a few details for any other beginners like me

Here are a few details that might help any other beginners who want to try to be helpful when Abby can not be there --


hot water blanket - kaput for the day

While helping Bill get back into bed the team noticed a quarter inch of water on the floor. This in a room with mulitple cords and outlets. The warm water pump for the 'hot water bottle' style blanket had leaked most of it's water out. Earlier, when we one of the male aides to help us turn it on, he added water. When it leaked, the traveling nurse wondered if it had been overfilled. Perhaps in moving cords and blankets, sheets and equipment out of the way something was stepped on or bent or nudged open - we don't know. A towel did not adequately remove all the water, but at 7pm the traveling nurse didn't know who she could call for help with water on the floor.


glove and gown - dialysis room

When I arrived, Bill was already downstairs in dialysis - I just walked in and held his hands, rubbed his feet, etc. No one asked me to gown up. Once back at the room I realized we were still supposed to gown and glove. When at dialysis I figured glove and gown had been set aside because his infection was over. Sorry. Please ask for glove and gown when you visit Bill, even if no one asks you to. It is to protect him from whatever may be on your clothes or skin. These have to be taken off each time we leave the room and new ones put on each time we come back in.


foot rub - let him show you want to do

At first holding his feet and rubbing with cream seemed to be helpful, but then I'd try to squeeze as he would raise his hands and make a squeezing motion in an effort to show me what he wanted. I could tell that sometimes I was doing it the wrong way - he'd wince! So I asked Bill to show me what he wanted. He held my hand and rubbed gently, slowly, up and back on each finger below the knuckle. Not too light to cause a tickle, but not strong or heavy. Gentle, kind, patient man.

I wished I'd asked Bill to show me what to do first. He figures that the foot rub is helpful to counteract what he feels as hot, dull pain in his feet, "It's probably neuralgia". Later he asked me to try rubbing ice on his feet, then blowing on the skin. I thought was counter-intuitive, but he said it felt good; "The nerves are confused." After that, just holding with warm hands felt best.


perceptual issues -

When in the cardiac chair, Bill had a sensation of falling - he was certain that he was going to fall out, and that he was already slipping. But he was not moving. Later we discussed how Oliver Sacs had noted during his bedrest (after he'd injured his leg hiking).. that his initial attempts to put foot to floor were plagued by mistaken perceptions of distance that constantly shifted in a dizzying bounce. Lack of proprioceptive feedback led to multiple perceptual difficulties. Bill nodded, smiled, opened his eye wide, raised his eyebrows, and mouthed, "Yes, Maybe so!"


fear

The velcro strap for his legs was in the wrong position so that the buckle was digging into his knee - the visiting nurse figured out it was too tight and released it. That felt better, but then the overall pain and sensation of slipping out, plus his natural fear of falling, "Catch me!", led to nausea. She ran for medicine for that - which gratefully worked instantly. I had that girl running all over for Bill.


ask before they leave - how to reposition the cardiac chair

Then I had to run for the head nurse to show both the traveling nurse and me how to help him sit back part way. He felt instantly better. 'Should we have a longer sit here at this angle, or move (back to bed) now?' Bill seemed to be so relieved he didn't mind either way. After 35 minutes I'd had it. And I didn't want to risk their leaving again. We helped him back onto fresh sheets, back into socks, calf cuffs, moon boots and left hand brace. He was ready for some sleep - so I tucked him in while playing James Taylor, "You've got a friend" on his iHome/iPod, put in his earplugs and left. Bill's angelic smile helped.


How to find the head nurse

If you walk past the nursing station, and continue around the corner a bit - as if you are headed toward the elevators, keep your eyes open to your right.. there is a little closet-sized alcove where the head nurse inputs her progress notes and billing.

Julianne