Teaching

JUNE 26, 2009
This is the parent/grandparent update for today. First of all, I had to call in early to let someone know that I had removed Dad’s shaver yesterday. I bought a new one last night that would be easier to clean than the one he already had. The other one gunked up so bad every time he shaved or was shaved. I always cleaned it here at home with compressed air to blow out all the clippings but that was a little difficult at the nursing home.

When I spoke to her about the shaver, I asked if there was a time that I could come in and talk with her about some concerns that I had and we picked noon because her other meetings that were going on this morning.

I got to the nursing home about 11:30 am and she was busy until about 12:30. No problem, I hung out with Mom and Dad and got to do more “training” while I waited. It seems that the staff there has never seen an iliostomomy or urostomy - whichever you choose to call it. That is the procedure that reroutes the urine directly from the kidney to a place on the abdomen into a bag. This is not rocket science but one would think it is when you see the confusion this thing has caused at the nursing home! Today I discovered a clue to the “being wet” that I discovered with Dad yesterday. Yesterday, I discovered that the seal wasn’t sealed. The “ostomy” appliance is a two-piece thing. The faceplate adheres directly to the body and the bag that the urine drains into snaps tightly to that. This forms a nice tight seal that doesn’t leak. Unless you don’t snap it all the way on and then any movement of the body back and forth will loosen this up and open up somewhat like an unsealed Ziploc bag that is only partially closed. Sorry, TMI? Well, I need to clarify to make my point.

While I was in the room visiting, they came to take Dad for his shower. That’s his favorite part of being cared for my others….NOT. The girls were sweet and kind and asked me questions about what to do. Well, when they came back with him the CNA proudly announced to me that she had removed his bag and rinsed it out to clean out the urine and freshen it up, so to speak. I told her, thanks, but you are not supposed to do that. It is only to be removed, emptied, changed, etc., by the RN. I checked it while she was there and saw that it wasn’t sealed again. This is very difficult to do while on the patient. It is much easier to snap it together before you apply it to the body. I showed her that it wasn’t sealed, explained the whole thing to her and snapped the thing on tight! I showed them how to put his support belt on – it was pulling on the ostomy area.

Later, when I talked with the unit manager/charge nurse, I suggested that when a new patient arrives, it might be helpful to have all of the staff that will be dealing with this person to have a training session explaining all of the things of interest about the patient and then describe and inform of all the medical needs. Why they have certain meds, how to take care of a urostomy and information about their backgrounds.

I offered to volunteer in a capacity to help with this education if needed.

I may be aware of these things that need to be worked out but, praise
God, Mom and Dad seem to be blissfully unaware and are happy – at least Mom is – and enjoying the new busyness. They are tired but it is a good tired - a busy tired. Falling asleep again!