THE CLIENT’S ENVIRONMENT PROMOTING WELL BEING, COMFORT AND REST CHAPTER 22

THE CLIENT’S ENVIRONMENT Clients often move from one environment to another In/out of facilities (admissions/discharges) From one room or unit to another (transfers) Clients should feel safe, comfortable and relaxed in any environment that they are in. However, transitions can be difficult for some and can cause them to feel: sad disoriented anxiety Fear unsettled alone confused

THE CLIENT’S ENVIRONMENT Admission is the official entry of a person into a health care facility. Often admission is uncomfortable and leaves people with a feeling of uncertainty ADMISSION IN LONG TERM CARE FACILITIES The admitting process usually starts days before the new resident arrives. The room is assigned and can be prepared beforehand. Facilities will supply the new resident with a bed, chair and bedside table, however, residents can provide their own. Rooms should be as home like as possible. Give the resident a warm reception and make a good first impression, remember this is a life changing event for the new resident.

THE CLIENT’S ENVIRONMENT ADMISSION IN HOSPITALS Admission starts in the admission office (pt. registration). Pt’s are given a room number and ID bracelet. The admitting staff then calls the unit where the new pt. is going and informs them. Room preparation is completed. The nursing unit will call when they are ready and have the pt. brought to the unit. As a PSW, you may help with admission procedures

THE CLIENT’S ENVIRONMENT TRANSFERS A transfer occurs when a client is moved from one room or unit to another. Transfer usually occur when a clients condition changes (medical unit to ICU or vice versa, isolation). Sometimes pt’s asked to be transferred to another room.

THE CLIENT’S ENVIRONMENT DISCHARGES Discharge is the official departure of a client from a health care facility. They are either well enough to go home, only need home care or are being discharged to another hospital or long term care facility. The health care team plans the clients discharge and health teaches before they leave. You may help clients pack their belongings and transport the client out of the facility. Physicians must write an order allowing the pt. to be discharged. If a pt. wants to leave against medical advice (AMA) you must inform the nurse immediately.

THE CLIENT’S ENVIRONMENT COMFORT Comfort is the feeling of contentment. Many factors affect comfort Temperature Ventilation Odours Noise Lighting PAIN To have pain means to have discomfort, to have aches, to hurt or to be sore. Pain is subjective. Never judge one’s pain. Pain is personal and can be emotional, social and spiritual as well as physical.

THE CLIENT’S ENVIRONMENT TYPES OF PAIN Acute pain - sudden from injury, trauma, disease or surgery. Usually lasts < 6 months Chronic pain - constant or occurs off and on. Lasts > 6 months Radiating pain - felt at the site of tissue damage and nearby areas Phantom pain - felt in a body part that is no longer there

THE CLIENT’S ENVIRONMENT FACTORS AFFECTING PAIN Past experience Anxiety Rest and sleep Attention The meaning of pain Support from others Culture Age

THE CLIENT’S ENVIRONMENT SIGNS & SYMPTOMS OF PAIN PSW’s should make the following observations about pain: Location Onset and duration Intensity Description Factors causing pain Vital signs MEASURES TO RELIEVE PAIN Distraction Relaxation Guided imagery

THE PAIN SCALE

THE CLIENT’S ENVIRONMENT REST & SLEEP Several factors affect the amount and quality of sleep Illness Nutrition Exercise Environment Meds Alcohol Change and stress Emotional problems

THE CLIENT’S ENVIRONMENT SLEEP DISORDERS Insomnia - a chronic condition in which the person cannot fall asleep or stay asleep Sleep deprivation - When people are sleep deprived, the amount and quality of their sleep declines Sleepwalking - walking around for several minutes while asleep. People are not aware they are doing this and do not remember sleepwalking