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For Ginger, RN and AMY, LPN
My Partners in "You want me to do WHAT???"
Nurses working with the Developmentally Disabled/Mentally Retarded
at Community Center Boards face unreal obstacles.
The A, Number One obstacle
is the total lack of training for aspiring DD/MR Nurses.
After your year(s) of training on a Med/Surg Floor,
you at least have a clue about the human body,
but it no way prepares you for this population.
You may follow another Nurse who has set-up Policies and Procedures,
but, again,
why were they developed and at who's behest?
The other Nurse is leaving in two weeks to a month.
I'll guarantee you that's not enough time to learn a smidgen of what you need to know.
So there you find yourself,
all alone in your hometown
without a clue about what to do next.
What IS DD/MR Nursing, pray tell?
Once upon a time, not that long ago
(just ask Geraldo Rivera)
the Mentally Retarded/DD were Institutionalized from the age of Diagnosis; very often, from Birth.
A few brave parents tried to raise their own children,
but with "The State" encouraging them to let go,
"We have the money, resources, and manpower to teach and take care of your child"
and very few resources available to parents,
a great many people diagnosed mentally retarded were placed in Institutions.
Institutions are extraordinarily expensive to build, maintain, and staff.
Cutting corners with Staff is generally the accepted way to save money.
(That was a very personal observation...subjective, not objective.)
Conditions at some Institutions were appalling.
Powerful psychotropic medications were prescribed and given for
"crowd control".
If you've never seen dear old Geraldo's story on this,
take the time to search it out.
It's a tearjerker.
As we all know de-institutionalization put many a poor, lost soul out on the streets.
The MR people were a whole different song and dance, though.
So, what's a State to do?
Contract out the care of these people who are unable physically or psychologically to take care of themselves, that's what.
So, Community Centered Boards were born.
How on Earth could this be fiscally reasonable?
No tall stone walls to maintain.
No Doctors specializing in the DD/MR.
Just your local Family Practice Physicians doing their damnedest.
Visits to Specialists (Neuro, Ortho, whatever) just like "regular folks".
Few to no Nursing Staff, that's how.
So "Joe Blow" off the street is hired.
No medical training, no medical license, no nothing, thank you very much.
I'm not even going to try to address Programatic Services here,
unless it falls specifically under Medical.
We still have "The Powers that be", Case Management, an Office Staff,
all probably bare-boned
but,
for the more rural areas (mine),
only one Nurse.
Who had better have more guts and inner strength
than General Patton.
One Nurse for 150 or more people.
One Nurse to train/teach Staff assisting those people to live lives as independently as possible.
One Nurse to supervise, lead, assess, advocate, and.....
One Nurse as Teacher, Mentor, Caregiver, and Caretaker of and to the entire Agency.
That's DD/MR Nursing in a nutshell.
And I love it.
OK, this is a field that interests you,
and you've taken on a job at your local Community Centered Board.
Now what?
You have 25 people in group homes with various and assorted physical malfunctions.
At least half of those people have "behaviours".
Over half of the people living in the group homes have seizures.
All varieties.
You also have another 50 - 100 people that live on their own,
or with "Providers".
Those 50 - 100 people come in the entire spectrum of Developmentally Disabled.
"High functioning" to "low functioning".
Behaviours, seizures,
and, of course,
every other disease and disability known to man.
You have the Staff and Providers to train.
Medication Administration, Gastrostomy Tube training, Infection Control, Bloodborne Pathogens,
training on individual Protocols.
Writing/updating Policy and Procedure.
Department of Health, the Division for Developmental Disabilities,
and all kinds of "interested entities" due in at any time to inspect and find fault.
It can truly be daunting.
How about downright scarey, terrifying, and,
"Oh, gods, my License is on the line".
I hope to come up with viable information and links for DD Nurses
and to share them with you on the following pages.
I'm talking "hands on", down and dirty, step-by-step help for my Compadres out there.
I may even get a little bit nuts and write on specific topics as I see them.
That, of course, will mean more pages.
Oh, gods,....(hangs head and whines a little).
I love this little lady.
I feel like this three-quarters of the time.
A little bit about me
or
MY CREDENTIALS:
I've been a Registered Nurse for over ten years now.
Right after I had a year on the Med/Surg Floor of our small town Hospital,
I picked up a second, part-time job working for our Community Center Board.
I was the very lost Nursing Supervisor for two years, then
I worked as a PCA Provider (Personal Care Alternative) for two years.
As a Nurse I lived with two beautiful, low-functioning women.
Seizures, one fed via G-tube the other a feeder with a pureed diet, both with bowel and bladder incontinence,
non-ambulatory, wheelchair bound, and one with choreoathetoid movements.
(I also lived in and cleaned this giant house, 3/4's of an acre of land, had two kids, two dogs, five cats, and one huge lop-eared rabbit.)
I pretty much know both sides of the spectrum.
I set up our OSHA and Bloodborne Pathogens/Infection Control Programs.
I'm not very good at tooting my own horn, so if you need more,
e-mail me, OK?
Anyway, I've been involved with our Agency,
off and on,
for about the past 10 years, now.
I'm a good-sized woman, and like to wear shoes that add two - three inches to my height.
As I tell my classes, "I was born and raised in Texas,
was a Trucker and a Drill Sergeant in the Army.
If I come across as big and loud, it's because I AM big and loud."
I am NOT my Nursing Instructors' idea of "Professional".
Tough.
I WILL NOT leave my Staff, my Agency, or my Consumers hanging in the wind.
There is nothing I have up here (points to and taps noggin)
that I am not willing to share with someone who needs or wants my help.
Obviously, personality comes into play here.
I trust my Staff and my Staff trusts me.
That being said, "Let's get the show on the road".
Oh, yeah, and I'm in Colorado.
Some of what I talk about here may not be pertinent to your area of the country.
We're very rural...we were, anyway.
Rats. That's another story.
I will to try to rein myself in and only include DD/MR links.
Sometimes, though, I just can't stand it and HAVE to include a Link I think is nifty.
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