Friends and countrymen, today we will start a journey down the road of convalescent care in grid down and covert environs. The trip won’t be short, because there are many aspects to cover, and we will try to get in as much as we can without putting people to sleep. We anticipate that we may have some lively commentary where hopefully some folks who do some of this work can chime in and enlighten us.
To be merciful to you, the readers, and ourselves, the guys who have to write this stuff, we will do this as a series of posts so that we can focus on certain areas and not write an entire textbook in one post.
First, let’s define convalescent via Webster’s.
Medical Definition of CONVALESCENT
You’ve just splinted your buddy’s broken femur and decompressed his left chest after a fall while rock climbing.Now what?Transport him out ASAP and get him to surgery.OK, they have screws in his femur with a big old cast and his chest is all sewn up.Now what?He’s got to heal. And he’s going to need a clean room, a bed, sheets, bandages, pain medication, antibiotics, food, bathroom help, baths, and routine checkups from the doc and nurses to assess his progress.
Physiological needs are the physical requirements for human survival. Physiological needs are thought to be the most important; they should be met first. Air, water, and food are metabolic requirements for survival in all animals, including humans. Clothing and shelter provide necessary protection from the elements. In a medical context, this may include the needed medications and treatment to keep your buddy alive, such as insulin for a diabetic, etc.
With their physical needs relatively satisfied, the individual’s safety needs take precedence and dominate behavior.
Safety and Security needs include:
- Personal security–protect your grid-down mates from either the charging bear, flash floods, or the rampaging zombie horde
- Financial security–who will take care of your buddy’s wife & kids while he is out of commission?
- Health–applies medically in terms of clean or sterile materials, protection from infection, getting the right treatment to the right patient, & etc.
Where we may quibble with Maslow’s Hierarchy for grid down convalescent care is to swap the two bottom needs so that Safety is the base and Physiological is one step above, or they are blended together as one.
Love and belonging
After physiological and safety needs are fulfilled, the third level of human needs is interpersonal and involves feelings of belongingness. This need is especially strong in childhood and can override the need for safety as witnessed in children who cling to abusive parents. Deficiencies within this level of Maslow’s hierarchy – due to hospitalism, neglect, shunning, ostracism, etc. – can impact the individual’s ability to form and maintain emotionally significant relationships in general, such as:
According to Maslow, humans need to feel a sense of belonging and acceptance among their social groups, regardless whether these groups are large or small. For example, some large social groups may include clubs, co-workers, religious groups, professional organizations, sports teams, and gangs. Some examples of small social connections include family members, intimate partners, mentors, colleagues, and confidants. Humans need to love and be loved – both sexually and non-sexually – by others. Many people become susceptible to loneliness, social anxiety, and clinical depression in the absence of this love or belonging element. This need for belonging may overcome the physiological and security needs, depending on the strength of the peer pressure.
Important stuff, here. We’ve seen this ball dropped too many times to ignore its impact on how well your buddy is going to do after he is injured. I would also add that one of the key elements to prevent is simple boredom. Shut up in a hospital room for 6-8 weeks, unable to move beyond your room, is a recipe for insanity.
All humans have a need to feel respected; this includes the need to have self-esteem and self-respect. Esteem presents the typical human desire to be accepted and valued by others. Maslow noted two versions of esteem needs: a “lower” version and a “higher” version. The “lower” version of esteem is the need for respect from others. This may include a need for status, recognition, fame, prestige, and attention. The “higher” version manifests itself as the need for self-respect. For example, the person may have a need for strength, competence, mastery, self-confidence, independence, and freedom. This “higher” version takes precedence over the “lower” version because it relies on an inner competence established through experience. Deprivation of these needs may lead to an inferiority complex, weakness, and helplessness.
Self-actualizationMain article: Self-actualization
“What a man can be, he must be.” This quotation forms the basis of the perceived need for self-actualization. This level of need refers to what a person’s full potential is and the realization of that potential. Maslow describes this level as the desire to accomplish everything that one can, to become the most that one can be. Individuals may perceive or focus on this need very specifically. For example, one individual may have the strong desire to become an ideal parent. In another, the desire may be expressed athletically. For others, it may be expressed in paintings, pictures, or inventions. As previously mentioned, Maslow believed that to understand this level of need, the person must not only achieve the previous needs, but master them.
- Wound care: types of wounds, primary vs secondary intention, types of dressings vs types of wounds, how to make Dakins solution, improvising bandages, overall cleanliness, how to deal with infections, etc.
- Physical therapy (PT): generally considered to be gross motor tasks, such as how to walk again.
- Occupational therapy (OT): generally, fine motor tasks, such as how to use a fork or write again
- Ortho issues: how often to change a cast, how long should it stay on, when do you start moving it again, etc.
- Nutritional therapy (NT): how to fuel the healing process
- Covert aspects of the above
- General nursing issues: everything not listed above, such as bathroom issues, bathing, medications, emotional support, etc. Lots of stuff here.
- Logistics issues: get the stuff where it needs to go, and the “public health” issues surrounding it
- Training issues: teach your replacement, teach your covert nurses, etc.
- Medical texts to have available.
Thanks for stopping by.