Thursday, September 27, 2007

On skin windows and flying patients...

Last night was a gorgeous, huge, glowing full moon yet all I can think to write about are pressure ulcer dressings and modes of moving fatty boombalatty patients who would otherwise kill your back. I'll never be a poet at this rate, topics like that just don't translate very eloquently.

Last night I lifted my 110 kilogram patient with just one finger! No, I'm not freakishly strong or even gifted with special powers, although it's understandable if those are the first conclusions you reach. It turns out the PUH MICU has installed these overhead lifts in each patient room, so if you put the special sling under your patient, you simply attach the straps of the sling to the arms of the lift, use the handy-dandy push button controls, and lifto-shifto, you can boost that patient up in bed! In mere seconds! Your old-beyond-its-years nursing back thanks you profusely, as do your colleagues who are too busy to put on gloves and risk their own backs just to help you get your patient straightened up in bed. The sling thingy even tilts a little sideways so you can put some pillows underneath and turn your patient with ease. You know, to prevent nasty pressure ulcers...which brings me to my next point...

Maybe this is already a universally known technique, (and by universal, I mean widely known to the huge population of people who are RNs and deal with skin care issues...perhaps not yet material for Good Morning America, but of growing importance to a wee minority...) but a colleague at PUH has introduced me to duoderm windows! It's a stroke of genius, an inspiration of brilliance. So...you know when you have those nasty tunneled oozing pressure ulcers, and of course by their very nature they are in the most inconveniently dirty places, such as the on the very underside of your patient, a mere centimeter (sometimes not even!) south of the a*us? So of course keeping a dressing over such an ulcer, nonetheless keeping it clean and dry, becomes a seemingly insurmountable problem. Then if you do manage to put a dressing over it, each time you have to change it, you are just bothering and irritating the already-sensitive skin by peeling stickies off it? Well...get ready for this...my brill-ee-unt colleague crafts a window out of duoderm, places it over the offending sore, then packs it, and covers it with gauze and finally a piece of tegaderm which adheres to the duoderm, but not the patient's skin! SO, the duoderm stays in place and each time the site is soiled you do not need to rip off a piece of duoderm, plus you can change the tegaderm as much as you might need to without hurting the adjacent tissue!

Oh my goodness. I think this has turned into one of those, "You know you spend too much time in hospitals when these things get you you excited..." posts. So sorry. Soon I will be in Europe and perhaps I will be excited by things like world-class art, ancient monuments, and legendary pain au chocolat. I certainly hope so. I just have to survive 168 more hours of work before I leave....I know, I know, could I have thought of a more depressing way to say, "I leave for Paris in less than three weeks!"??

Picture of MAXI SKY 600
*This is an example of the patient sling I am in love with.
*Disclaimer: The people in this photo are not me and my patient, nor do they even remotely resemble me or my patients. For example, notice the cheery smiles on their faces and the sunlight streaming in through the window...and that's just to start with...

2 comments:

girl_in_greenwood said...

Clearly I need to get out more often as well, because I concur that both the lifty thing and the duoderm windows are freaking brilliant! And the fact that you have those sling thingies installed in your MICU means that I will be emailing you about any open jobs on your unit next spring when I graduate. :)

raecatherine said...

oooh...with the push of a finger.... i'm still so much in awe of the first thing I can't even contemplate the wonder of the rosey-cloured duo-derm window..