Friday, November 26, 2010

The Nursing Pocket and Uniform

The most essential component of any nursing uniform is the pocket. It holds items essential for efficient function. It keeps your hands free.

I refuse to purchase a uniform for work as a nursing student, nurse aide, or nurse which does not have at least one pocket on the pants and at least two pockets on the shirt. The same goes for a jacket.

My nurse tech uniform I consider to be the best I've found yet. The pants have a deep rectangular pocket on each thigh. These are handy for keeping personal items that one wishes to keep on her; driver's license, cell phone, sanitary items, a tissue, lodge in these cavities. I don't have to worry about them all day because they won't fall out, but will be there if I need them. The shirt is a generic unisex top with a single rectangular pocket at each side. These generally hold a bandage scissors, shield skin, alcohol preps, perhaps a chloroprep or small gauze dressing. I don't put anything in these pockets that I'll be needing immediately or often, or anything that won't lie flat.

The pockets of my jacket are really my functional pockets. I work out of them.
First, a segue in defence of my jacket:
I realize that a jacket is unnecessary and in fact may be cumbersome or unrecommended in some areas of practice. Here is why I always wear one.
First, I wear it to make myself comfortable. Sleeves shield my arms from debris in the air and from the patients I have close contact with. Since my skin is often chapped and broken, I feel especially reticent to expose it directly to debris and frequent caustic cleansers. By the end of the day, my arms still feel dirty, but they feel less filthy than my face because of the slight protection afforded by sleeves. Second, I wear it for appearance. Unisex scrub tops are distinctly unbecoming. Jackets (particularly tailored designer ones) add a more professional appearance to my otherwise short, squat frame. Thirdly, jackets afford me large pockets not closely bound to my body (i.e. they don't make the shirt bulge uncomfortably). Jackets often have three or more easily accessible pockets where I can categorize and reach commonly needed materials and instruments throughout the day.

Back to pocket contents. My nurse tech scrub jacket has four pockets: two large rectangular front hip pockets and two slightly sloping pockets outside of these. In the right outer pocket I keep my notebook, in the inner pocket my pens. In the left pockets I keep my watch face and small bottle of hand-sanitizer. Also, any extra gloves end up in this pocket. These are the basics. Other things may be added as the day goes on, but this is the minimum.

Basic Pocket Supplies
Pens
Must have pens. Your day will be miserable if you don't have black pens handy to write information and chart. There will be vital signs to take and record, patient requests to relay to the proper personnel, and important info to jot for yourself.

Pocket Notebook
You must have paper of some sort to do the jotting upon. You don't have time or hands to carry a clipboard or large notebook with you. Your paper must fit in your pocket. You also don't have the luxury of a hard surface. You'll have to lay the paper on your other hand or the wall (if you can reach it). Hence, my preference is a pocket size spiral bound book of notecards. The whole thing is hard and easy to write upon. Each page is sturdy and won't tear or bleed on you. In the case of a missing I&O slip or the need to pass vital signs to a nurse, you can hang or hand a note card rather than searching for a medium.

Alcohol Preps (and Chloroprep depending on the facility)
This is not as essential for the aide or tech, but for the student or nurse to venture into the fray without alcohol preps is madness. Almost every task you will perform will require you to disinfect the area you are to work with whether it be related to an IV, and injection, a port, or a blood sugar check. Furthermore, (and here I refer especially to aide and tech work) alcohol is just about the only thing that completely removes staining from dry erase patient sign boards. During the day you may drop many things on the floor. Before returning them to the bedside table or your pocket, alcohol is indicated.

Watch
A patient's wall clock may provide sufficient orientation to time, but when vitals time comes around, you'll need a second hand that you can hold within your line of vision as you watch your patient's respirations.

Bandage Scissors
There will always be nasty stuff to cut off in nursing. Old bandages, tape, even clothing if too tight or an emergency. Clean dressings and biohazard bag covers for IV's (while showering)need to be cut out as well. You won't have time to run for scissors - you need them on you now.

Tape
In the same vein as scissors, tape is essential. In addition to the uses of tape the average person is familiar with, dressings may need to be reinforced. For this reason, I suggest cloth or paper tape at least. If possible, I recommend carrying both paper and plastic tape (for waterproof and non-skin adhesive needs)

Skin shield
If you don't use it, the nurse you're assisting probably will. It's just nice to have handy.

Gauze or Bandaids
It's nice to have gauze near to reinforce dressings or apply to exposed wounds or scrapes when needed. Also, its something your nurse may ask for.

Hand-sanitizer
When you need quick cleansing but sink and foam alike are out of reach, a personal bottle of alcohol scrub is quite convenient.

Gait Belt.
In my work, either my patients don't need a gait belt or have their own at bedside. But as I understand, in a residential nursing facility it's helpful for the aide to wear one so as to have it constantly at hand.