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

2. 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

3. 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.

4. 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

5. 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.

6. 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.

7. 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.

8. 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

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

10. 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

11. THE PAIN SCALE

12. 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

13. 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