Feb32011

13 Comments

Medical Planning and Training for Uncertain Times, Part 1: Homecare Nursing

Guest post by Dave, LPN, EMT, WEMT

image by Bruce Turner

Medical planning and training is a huge subject. This article will be broken down into several areas, and the necessary gear and training for each topic will be covered.

I am a Licensed Practical Nurse, EMT, Wilderness EMT, phlebotomist, and a CPR/ First Aid instructor.  I also instruct disaster medicine with a well known firm and am currently working on my RN. I work full-time as well and have done this over the last several years. In addition to this training, I have had the opportunity to care for two relatives that have been on hospice.

I have noticed that many preppers want to know how to suture a wound or remove “the bullet” or some other “glamorous” task. But the more training I receive and practice in the field, the more I realize how much I do not know. That concept really scares me but it’s a healthy fear.  Preppers will benefit from that realization as well.  Learn the basics.  Have the proper supplies ready.  And then take the next step to learn how to suture a wound or remove a bullet.

image by ulrichkarljoho

Homecare nursing

The most ignored area I have seen for survival is homecare nursing. I know it may be a boring subject, but it’s an absolute necessity to keeping your patient alive and viable.  It is sad when I deal with a young person or older person who has contractures, bed sores, develops pneumonia or just fights to maintain some level of independence.

Skill set

Good basic patient care can be learned and mastered by becoming a CNA (Certified Nursing Assistant). They are great at taking temperatures, blood pressures, giving bed baths, turning and feeding patients. They help monitor for bed sores, pressure areas, changing incontinent patients and providing basic necessary care. It may not have the glamour or prestige of removing a bullet but is actually more necessary.

I know people that do not understand that you cannot have someone lie in bed for hours/ days / weeks and not be really involved in their care. A patient that is not mobile needs to be turned and checked every two hours. If you turn them and see a red mark on their side, butt or back, you are probably looking at a bedsore very soon. Bedsores can kill patients!! I have seen Stage 4 pressure ulcers that go to the bone. Do not let that happen. Patients need to be clean, dry and intact – always!

Patients need to be exercised daily if they are bed bound. This will help prevent contractures, a shortening or distortion of muscle or connective tissue. Contractures ultimately have the patient going into a fetal position. In nursing school we have worked with patients that required four adults to just change them and get them out of bed.  Very, very sad. Have them or help them move all of their joints for full range of motion. Start with the head by going side to side and rotations, move to the neck, shoulders, arms, fingers, knees and toes. Hopefully you get the idea.

I also use incentive spirometers for lung exercises. This can help prevent pneumonia. If that is not available, try chest physiotherapy. Try cupping your hands and have the patients on their side. Use your cupped hands and tap on the patients back to loosen anything in the lungs. Do not use too much pressure but tap several times a day.

image by Mat Honan

Necessary materials

  • Gloves – no latex. I prefer Nitrile for durability. It is impossible to have too many. I personally have 10 –12 cases. Each case has 10 boxes of 100 gloves.
  • Bed pans
  • Urinals – male and female
  • Wash basins
  • Emesis basins
  • Bed pads for incontinence – reusable or disposable. The reusables are strong and can be used to help turn/ reposition your patient
  • Incontinence briefs (diapers) and pull-ups
  • Baby wipes – you can never have enough.
  • Thicken – makes liquids thick for people with swallowing difficulties
  • Nosey cups – plastic cups with the nose section cut out to help with liquids for patients with limited   mobility
  • Incentive spirometers – lung exercisers.
  • Walkers
  • Crutches
  • Canes
  • Bedside commodes
  • Gait belts – assistive belt to help a patient ambulate
  • Thermometers
  • Blood pressure cuff and stethoscope
  • Manual wheelchair
  • Hand Cleaner
  • Clorox and sprayer

I have designed a “raised platform bed” to be used for homecare nursing. I could not justify a hospital bed with hand cranks at this point. The raised bed would allow me to care for the patient without killing my back.

This is just a starting list and concept. It is far from complete but should give you an idea about needs for your patients.

Remember, everyone needs the training and practice. The patient may be you someday, and these simple procedures may save a life, including your own.  Also and most important, many of these tasks are not fun. Many are done for infants and young children without any thought. Please be kind and offer privacy and dignity to your patients. Treat them as you would want to be treated.

God Bless, good luck and please let me know what you think or if you have questions.

There may be links in the post above that are “affiliate links.” This means if you click on the link and purchase the item, I will receive an affiliate commission, which does not affect the price you pay for the product. Regardless, I only recommend products or services I use personally and believe will add value to my readers.

Post Footer automatically generated by Add Post Footer Plugin for wordpress.

© Copyright 2011 The Survival Mom, All rights Reserved. Written For: The Survival Mom
The following two tabs change content below.
I'm the original Survival Mom, and have been helping moms worry less and enjoy their homes and families more for 5 years. Come join me on my journey to becoming more prepared to handle everyday emergencies and worst case scenarios.

(13) Readers Comments

  1. Great post Lisa! This is a critical skill to learn for any type of emergency. Your list of items is great!

  2. Excellent info! Really timely and well thought out. Appreciate your post!

  3. This is a great article, but being medically prepared could go so much farther. As a Respiratory Therapist living in the interior of Alaska, I see on a daily basis the effects of not only being unprepared, but the devastating impact of smoking, alcohol abuse, etc, on one's ability to survive and thrive in an adverse environment. Knowledge is power! The more you know, the better you can adapt and survive, and aid those around you!

    • Dan, thanks for the comments. You are so right about being medically prepared. I know that Dave has two other articles planned on the topic, but if you would like to add information or provide an article yourself, that would be great. Such a relatively small percentage of our population has medical training, and yet in the future, that could become the greatest area of need.

    • Dan,
      I agree with you on how much further medical preparedness can go. The "medical" topics are massive. I was trying to cover basics and start the wheels turning for everyone. I know as a Respiratory Therapist you see the long term effects of our poor lifestyles.
      Take care and stay safe!
      Dave, LPN,EMT, WEMT

  4. Another person in your community who has extensive knowledge of human anatomy and physiology is your local funeral director. Many of the classes they are required to take are pre-med classes. As they are in the business of caring for families in times of severe distress, most are very compassionate people. They are also wayyyy past any 'gross' factor. They would be a good resource if medical personnel are in short supply for whatever reason.

    • That's quite good advice. I'm amazed by how much medical information is retained, even by people no longer in the medical field. My sister was an RN close to two decades ago, and still remembers so much of her training. Heck, I remember all the basics of First Aid from a class I took when I was in 7th grade!

    • Great point. I would never have thought of them, but it makes a lot of sense. I'd also include a couple more obvious groups – pharmacists, physical therapists and chiropractors. While none are a replacement for an MD, all bring invaluable knowledge.

  5. Outstanding post and information ~ thank you so much! I'd add extra bedding and towels, skin lotion, lots of plastic shopping-type bags for disposing of soiled items (bags with handles so they can be "tied"), room freshener spray & laundry detergent. This isn't from a medical background, only experience but I hope it can help someone.

  6. Excellent article. This is something I have been worried about being unable to do. Your instruction laid it all out in simple, empathetic terms. Thank you so much for taking the time to share you knowledge. I am much more confident that I would be able to care for a bed-ridden loved one. Best of all that’s good to you.

  7. Great Article Dave! As a full-time caregiver for a family member, I have to agree that a lot of people look past the mundane (and likely!) aspects of caregiving. So you suture a wound closed, or splint that broken leg… and then what? Leave you patient laying in the yard, or expect them to get up and be back to normal? Most injuries or illness that require that level of treatment are going to require significant follow up care, and many people are unprepared (in skills and supplies.) I think you did a great job of reminding people of that an encouraging preparedness for the most likely scenarios!

    • Thank you for the kind words Mrs S. It became very clear to me in doing homecare for family members what is necesary in time, skills and materials.
      Your family member is very blessed to have you caring for them!
      Keep up the good work!
      Dave

  8. You are right on target with respect to learning the basics. Too many posts I've seen cover emergent situations and not the recovery period afterward.

Leave a Reply

Your email address will not be published. Required fields are marked *

You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <strike> <strong>