Would you like cream with your powder?
Let me just say this right up front:
We love our hospice nurses. No scrap that. We love nurses. Period.
They are some of the kindest and most caring people on this planet. When everyone else is standing around getting grossed out by some perfectly natural problem (pick from the big four: pee, poop, puke or blood), nurses jump in and take care of it without hesitation or complaint.
But they are still human beings and if they've been nursing for any decent amount of time, they've almost certainly developed a treatment preference or two about which they feel rather strongly.
One such preference we've noticed is that hospice RNs seem to fall evenly into two groups: those who are pro-powder and those who are pro-cream. We've yet to meet one that likes both equally. Since hospice protocols are more flexible than in other clinical settings, nurses have more freedom to implement their personal preferences in some situations -- like the skin problems which plague pretty much all hospice patients.
And probably due to nothing more than random coincidence, we occasionally seem to be assigned our nurse from the opposing camp of whichever nurse visited the prior day. So, if we're cream positive on Monday, you can bet we'll be powdering it up on Tuesday.
Powder Nurse: Oh dear, who put this cream on her?
Me: The RN who visited yesterday.
Powder Nurse: Well, it needs air and we can't see the skin. Let's get all this cream off.
Me: <sigh>Okay.
Powder Nurse: Then we'll put some powder on it to keep it dry.
Me: I thought you might say that.
The next day, we might follow with this:
Cream Nurse: Oh dear, there is powder everywhere. Did you put this on?
Me: Nope. That would be yesterday's nurse.
Cream Nurse: Well, I think the powder gets in all the cracks of the skin and gets wet and clumpy. Let's get it all off and get everything clean.
Me: <sigh>Okay.
Cream Nurse: Now that it's all clean, we need to protect the skin so we'll put some cream on.
<long pause>
Me: It's funny how the hospice nurses seem to go back and forth on this issue of cream and powder.
Cream Nurse: Really?! I never noticed. That is funny. I guess there are some who still like the powder, but it seems kind of old-school to me.
Me: Yeah, that's what they said about the creamers too.
In the end, each camp shares the common desire to start with a clean slate and then apply what their experience has taught them is most likely to produce the best outcome. Their only real problem is a smart-aleck family member who likes to make unnecessary and unhelpful remarks and then write about it in his blog.
Update 1: Our nurse today asked what I call the pro-powder nurses if the pro-cream nurses are called creamers. Let's go with Powderinas.
Update 2: Someone made a good point. A male nurse would be a powderino.
