My take on 'Basic Care'

OK...so i suggested a topic for discussion on the NURCHAT twitter chat (every 2 weeks on a Tuesday) about 'Basic Care' in nursing, so I thought it only fair to say why I suggested it.
As always, any views are my own (now there's a disclaimer if i ever heard one!!) but it is a very emotive subject I think...
I was on my way back from a conference on 'wound care' in the South Glos region, and was listening to a show on the radio all about health care and the 'state of nursing' in the UK. Actually, i think it should have been called "Lets slag off Nurses because they do Sod all for people".
The 'presenter' was saying that the general public (including herself, with first hand experience of it) had seen nurses give some medicines out, Ignored the patients requests for help and then gone back to the nurses station to discuss their 'Facebook & social life', until it was time for the next lot of blood pressures & obs.

Yeah....right...coz Nurses have sod all to do when they are at work. Sure, you Idiot (that's the last time I ever tune into "you & yours" on Radio4).

I work Night shifts, and as any of you with any experience of them know, realise that it becomes a skeleton staff at night. We don't have the luxury of office support, people to answer phones, kitchen staff, extra care staff, management, domestic staff, maintenance staff etc...on a night time, I do all those roles.
I also do my 'nursing' things as well as my 'carer' things.
And that is what bugs me.
Not the fact that I have to help out with the 'carer' things, but rather that people (and colleagues) seem to differentiate between the two.

I do my nurse things and get on with it, but when i do carer things like change pads, empty catheters, feed someone, wash someone, wipe bums, roll people, wipe bums, make beds wipe bums and wipe more bums, I seem to get a look that views me with surprise or that i am an alien for doing them.

(wrong kind of 'Bum'.....idiot)

I think in all honesty, it comes from a culture that some nurses and carers have made a differentiation between the two roles, but actually this so called 'basic care' is so extremely important in nursing.

When i wipe a bum on shift, It's never just that easy. It becomes an interaction, an assessment and helps me put into context a care package for that person. Some carers are so busy rushing to the next thing on their list that they don't see the full picture - it really is just a case of doing a pad change and then moving on. And to some degree, that's fine as they do have a billion things to do so they get on with it. But Nurses don't have that excuse.

But for me as a nurse on night duty, I get the advantage of some 'up close and personal care' with that person and can spend some valuable time assessing things without even the person knowing that i am assessing them. Sometimes it's not even something related to a care plan or bit of paperwork (which we love as nurses), but rather it's a chance to get some insight into that persons life and upbringing, which you can relate to where they are at now and how it affects their overall perspective on it all. It's such a complicated process that it's SO hard to even explain the interaction and how it fits. I try to use my people skills, some of which I have had to learn when being at the sharp edge of youth work on the streets of wherever, or the times spent with kids or elderly folk, to try to read into situations and connect with that person so that they feel able to open up to me. Sometimes with all this (limited) experience, the only major factor missing is 'time'.

'Basic care' for me as a nurse, is a gateway.
It is the shop window that allows me to see deeper into a persons care experience, and allows me to make some guided decisions and choices that suit and agree with that person. And as a nurse, I have the unique position of being empowered - which means that after an interaction I can put measures or plan care in such a way that it actually affects things in a positive way!
'Basic care' isn't just the remit of care assistants, it's a nurse thing and I hope that we don't drown too much in paperwork or assessments, to miss the interaction with that person in a real and dignified way.

Don't get me wrong, Nursing is hard and wiping bums is truly NOT rock & roll, but being a nurse is rewarding and can give opportunity for that nurse to 'do the right thing' in a given situation in life.
I have a good advantage on night duty, coz i do get get to do 'basic care', but i would challenge the term 'basic care' because that makes out that it's simple.

And it's not.

The old Poo & wee story.

Ok...strange title but its a strange subject.
As you probably have gathered, I am a nurse. A nurse who (at this point in life) tends to work multiple 12hr night shifts.
On shift, i tend to have a lot of different tasks to get through like medicine rounds, dressings, paperwork, stocking up, checking supplies in, pad rounds and other bits & bobs to go with it all.
We tend to also do 2 hrly rounds in the place that i work - mainly to check that people are OK or to turn them if they need to be turned in bed (to make sure they don't get sore etc..). We also do pad rounds.
Now...when i say 'we' i mean 'we' as in myself and the Care assistant/s who is on duty that night.
And when i say 'pad round' I mean that we change (elderly) peoples pads which they wear if they are incontinent of faeces or Urine (poo & wee to you).

No....wrong kind of poo.  Idiot.


What got me thinking and pondering, is WHY is having a wee or poo SO important to us as human beings?!
I know it's a strange question, but its really a massive factor that is possibly more obvious when you work with elderly people. You see, it feels at times that some folk spend their night worrying and planning out when they NEED a wee, CAN they have a wee, will someone be there to HELP get them on a bed pan/toilet/commode, will their pad be dry or not etc...

Its such a massive issue and incorporates loads of different things such as the embarrassment of getting a stranger to help them with a really intimate task and their 'private parts', the persons struggle to sometimes come to terms with their independence and needing help from people, and their own comfort etc...I start to understand it.

But I appreciate its a big issue and not one I can do it justice in my little blog post, and I still feel that I'm left with a sense that toileting, bladder and bowel issues are something that are deep rooted in the human makeup and can really drive us and frustrate us at times - especially when you have to rely on others to help you with something that you have spent the majority of your life just getting to grips with - lets face it, some times you spend your first 5 or so years learning how to deal with it!

In my job (I mean my workplace - sorry to use the word 'job' in this post) its a funny issue because its sometimes a bit of an unspoken one but it actually is a major player of growing old.

Wee and poo are usually the stuff of jokes and humorous tales, so its a challenge to deal with them as part of caring for people. I only hope I keep my sense of humour as i grow old but still carry on caring with dignity for people who need it. This is basic care, and not one that is (or should be) left up to the care assistant to do - not that carer do a bad job but its not just them who have to get their hands dirty. To really be a good nurse actually means that we have to get in there and do the tasks that some people make out to be beneath them.

In the meantime, i'll do my bit for dealing with the shit of life...and also poo & wee.

(male) Nurse...

Yes...it is me. It was taken on a break so don't worry..I didn't waste my precious time on such frivolities such as 'Moustachio Documentation'.

But so what?? When I am at work, although there are many things going on on many different levels there is always the opportunity to have a laugh.
It's always appropriate to the situation mind you...I don't laugh at things which are obviously important, or embarrassing to the person I am looking after so it HAS to be professional and in line with my Nursing code of conduct. That said...it doesn't half cheer some folks up and i don't just mean patients but staff also.

If we live in a world where there is no joy or soul to what we do, then we may as well give up, and do it with our heads up our own backsides.

I know my stuff as a nurse. I spent 3 (hard) years just to get my PIN to work as a registered nurse. I did another year doing 'on the job' competencies so I could work solo (also so i was eligible to work the night shift) . And then i did another course over about another year so i was working with an official recognized qualification for Anaesthetics and Recovery nursing. I worked long shifts, and most of them were on the edge of my seat as it was pretty intense. Thankfully, I had good support and people around me.

Talk about a steep learning curve though!

On top of that (and here's an important part of it all) i worked in youth and community settings, music and art, small teams, Church, i was an 'auxiliary nurse' (the old style 'care assistant') and i moved around a lot.

So i ain't just in it for a laugh. And the skills i learnt in how to talk to people played a massive part. I noticed it most when i worked with elderly clients and children - especially in theatre, when it was the most stressful for the person and sometimes their parents & carers.
And to top it off...i had to work with Doctors - who are a different breed most of the time!

Some stuff I can get proof of learning and its application. Taking bloods, Male catheterisation, setting up pumps and infusions, giving IV meds etc...etc...

But some stuff I can't show it off so easily. You could say I just do it. How do you approach an elderly person who has dementia and is about to hit you? There are some skills that you just know how to do it, and it's all very individual to me, as it would be to you. Add on top of that the fact that as a nurse you have a stack of paperwork to complete, dressings, medicine rounds, supervision etc...to do and you gotta have it all sorted out by 10.30am so you can start the next medicine round again!

I was told recently that I "was like Jesus. I was just there in the shadows ready to pop up when I was needed" and this very fact made this elderly person feel comforted.

Was i really waiting in the shadows? Did I really do things drastically different to my colleagues to warrant this comparison?

No...I think i just gave a shit.
I think I just cared to do my job, and to do it sensitively.
And i think i just did it without rushing to get to the next thing.
I have stacks of stuff to do as a nurse, but when you make space for someone, I think they notice it. Sometimes they notice and are able to communicate their relief and gratitude, and they become vulnerable and this facilitates a good place to communicate real issues.
Other times, the person knows that they have someone who is opening up for them and they offload to you. Sometimes it's just their frustrations at many things that come out, but other times its just a bitter, rude person mouthing off at you.
Nice...not.

Anyway, don't be put off by my drivel and random thoughts - posts like this are just as healthy for me to say, as they are for you to read and groan.

I'm a nurse.
Yes...a male nurse, but a nurse.
You can tell from my outstanding moustache - made from a glove box lid, lots of love, grooming and strategically placed sticky tape. Say what you want, but it did get a smile and hopefully a little bit of happiness in a long run of night shifts.

I'm all for positive workplaces and facial hair.

Hip hop changed the world - but I'm not sure of Channel 4!

So Channel 4 in the UK, aired a show called 'How Hip Hop changed the world'...

Now I was raised on Old school Hip Hop, and in the top 50 slots of the show, there were some undoubtedly correct slots - everything from GrandMaster Flash, Cool Herc, Run DMC - you know...all the stuff you would expect to be in there..
And they consulted the Mega stars of HipHop for their opinions such as Jessie J & N Dubz......

WHAT???

Since when do N Dubz have any authority on HipHop?

And so they must have consulted some "pretty serious " names (quote from the show- i'm thinking JayZ and the like..), and in amongst ALL the moments you could choose for a lifestyle that has impacted literally EVERYTHING, what is the number one moment that is 'picked'??

President Obama getting elected as president.

Don't get me wrong, its cool and all that, but its hardly Hip Hop is it?? Politics, yes but Hip Hop, no.
But then it goes on to say that there were a few rappers that were pulled in to his campaign (Jay Z, LL Cool J, Nas) and after all, Obama did say he liked listening to a bit of Jay Z, so i guess its all ok...

I love it when a sub culture that grows out of the ghetto, has hard beginnings, influences the world for a positive impact (and before you start, its not about gangsters and all that - it never was - the hip hop elements NEVER featured gangs, guns or bling), and then along comes politics claiming it for themselves.

I guess that if you asked any B Boy or B Girl their opinion, I suspect that they wouldn't have chosen Obama as their ambassador., but he chose Hip Hop to be included in his values, but only when it suited him. Call me cynical, but I'm sure he hit a target group of people that was ready to vote for him...or vote for his values such as Hip Hop, even though he aint got a clue.

If N Dubz and Obama represent Hip Hop, then I think they must mean another Hip Hop than what I know.
Well done channel 4, you managed to try to Hijack Hop Hop for MTV, Politics and Gangsters - I only hope the Hip Hop community is wise enough to sort out the true moments in your top 50, from the crap.

Rant over.

Evas Garden..

Typical Dad...shouting bout how awesome his daughters are!...Well, just to prove it, here's Eva with her gardening kung-fu! Sure, she gets it from her Mum but it's still great coz not only did Mum and Daughter get time together, but it looks pretty cool as well!

Now Eva and her Mum are keen gardeners, so if you want to learn some more tips on how to keep your allotment looking tip-top, then check out her instructional video here and be sure to send back some good comments for her!

tips for life...

Ok...easy...so i haven't posted for a while, i know...
To make up for it, check these out:

(taken from: http://wordsandlinks.com/2010/07/03/101-things-i-would-like-to-teach-my-children-to-make-their-life-easier/ )

1. Stay in school.  Don’t even think of dropping out.
2. Don’t have a baby until you’re married.
3. Don’t ever quit a job unless you have another lined up.  And if you follow 1, 2, and 3 you will never live in poverty, according to statistics.
4. Have an honest interest in everyone you meet.
5. Give to charity.
6. Read.  Read.  Read.  Everything you can.  From instruction manuals to the newspaper.  And learn to enjoy it.
7. Have compassion.
8. Value your family and friends above all else.
9. Learn about money.  How to make it, save it, and spend it.
10. Trust your parents.  They have been where you are now.
11. Take good care of your body.  It will have to last you a long time.
12. Learn to be adaptable.  Situations will rarely be what you want so you must learn to make the most of them.
13. Teach yourself to drive a stick shift.
14. Learn at least basic physics.  It will come in handy often.
15. Find a sport or sports that you enjoy and make time for them.
16. Learn how to do at least a few magic tricks.  You will need to entertain a child sometime in the future.
17. Understand how your car works, and learn how to fix it.
18. Don’t be afraid to take menial jobs early on.  If you keep your eyes open you will get valuable experience from them.
19. Set your goals early, but don’t be afraid to change them.
20. Learn to use the English language to the best of your abilities.  Perfect grammar and usage may not always be noticed, but mistakes are.
21. Learning how to take tests is half the battle.  Most of the tests you will take in the real world are multiple choice.  Even if you don’t know the information you can do well on these.
22. Learn how to play at least one musical instrument.
23. Memorize all your basic math facts.  It makes the more complex stuff easier.
24. You will never know when the most trivial and useless bit of information you have will become useful.
25. Always keep learning new things.
26. Have confidence in yourself and don’t let other people limit you.
27. If you borrow something, return it in better condition than when you got it.
28. Keep your credit rating good from day one.  You will need it later on.
29. Go to college even if you’re not sure what to study.  The experience alone is worth it.
30. More than one time in your life you will need first aid skills.  CPR is also a must to learn.
31. If you have a natural talent in something, develop it.
32. Don’t ever drive drunk, high, or especially tired.  Someone will give you a ride.
33. Driving is a skill.  Always work on improving it.
34. Always show respect for others.
35. Have a good sense of humor and share it.
36. Make sure to make some time for yourself.
37. Learn how to make a few great meals.
38. Learn self discipline.  That’s a big one.
39. Work at at least one hard, physically demanding job in your life.
40. Don’t be afraid to go to the doctor when you need to.
41. Chose good people to develop friendships with, whether the janitor or CEO.
42. Learn the tricks that “psychics” use to read minds.  Always impressive.
43. Remember that your first true love won’t be your last.
44. Don’t try drugs or alcohol.  You will, but don’t.
45. Do not ever start smoking.
46. Make sure you always appreciate what you have now.  Even the small things.
47. Your interests will change over time.  Learn to adapt.
48. Learn how to write a simple computer program.  It will teach you logic and how to work within strict rules.
49. Basic home repair is easy and mostly common sense.  Don’t be afraid to try.
50. Present yourself as if you are successful and you are half way there.
51. Your time can be as valuable to others as it is to you.  Don’t be shy about volunteering for a good cause.
52. Exercise regularly.
53. Practice good personal hygiene.
54. Find a good balance between what is good for you and what you enjoy.  If you can make the two meet, excellent.
55. You will make mistakes both small and huge.  Fix them, apologize if necessary, and move on.
56. Be soft spoken and don’t swear.  If you ever need to make a point those two options will make people take more notice if seldom used.
57. Never complain without having a solution to the problem at hand.
58. Nothing good happens when you are out late at night into the morning.
59. Don’t be afraid to ask for help when you need it.  Give help freely when you see others in need.
60. Learn to appreciate real art.
61. Travel whenever and wherever you can.  Keep your eyes open when in new places.
62. Always try to have something saved for a rainy day.
63. You can be critical, but be sure to do it in a positive way.
64. Give honest compliments freely.
65. Try to have one sales job in your life.  The experience will be valuable.
66. Learn how to use the telephone.  Being strong on the phone is a good skill to have.
67. Each moment is a new opportunity to change anything that you are not happy with.
68. Tackle the hard jobs before the easier ones.
69. Understanding basic psychology will go a long way to helping you along.
70. Avoid arguments.  They seldom resolve anything, and usually make you look bad even if you are in the right.
71. Never be afraid to try new things if you think it might be a good idea.
72. Be 85% in the present, 10% in the future, and 5% in the past.
73. Failure is absolutely guaranteed if you never try.
74. Positive thinking will accomplish things that you won’t expect.
75. Try to have a backup plan, especially when it comes to making a living.
76. Learn to type as soon as you can.
77. You should always be proud of your actions, so take responsibility for them.
78. Keep on top of new developments in technology.
79. Keep up to date with the local, national, and world news.
80. Share your good fortunes when they happen.
81. Never hold a grudge and always be quick to forgive.
82. Don’t concern yourself with what others think of you.  If you are doing your best the negatives coming from them reflect their own shortcomings.
83. Remember that the experts are no better or worse than you.  They just have been doing it longer.
84. You can and should question what seems “funny” to you.
85. When choosing a mate, if you are thinking “I could live with this person forever” you are on the right track.  “I can’t live without them” might mean you have some more thinking to do.
86. Learn the rules inside and out.  This makes it easier to win.
87. Enjoy teamwork and be supportive of your team.
88. Try to make what you are doing fun.
89. While you are in school, try to keep in mind that this is the fun time.  Work gets harder from here.
90. Become an expert in at least one subject.
91. Be good at sharing.
92. If what you are doing is important to you, be enthusiastic and passionate about it.
93. Once in a while try to see things through a kid’s eyes.
94. Learn from mistakes instead of wasting the experience.
95. Be kind to animals and if you can, keep a pet.
96. No good comes of lying, but you might have to bend the truth to spare feelings once in a while.
97. Enjoy the outdoors as much as possible.
98. Learn about basic financial principles.
99. Educating yourself about science is never a waste of your time.
100. Make great plans, but make better contingency plans.
101. Never forget about the people who love you. 

Well done...now go do'em.
Peace.