Can I Depend On You? 

Submitted by by Melanie Outlaw, RN


Can I Depend On You? 

 As the economy worsens, jobs diminish and money dwindles, the healthcare field also grows more constrained. The hustle and bustle of the increasing need to earn greater salaries, work longer hours and take on more and more responsibilities as a nurse is also on the rise.

The Georgia Board of Nursing has always been steadfast as govern for the safeguard and protection of all nurses. However, the State of Georgia has no law that governs the nurse-client ratio. With that being said, what kind of care might the clients be receiving due to the increase of assigned work load? Not only do the nurses get discouraged in the care provided, but the clients become disgruntled.

In my role as instructor of the Licensed Practical Nurse night program at East Central Technical College of Douglas, Georgia, I wanted to instill the desire of basic care of all clients to my students. This desire would include providing a clean dry brief as needed and responding in a timely manner. In doing this, I incorporated in the skills check off assignments for students to wear a wet adult brief for 30 minutes at home as a grade. After doing this, they would then describe how their skin looked and felt, the sensation of the wet brief and the emotional state they experienced. They also had to describe how this experience would affect their career as a nurse. As a result, I had some very interesting comments shared in the essays.

Comparisons of the nursing home staffing found at medicare.gov revealed an amazing insight into the available staff at long term care facilities. The rating used to score consisted of health inspections, staffing and quality measures. Each facility had the possibility of scoring five stars which would have meant it was much above average. Of the nineteen compared twelve scored 1 of 5 stars (much below average), three scored 2 of 5 stars (below average), and one scored 3 of 5 stars (average).    This is a startling reflection of the care that may or may not be provided to your loved one.

We have all been taught to handle the older population with kid gloves. According to Pediatric Dermatology, the effects of wearing wet briefs are very negative. While the client is not only experiencing emotional turmoil, it is causing a breakdown of the body’s protective covering (the skin). This breakdown of tissue then opens up a doorway for infection and possible sepsis.

As previously mentioned our healthcare system does not offer an umbrella for the nurses to be protected against the increasing nurse-client ratio in hospitals and long term care facilities. When applying for a job, each hospital or long term care facility is responsible for determining the nurse-client ratio. This is where the problem occurs! Many clients and not enough help. This is why it has become so important for the student nurse to experience what wearing a wet brief feels like. If all students are required to wear these, then our health care for the older generation may have higher standards. Here are some of the students comments:  “It seems that no one cares about me,” I feel worthless, undesirable and ugly,” “I see myself being more punctual,” “I will try to think of every client as my mother or father,” “feelings of hopelessness,” “keeping a person dry is the least you can do,” and “I will be as prompt as possible.”

I allowed everyone who wished to read out loud their essay in class. By the end of class there were teary eyes and almost everyone thought that this was a terrific idea for all nursing students to experience. If you are a nurse educator, then I plead with you to include this learning experiment in your school. We owe it to the elderly to help ensure that they have someone who cares.  

I will close this by repeating a prayer that one of the students wrote in their essay. “Dear Lord, if you don’t mind, keep me strong, healthy and alert, so that I am able to take care of myself and watch over, strengthen and protect the ones that aren’t able to take care of themselves.” Oh, yes you can depend on me!