Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: SUNDAY, November 27, 1994 TAG: 9411290018
SECTION: BUSINESS PAGE: F1 EDITION: METRO
SOURCE: SANDRA BROWN KELLY STAFF WRITER
DATELINE: LENGTH: Medium
Orderlies wore blue shirts; nursing assistants wore white ones.
Just from the color of shirts, it's easy to figure out which job commanded more respect.
An orderly's job was to weigh, lift and bathe patients, Poindexter said.
If there was a mess no one wanted to deal with, it was "call the orderly," Poindexter said. "I used to say: 'Everyone wants us, but nobody wants us.'"
When orderlies' jobs were eliminated, the workers had a chance to be retrained as nursing assistants and the nursing assistants were given additional patient-care duties.
"It was a reversal of fortune," Poindexter said. "Now we're on the other end of the ladder, climbing and it's, 'I'll help you if you'll help me.'''
The changes have made everyone uneasy, however, he said.
"I wouldn't say there's an animosity; there's an urgency of 'Where do I fit in?'''
As a nursing assistant, Poindexter is assigned a certain number of patients, usually eight or nine. It is his responsibility to make certain they get meals and baths, and are transported to hospital services, such as dialysis or X-ray. He also regularly checks patients' blood pressure, temperature and pulse and attends to incontinence problems.
Poindexter, 31, said he likes having more say in patient care.
He likes the teamwork that has emerged where he gets to do some things once handled by nurses, who in turn sometimes take care of situations they previously would have delegated to an orderly. He is so committed to the new way of working at Community that he volunteered to be a liaison between nursing staff and nursing assistants. He also enjoys finding ways for the hospital to save money and approves of how it has cut down on waste.
In the past, for example, linens, such as washcloths and towels, that were stained from blood or medicine were tossed away.
"Now, they're dyed a color so the stain doesn't show and used for rags," he said.
Also, patients aren't given the standard wash pan filled with personal-care items, many of which used to be tossed out when patients left the hospital.
Now, a nursing assistant determines which items the patient needs and orders them, and, of course, charges the patient for them.
The frugality at work has even had an effect on Poindexter's personal life.
Instead of throwing away a little piece of soap, he sticks it to another piece to make a useable bar of soap, he said. And the furniture polish spray usually produces a bit more if you shake the can.
"When I run errands, I think about where I'm going and figure out the shortest distance. I even make a little list now of things I need to do and stick it on my dashboard," Poindexter said
It makes sense for the people who work with patients to make decisions that affect them, he said.
For example, the skin integrity committee, on which Poindexter serves, recently replaced all of the hospital's mattresses with ones designed to make patients more comfortable and less prone to bedsores. Before the committee made its choice, it tested six different styles of mattresses and documented patients' responses to them.
In addition to cutting down on the incidences of bedsores, Poindexter said, the new mattresses eliminate the need for a sheepskin mattress overlay that doctors often order for bedridden patients.
The overlays are wasteful, he said, because they cannot be reused.
But habits are relinquished slowly, he's found.
"There have been some battles trying to persuade the physicians not to order them, though," he said.
by CNB