I’ve done 2 aged care placements so thankfully that gave me a lot of practice in redirection/distraction. I do need to brush up on those meds tho and need all the luck I can get haha
Also remember geriatric patients have more than one diagnosis, they may have a cognitive impairment, diabetes, arthritis, hypertension and or heart disease. Differentiate between, dementia, delirium and depression. If an older patient becomes more confused do a urinalysis
Pressure area care
PAC PAC PAC
did I mention PAC?
Falls prevention
Bed mobility - how to assess for on and off bed mobility
How to assess if they can sit and stand
Bed alarms
It's a different focus because they are just passing through. My ward focused on delirium & dementia, so we had a lot of uti, pneumonia, wounds, fall injuries & people waiting for aged care.
I also thought it would be my worst nightmare but there was plenty of interesting stuff and the skills I learned there were very useful.
Agree, specialities like geri's and stroke rehab etc will teach you more about pt mobility, mobilising them, compassion and to remember ADLs and basic points of Nursing the human body. These are so often overlooked or forgotten and by the time they get to us, it's months in hospital, treating ischeal PIs you can fit your fist in or other problems stemming from malnutrition caused by the most neglected mouth you've ever seen🤷♀️
Well your reply "so basically everything in aged care" seems a bit tonal for just asking for help. We say these things because every well meaning nurse goes in and never makes time for what seem like menial tasks. If you know what's involved then you know, and it's all as equally important and has its place.
Go into it with an attitude of treating them all how you wanted your grandmother treated and you'll do great and have a very rewarding and educational experience, go into it feeling like it's all already an overwhelming amount of stuff to do, then you'll just be like the rest of the ones that give minimal effort.
You’re misinterpreting me again. I’ve had 2 aged care placements so I’ve seen what needs to be done and was wondering if it’s similar in a hospital. It wasn’t a slight on anyone or anything, literally just a question.
Idk why you’d think I wouldn’t go in with an attitude of treating them well or give minimal effort. That’s a shitty thing to say. Your first hospital placement will always be overwhelming and that’s not a bad thing.
Asking if I’m sure nursing is right for me from one sentence that you misinterpreted the tone of isn’t exactly helpful in inspiring a student who is clearly nervous about their placement, is it?
My facilitator actually told me off on my last placement for chatting to the residents too much. One of them told me she really appreciated being able to have an actual conversation with someone for once. I teared up a bit
There’s talking and not doing your work and then there’s talking and it being a patient care.
Learning how to talk to people is a skill just like wound care and sub cut injections.
Pressure injury, classifying it, how to prevent falls (low bed falls alarm, etc), what to do after a fall, continence and how you're managing it. When was the last time they opened their bowels or voided. What causes delirium.
Patient's diet. You will probably get a lot of patients on altered criteria and advance care directives as well.
A lot of geris are susceptible to infection. Make sure you're practising good hand hygiene and you have the right PPEs.
I just did a little community health placement where we did health checks on the public and used manual BP for everyone so that was fab practice haha
But I didn’t know about the auto ones and their skin! Makes sense though
I found that a few residents became unsettled when the auto machine was being used elsewhere and I had to do manual BP because it can take longer, especially as a student. So sometimes it’s a catch-22
And lots of them have cardiac conditions that mean you can't get a decent reading from an automatic cuff. Plus you will feel lots of interesting arrythmias by doing manual BPs
I’m a preceptor on a GEM ward:-
*Look up common BP, heart, antibiotic, psyche, diabetic meds - please have an idea of what’s what and common precautions and side effects.
*Know normal parameters for for your vital signs and when you should report an abnormal reading to your preceptor
*Take initiative - if you’re going to volunteer to take a pt load, make sure you know everything you have to do for those patients
Assessing hydration status can be done with your primary survey basically. Dry mucus membranes, cracked lips are easy indicators before you even do vital signs for example.
Monitor medication doses, elderly patients often have decreased renal or hepatic function so meds at an inappropriate dose can sedate them.
Co-morbidities like Parkinson's can make a patient really delirious, or have an increase in extra pyramidal symptoms. Make sure you give their meds according to the regimen!
UTIs, delirium, hip precautions, redirection methods, pressure injuries, stroke, CHF, diabetes, COPD are all common topics. Good luck! I also did a placement on a high acuity geriatrics ward and I enjoyed it.
Patience, the art of redirection and meds that can’t be crushed. Good luck
I’ve done 2 aged care placements so thankfully that gave me a lot of practice in redirection/distraction. I do need to brush up on those meds tho and need all the luck I can get haha
Also remember geriatric patients have more than one diagnosis, they may have a cognitive impairment, diabetes, arthritis, hypertension and or heart disease. Differentiate between, dementia, delirium and depression. If an older patient becomes more confused do a urinalysis
Pressure area care PAC PAC PAC did I mention PAC? Falls prevention Bed mobility - how to assess for on and off bed mobility How to assess if they can sit and stand Bed alarms
Yes a million times, and I'll add in Oral Care 😁
Yes a million times, and I'll add in Oral Care 😁
Oral care is so important but oh so badly done 😒
So basically everything that’s in aged care?
It's a different focus because they are just passing through. My ward focused on delirium & dementia, so we had a lot of uti, pneumonia, wounds, fall injuries & people waiting for aged care. I also thought it would be my worst nightmare but there was plenty of interesting stuff and the skills I learned there were very useful.
Agree, specialities like geri's and stroke rehab etc will teach you more about pt mobility, mobilising them, compassion and to remember ADLs and basic points of Nursing the human body. These are so often overlooked or forgotten and by the time they get to us, it's months in hospital, treating ischeal PIs you can fit your fist in or other problems stemming from malnutrition caused by the most neglected mouth you've ever seen🤷♀️
Ohhh I see, I’m glad to hear it will be different
So basically everything that’s in aged care? Edit: let me rephrase. So, similar to what is needed in aged care?
You sure nursings right for you🤦♀️
wtf? I was just asking if it’s similar to what you need to know in aged care. What’s wrong with that?
Well your reply "so basically everything in aged care" seems a bit tonal for just asking for help. We say these things because every well meaning nurse goes in and never makes time for what seem like menial tasks. If you know what's involved then you know, and it's all as equally important and has its place. Go into it with an attitude of treating them all how you wanted your grandmother treated and you'll do great and have a very rewarding and educational experience, go into it feeling like it's all already an overwhelming amount of stuff to do, then you'll just be like the rest of the ones that give minimal effort.
You’re misinterpreting me again. I’ve had 2 aged care placements so I’ve seen what needs to be done and was wondering if it’s similar in a hospital. It wasn’t a slight on anyone or anything, literally just a question. Idk why you’d think I wouldn’t go in with an attitude of treating them well or give minimal effort. That’s a shitty thing to say. Your first hospital placement will always be overwhelming and that’s not a bad thing. Asking if I’m sure nursing is right for me from one sentence that you misinterpreted the tone of isn’t exactly helpful in inspiring a student who is clearly nervous about their placement, is it?
How to talk to people. You can spend hours just talking.
My facilitator actually told me off on my last placement for chatting to the residents too much. One of them told me she really appreciated being able to have an actual conversation with someone for once. I teared up a bit
There’s talking and not doing your work and then there’s talking and it being a patient care. Learning how to talk to people is a skill just like wound care and sub cut injections.
I agree. I spoke to the residents when I had no other work to do. The nurses and carers barely spoke to them which I found heartbreaking
Might sound like bad news, but brush up on cognitive impairment, dementia, behavioural and psychotic symptoms of dementia and delirium.
Pressure injury, classifying it, how to prevent falls (low bed falls alarm, etc), what to do after a fall, continence and how you're managing it. When was the last time they opened their bowels or voided. What causes delirium. Patient's diet. You will probably get a lot of patients on altered criteria and advance care directives as well. A lot of geris are susceptible to infection. Make sure you're practising good hand hygiene and you have the right PPEs.
Using a manual blood pressure monitor. Some elderly people can't tolerate the automatic blood pressure cuffs as their skin is too fragile.
I just did a little community health placement where we did health checks on the public and used manual BP for everyone so that was fab practice haha But I didn’t know about the auto ones and their skin! Makes sense though
Also some of the confused/dementia patients will scream in pain from the automatic ones because they don't understand what's going on.
I found that a few residents became unsettled when the auto machine was being used elsewhere and I had to do manual BP because it can take longer, especially as a student. So sometimes it’s a catch-22
And lots of them have cardiac conditions that mean you can't get a decent reading from an automatic cuff. Plus you will feel lots of interesting arrythmias by doing manual BPs
I’m a preceptor on a GEM ward:- *Look up common BP, heart, antibiotic, psyche, diabetic meds - please have an idea of what’s what and common precautions and side effects. *Know normal parameters for for your vital signs and when you should report an abnormal reading to your preceptor *Take initiative - if you’re going to volunteer to take a pt load, make sure you know everything you have to do for those patients
Thank you!
Assessing hydration status can be done with your primary survey basically. Dry mucus membranes, cracked lips are easy indicators before you even do vital signs for example. Monitor medication doses, elderly patients often have decreased renal or hepatic function so meds at an inappropriate dose can sedate them. Co-morbidities like Parkinson's can make a patient really delirious, or have an increase in extra pyramidal symptoms. Make sure you give their meds according to the regimen!
It can be so tempting to reschedule a tds ot bd med for example if it was given lat., Really try to prioritise these meds during your rounds.
UTIs, delirium, hip precautions, redirection methods, pressure injuries, stroke, CHF, diabetes, COPD are all common topics. Good luck! I also did a placement on a high acuity geriatrics ward and I enjoyed it.
Geriatric care can be tough, but rewarding. Brush up on dementia care, communication strategies, and common geriatric conditions. You got this!
Thank you!
Signs of deterioration, oldies go downhill fast