hospitals associated with large SCI rehabilitation centers, especially if they can arrange consultation by a nurse (usually an APRN) from the rehabilitation center for patients in the regular hospital.
In the VA system, those VA hospitals that have a SCI Center (25 out of about 168 VA hospitals) are required to have both a nurse and a physician from the SCI consult DAILY with the staff on a unit of the regular hospital where a patient may be located, whether this is the ICU, psych unit, or other unit. In those VA hospitals without a SCI Center that have a SCI Support Outpatient clinic, there is a similar requirement for the clinic staff to see those patients and assure their SCI needs are being met. I don't know of any non-VA hospital that has this set up formally, but you can certainly inquire.
(KLD)
The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.
could you elaborate on this one, I'm not sure what hospital protocols might mean and what we should do instead. thanksOriginally Posted by SCI-Nurse
There is a big move on to remove indwelling catheters ASAP in hospitalized patients to avoid hospital-acquired CAUTI (Catheter Associated Urinary Tract Infections), with Joint Commission guidelines which hospitals are expected to implement. This has been going on for at least 6-7 years now. It is good for people who have a normal bladder.
Many hospitals have implemented protocols (essentially standing orders) for nurses to remove indwelling catheters inserted for surgery or other procedures as quickly as possible, without needing a physician's order to do so. Sometimes these orders are included in the order to insert the catheter in the first place. Knee-jerk implementation of this by a nurse who does not understand neurogenic bladder and the needs of those with long-term indwelling catheters can cause serious problems including urinary retention, autonomic dysreflexia, incontinence, and even urinary reflux and hydronephrosis in people with an a neurogenic bladder. To be on the safe side, if you do have one, discuss with your physician and ask them to write an order to NOT remove your catheter per protocol.
(KLD)
The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.
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