Why Patient Assessment is Crucial in Nursing

One of my nursing instructors shared this story. I’m so glad it didn’t happen to me. I’m sure I’d have an anal sphincter malfunction.

Her cancer patient had asked for a pain shot. Of course she’d developed critical anxiety dreading giving her first injection. It took her forever to check and recheck herself in preparation. Eventually, the big moment came. Her instructor helped her position the unfortunate patient and guided her through the shot and repositioning the patient. She sighed with relief till her instructor told her to her to check the patient’s vitals. To her horror, she couldn’t find a blood pressure, heartbeat, or respirations. Having no confidence in her skills, she tried again. Nothing! Terrified she had just killed her patient, she looked to her instructor who spoke to her levelly. “Always assess your patient before you do anything. She died while you were gone to get her medication.”

I’m sure she never forgot that lesson. I certainly didn’t.

Battery Socks

My brother was an avid deer hunter. That Christmas Mother bought him a gift of battery-powered heated socks. This seemed like a great idea, since deer season fell during cold weather. Bill was up long before dawn, dressing for the hunt. Sadly, the Christmas budget hadn’t extended far enough for the purchase of hunting boots. Never fear. His new socks would keep his feet warm. He layered his clothes down to his fine, new battery socks. To ensure his comfort, he pulled plastic bread bags on over his shoes.

He set up in his deer stand, knowing he’d be comfortable. All went well for a few minutes until the heated socks encased in plastic bread bags made his feet sweat. It felt like ants were eating him up. Frantically, he stripped of bread bags, shoes, and his fine, new battery-powered socks, leaving him standing on the cold, cold ground with his sweaty feet. What a treat for a frosty morning!

Sew and Sew Part 4

I went to a tiny high school. There were only nine in my graduating class. All the girls had to take four years of Home Economics, the boys four years of agriculture. I benefited from the sewing instruction. I was horrified to learn what my sewing project was to be my senior year. We were to make a fully-lined wool tailored suit with lapels, welt pockets, bound buttonholes, and set in sleeves. The skirt had side pockets and a set-in waistband. The other concern was the extreme cost of the fabric. I’d never sewn fabric that expensive, not to mention it would be an extreme stressor to my family’s budget. Somehow, they came up with enough money, forty-five dollars.

I was terrified to put scissors to the fabric. I measured, pinned, remeasured, and could finally could put off the cutting no longer. I had the teacher check every step. Each day, I folded every precious piece carefully and put it in my sewing box, terrified one would slip into the trash and doom my project.

My anxiety increased exponentially when my friend, Mary, folded her scissors inside her jacket pieces. She was devastated the next morning to unpack her project and found her scissors had cut a one inch slash in the right front portion of her jacket. Naturally, she was distraught. The whole class was traumatized, seeing her disaster. She had no extra fabric.

The teacher comforted her, assured Mary there was a solution, and showed us all the pattern could easily be altered to put a pocket with a flap on both sides of the jacket. The change actually was more attractive than the original design.

That lesson amazed me, increasing my confidence. I was able to go forward with less reassurance, competing my project with pride. I wore that suit with confidence. It was one of the nicer outfits I ever owned. Mary’s suit turned out beautifully as well.

From that point forward, I knew that if I didn’t have the skills I needed, I could research and get the information I needed. Sewing has served me well. I bought a sewing machine and made everything the children and I wore until peer pressure made them insist on name brand clothes.

This is the exact pattern I used.

Sew and Sew Part 3

Home Economics in ninth grade pushed me a little harder. I had to make a two piece outfit with a collar, long sleeves, and cuffs with buttons. That meant lots of buttonholes since the blouse buttoned up the back. The skirt had to have pockets, a zipper,a set in waste band and a kick pleat. It taxed me. I ripped out at least half my stitches and redid them. Sewing a straight seam is harder than it looks. To make matters worse, the teacher assigned a home sewing project with the same specifications as the in class project due at the end of same grading period.

The home sewing project was a bigger challenge since I didn’t have the teacher casting her expert eye on every stitch I made. In theory, I would remember all the skills I’d learned in class and practice them on the home project. Sadly, I’d retained little. I struggled with every step. Of course, I didn’t get right on it, so my meagre skills diminished as each day passed. That project was a total misery, but I did finally get a barely acceptable product turned in. I was grateful for a c+ on it.

A couple of girls in the class turned in projects made by their mothers and got A s. I was so jealous!

I wore both those outfits till they wore out. After I struggled through that class, I had sufficient skills to start making my own clothes, though I still had a lot to learn.

Miss Laura Mae’s House Part 16

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As Miss Laura Mae continued with her story of Myrtle and Little Jackie, he was about my age. Maybe he’d come to visit sometime and we could play.

“Myrtle like to threw a fit when she got back in the car, but I told her I didn’t want to hear no more about it. That boy told her he didn’ want no company. She could just hush up about it to me. She might be forty-five years old but I was still her mama and didn’ mean to listen to no fit throwin’.

She sulled up like a possum, but we went on to her sister-in-law, Judy’s. She sweetened right up when we got there, tellin’ ‘em what a fine place Little Jackie had. To hear her talk, you’d a’thought we got the royal tour. I had a real good time at Judy’s. She had a big ol’ pool. I didn’ wanna git in, but she fixed me up a cushion and I dangled my feet while the kids swam. I don’t think Myrtle liked it much when I stripped my shoes and stockin’s off in front of ‘em, but that cool water was just the thing on a hot day. Judy kept bringin’ me them icy lemon drinks. She tol’ me they was spiked a little but they sure was good. After a while, her husband got me in one a’them floatin’ chairs out in the pool with the rest of ‘em. Myrtle didn’ git in. She was just a’settin in the shade a’drinkin’ them lemon drinks. That floatin’ chair was a fine thing. I wouldn’ mind havin’ one to put in my pond, but I ain’t sure I could git in it by myself. Yes Siree. I had me a fine time at Judy’s. When I got out, Judy loaned me a nightgown and put my clothes in the clothes dryer while I took a nap. That clothes dryer was a handy thing, but I don’t know that I’d want one. Stuff just didn’ smell as nice as line-dried. We ended up spending the night since Myrtle wasn’ up to drive home. It wouldn’ a’hurt my feelings to stayed a week at Judy’s. That’s the best time I had.

Anyways, we headed home Tuesday mornin’. Me an’ Myrtle both kind’a had a headache, so we didn’ talk a lot on the way. When Jack got in Tuesday night, Myrtle started in, “Little Jackie wouldn’t even invite us in after me and his grandma made a special trip by to see him. I don’t know what is wrong with that boy. He thinks he’s too good for us since your daddy set him up in that furniture store.”

“Now, Myrtle, you knew when you went by there he wasn’t looking for company. You’ve tried to control that boy his whole life. Now leave him in peace. That’s the last I want to hear of it. When Jackie wants you to come see him, he knows how to invite you.”

After Jack left out, Myrtle continued. “I bet he had a woman in there and didn’t want me to know. No wonder he didn’t invite us in. Oh, I do hope he is getting serious. He’s such a good-lookin’ boy, I know he could get a girl. He’s a snappy dresser, too. Maybe he’s planning to get married. I do hope so. He worked so hard in college he didn’t have time to date, but maybe now since he’s working, he’s got a girlfriend. That was silly of me to go by there like that. Of course, he didn’t need no drop in company on the weekend.”

I didn’ think that was it, but I kept my mouth shut.

Thursday night, Little Jackie come over. “Hey, Mama. Hey Grandma. You’re looking good. How in the world are you?”

“Just fine as frog’s hair. You’re sure a sight for sore eyes. Tell me what you’re up to. I’m real proud your grandpa set you up with that nice store.” We talked all through supper.

Finally, Jackie faced his mama. “Mama, I hated I couldn’t invite you in last Sunday. You came at a bad time. I’ve been working a lot and I’d slept late. It wouldn’t have been a good time at all. You couldn’t have gotten through the place. I’m doing some work on it. I was going to tell y’all a little later, but now I’ll go ahead. That big old house is way too big for just me. It’s got six bedrooms……”

Myrtle burst in, “I knew it! I knew it! You’re getting married! I should’ve known there was some reason we hadn’t heard much out of you since you got that place.”

Jackie looked pained. “No Mama. Where’d you get such a wild idea? I am remodeling the house so I can take in boarders. I can rent those rooms out to single men and make a lot of money. I’ll still have my apartment downstairs and rent out the rest. Won’t that be a great idea! One fellow has already moved in and is doing a lot of the work. ”

Hogwagon

What is your all time favorite automobile?

This sounds like a bonafide hillbilly story but I’ll tell it anyway. When Daddy bought his farm, it was covered in trees which had to be removed to create pasture. He came up on a bastardized vehicle that had been cobbled together that was ideal for pulling stumps. An avid hog hunting neighbor had acquired a bizarre amalgamation of various vehicles that met Daddy’s needs perfectly. It was a cutdown school bus with no windshield. An ancient truck seat replaced the bus seat. It had a flathead v-8 motor that was geared low enough to pull tree stumps. Its most distinguishing feature was a wire cage on the back the former owner had transported wild hogs in. With tractor tires on the back and big truck tires on the front, boggy ground was never a problem.

Christened the “Hogwagon,” this vehicle was a wonder to behold. Of course it could only be used off-road. Daddy could hook it to a stump, pull the stump till the deep roots were exposed, maneuver around till he could cut deep roots with his power saw and eventually pull the stump out of the ground. It was amazing to see the stump finally lose the battle against the hog wagon. Daddy cleared forty acres in a few months. With that job complete, the Hog Wagon fell into disuse, It had certainly helped Daddy complete a monumental task in record time.

Sew and Sew

In the years after my big 4-H apron failure, I had little interest in sewing. Mother did take time to show me how to use her “new” second-hand electric machine enough to sew up rips. She was a barely adequate seamstress with only the basic skills to show me, even though she made most of our clothes. She avoided challenges steering away from fussy details.

Mother rarely took time for mending, so if I got a rip, I was on my own. Of course, I mastered sewing on buttons. I think one afternoon she guided me through making a simple gathered skirt on a waist band. The button at the waist had a wide overlap, making it ok without a zipper. The waistband had no interfacing to make it hold its shape. My stitching wavered. All in all, it was tacky and amateurish. It screamed homemade!

In the eighth grade, all girls had to take home economics. I made a flannel robe with a snap front. All went well till I had to sew braid down the front panel, covering the snaps. I had trouble keeping the braid lined up over the snaps. I broke several sewing machine needles by sewing too close to the edge of the snaps. I think the department was running out of needles, so my teacher did the last few inches. The robe was an improvement over the skirt I’d made at home with Mother’s help.

I was delighted to get a B on it, but I think the teacher had had enough! I wore that robe till it shredded. I felt like I’d learned quite a bit.

Miss Laura Mae’s House Part 12

My grandma was in the hospital. We had a houseful of company and we didn’t go to Miss Laura Mae’s house for several days. I was happy to be sitting on her top step with a biscuit again.

“Well, I ain’t seen y’all in a month of Sundays,” she said “Where you been?”

“Right there at the house,” answered Mother. “I’m so tired I can hardly wiggle. Bill’s mama thought she was having a heart attack and they kept her in the hospital overnight. It turns out it was just a hernia. She was doing fine but they still kept her overnight for tests. They were supposed to let her out the next morning. You know how Dr. Hawkins is. You can’t go to see him without him wanting to keep you overnight for tests. Anyway, she was sleeping and the nurse came to check on her. Miz Swain thought she was seeing a ghost and got all upset, convinced she was dying. She had the nurse call Bill to call all the kids in. You know she has seven. 

Anyway, all the kids and in-laws came flocking in to the house along with all their kids. There was no need to all pile in at the house and stay all that time. They all live within ten miles of us. I don’t know what good they thought they were doing, anyway. Next thing, her two brothers and their wives showed up. Somebody called her step-brother from way down in South Louisana and told him it might be his last chance to see her. They couldn’t have been close. They hadn’t seen each other in more than twenty years.” Mother complained.

“Lordy, was she really that sick? That sounds like a mess.” Miss Laura Mae offered.

“No, nothing was bad wrong. She’s just the superstitious type and was convinced it was a sign she was going to die. Anyway, the whole bunch hung around the rest of the night and visited the next day, like it was their last chance to see each other. They made a bunch of long distance phone calls, which I know they’ll never pay for, ate up my week’s supply of groceries, drank up all my coffee, and even used up all the toilet paper. Even after she got out of the hospital, they kept right on visiting. The kids were running in and out banging the doors, screaming and yelling like a bunch of heathens. I stayed behind them with the broom and mop, but it was hopeless. It was horrible. I thought they never would go home. I am so tired, I could sleep for a week. We are out groceries. I don’t even have any dry beans left. We’ll be eating biscuits and gravy till payday.” Mother sighed. 

“You know, my mother had a stroke last summer. They didn’t know if she’d make it. She lives out in Texas. I wanted to go, but we talked about it and Bill decided we really didn’t have the money. I didn’t get to go for three months. It’s strange how when it’s the man, it is so different. It makes me mad all over we didn’t go when Mama was sick. I could have missed my last chance then. Why are men so selfish?”

“Honey, that’s why I never married agin after Floyd died. Most men think they own their women, an’ women don’t need to do nuthin’ but tend to them, the younguns, an’ the house an’ garden. I wasn’t much past forty and still had a couple of younguns to raise when Floyd died, but it was a lot easier for me to take in ironin’, sew for the public, babysit, or sit with the elderly or the sick than have to answer to another man. Now, don’t get me wrong. They’s a’plenty o’ good men out there, but they do that one bad thing. They just keep on a’breathing in an’ breathin’ out.”

They both laughed till tears were running down their faces.

Izzy’s Coffee Break

Izzy sharing a coffee break with me. He polished off the foamy milk.