1. Admissions and Discharges
Welcome aboard and good bye

2. Welcome aboard
Be understanding of new resident’s losses and life-altering changes
Prepare the room so it would like a home
“The best thing we can do is to make wherever we are in look as much like home as we can” Christopher Fly,
Personalize their space with flowers and a greeting postcard

3. My new very little space now… But it is my space…

4. Welcome aboard Greet them with respect
Introduce yourself and ask them how they want to be called
Introduce them to their room, bathroom, and roommate first, help with items to be arranged, then introduce them to the facility, activities, meals time, and menu
While doing the tour, introduce them to people in the hall either they are residents or staff members, but be careful, don’t overwhelm them with too much information

5. Let me know you

6. Family
Talk to family. Ask them about resident’s habits, traditions, and preferences in meals and sleeping time.

7. Valuables and personal belongings
Valuables as money, wallets, jewelry, passport, and important documents should go to the facility safe
Have second person to count money with you to be a witness
Make a list of all personal belongings on admission , including valuables, make family to sign the paper
Place personal items per resident’s preference
Make their environment welcoming and home-like
Adjust temperature in the room per resident’s preference, not yours

8. Admission pack May include different items per facility protocol
Normally it is water pitcher, toothbrush and toothpaste, comb, Kleenex, big and kidney basin, and bed pen or urinal if needed
Activity – collect the admission pack for the resident in groups

9. Let sunshine to come to the room
Per nursing home requirements, unless resident requires otherwise, shades should be open during the day and closed at night
If not, resident’s get confused on a day time and change their sleep pattern

10. Assisting with the physical exam

11. Check resident's baseline vital signs
Activity – check vital signs on each other – T, HR, RR, BP, O2SAT, pain level. Also check their weight, and height
Baseline vital signs are the initial ones taken at the time of admission.

12. Conversion of weight to metric system
Activity – convert weight of your patient into kilograms
To convert kg to pounds: multiply by 2.2
To convert pounds to kg: divide by 2.2

13. Medical math 1. 70 kg 2. 3.5 kg 3. 0.4 kg 4. 12 kg 5. 200 kg 6. 40 kg
Convert to pounds
Convert to kilograms
1. 70 kg kg kg
4. 12 kg kg
6. 40 kg
7. 50 kg
8. 80 kg lb
2. 5 lb
3. 8 lb
4. 26 lb lb lb
7. 24 lb lb

14. Height of a patient in a bed is measured by measuring tape p. 144
Activity – measure the height of the mannequins in groups. Skill on p. 144
Activity – measure the abdominal girth of your mannequin, logroll them for placing and taking tape off, never pull the tape from under the patient to prevent skin tear

15. Assisting with the physical exam

16. Assisting with the physical exam
Know what you need to gather, have a little notebook for the specific exam’s equipment
Know positions which are required for the particular exam and position patient accordingly

18. Dorsal recumbent
Is used for the chest, abdomen, and perineal area exams

19. Lithotomy position
Is used for the exam of the vagina and pushing period in labor

20. Knee-chest position
Rectal exam

21. If you are present in the exam room
Be ready to comfort the patient, since sometimes patients are anxious about what examiner will do during exam and fear of the pain and the results of the exam

22. Discharge
Discharge is only official after the doctor writes the discharge order
NAC helps the resident to pack to be sure that all items are packed
Leaving the facility without doctor’s order is called AMA – against medical advice. If you see patient leaving the facility, or going to, notify the charge nurse immediately, and ask patient to sign the AMA paper to save facility from liability.
When discharge patient, your responsibility does not end until the doors of the vehicle closed.

23. Find good words for your patient on discharge
Good bye!
Activity – find the words for the patient on discharge, when you help them into the car and wave good bye. Write them in the orange sheet.

24. Homework WB 9 due tomorrow Test 9 tomorrow Abbreviations 53-62
Read the book for Thanksgiving cookie and conversation book club