Reply to Renee Cordrey
Thanks for the early reply !
I quite agree that foley's in themselves are not an
obstacle to getting people up, but I think there is
a deeper problem with the nursing staff grasping
the fact that these patients need to walk [all
other factors permitting] but because they are
catheterised and have a large catheter bag they do
not present with a need to empty their bladder. It
was not so much their bladders I was thinking about
but the fact that the first functional walking
patients do following lower limb surgery have to
perform is walking to the toilet. Patients who are
catheterised still have to open their bowels and
the nursing staff do not appear to have a problem
in commoding those with catheters, but do not seem
to appreciate the patients' need to get mobile as a
primary aim of their recovery. "Oh, the physios are
there to walk the patients, therefore I don't need
to". I know that is a big generalisation and
certainly does not apply to all nurses but there is
still resistance to the idea of leg bags/valves.
Those patients who are leg bagged are commoded to
the toilet, probably several times a day, and it is
this stand-turn-sit transferring that helps the
patients to at least find their feet a bit quicker,
and therefore go that bit further and start to
walk. It isn't just a physio who can walk a
patient. In my philosophy the physios' real
targets for treatment are those patients that the
nursing staff can't walk - I must hasten to add
that there are patients who will walk with the
nurses very well but won't do anything for the
physios, so it does sometimes work both ways ! In
our unit where there are mixed trauma and elective
surgery patients [mostly THR & TKRs] there is a lot
of pressure to get the easiest out of the acute bed
as quickly as possible, and the poor old codger in
the corner just does get enough of a chance because
he doesn't have a leg bag. I really think that
there needs to be a cultural change from the
patients being passivised [is there such a word ?]
by their inability to regain their independence due
to their being attached to a large catheter bag.
Waiting for more - I am sure that this is quite a
common problem !
Anthony Morgan
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
|