TIPS for your 1st PA overnight shift alone

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DRT 

A Must Read For New People 

Very important, when I ring the bell immediately stop what you are doing and get the spell board because you could be hurting me or you are doing something wrong. Also you only get 3 chances guessing what I want after that get the spell board. It's easier than guessing all night. Lastly if you come in my room and I am coughing immediately clamp my burp tube!

FEEDING-
  • Always put a towel on my chest before feeding me. Hold both the feeding tube and the peg tube otherwise the feeding tube could pop off and make a mess. 
  • Before taking off burp tube clamp it first and then turn dirty burp tube up side down before taking it completely off. That way the paper towel cork can catch any liquids. 
  • Never put breakfast in the refrigerator after feeding me.
  • Always use a clean tube in the morning before breakfast 
  • Don’t forget my drop of hydroxo 12 before medicine in the morning.
  • Don't clamp burp after you give me only medicine. Always clamp burp after breakfast, 10 a.m.  snack, lunch and dinner. Also for each set an alarm for 15 minutes to burp me. 
  • Rinse the burp tube in the kitchen sink after lunch and dinner  please. 
  • Plan your morning properly, do vest one hour before my CNA arrives and give me breakfast 30  minutes before she arrives. 
BREATHING/LUNG SUCTION-
  • Lung suction in bed is easier because I don’t have my brace on. Unlike in the WC you don’t have to keep my head turned all the time, my head stays in place. The important rule is turning my head slowly. Also turn my head exactly how you turn it in my WC.  Always turn my head 90 degrees. 
  • Before you do Water Management or my vest Nighttime and Morning in bed read the instructions on the bedroom door. 
  • After lung suction burp me  before mouth suction and put trach cap back on. Take feet off box and adjust arms. Here's a picture of how my hands are placed on the white towels: 
  • If I am coughing in the living-room and especially if the vent alarm goes off immediately clamp my burp tube, put shoes on and raise my feel all the way up. 
  • I never turn down mouth suction! Ask me anytime my chin is wet and foaming at the mouth. 
  • In my bed when you put the suction tube back in the plastic bottle make sure that the tube is behind the foot board otherwise my foot might touch it when I ring the bell.  
COMMUNICATION- 
  • When I open my mouth and leave it open that means fill my trach balloon. 
  • Know how to do lip reading especially Up, Off and I don’t know with my eyes before your first overnight training.  When using the spell board know that I can mouth the letter O. when you start to count the numbers on the spell board and I say No it means you are on the wrong side. 
  • Using the spell board always count the numbers slowly. 
WHEELCHAIR GUIDANCE-
OVERNIGHTS-
  • In bed my trach tubes go to the left of my peg tube. Always check tubes after water  management. It's important when you do the blue tube keep it in place, to the left of peg. 
  • Don’t ask me too quickly your question especially in the middle of the night, it takes me a few seconds to think about the answer
  • Always check tissues and wipe, neck and chin in the middle of the night and do chapstick. Apply liberally! 
  • If my condom comes off in the middle of the night take it off and tuck me into the diaper. Get 2 diapers from the hall closet, rip both sides and lay one under my thighs to prevent more wetness if I go again. Put the other diaper vertical stuffed in my privates to keep the sheet from getting wet. If it is before 1 am replace condom only if you are qualified.

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