A dog will become an emotional support animal (ESA) if it can take the basic obedience commands. A dog that cannot stay or sit properly after a command will have challenges in understanding instructions and will not provide the kind of emotional comfort that you expect it to provide. Start the training early and stick with the routine.

Taking commands is crucial and it might even require the help of a professional if you are not making progress in making the dog to learn obedience.

Steps To Train Your Dog to Be an Emotional Support Animal

1.Start with simple steps

Start easy by teaching your dog these four most common commands.

Say each of these words in a level and a calm voice when practicing these steps with the dog. Use release words like good or ok when you are ready to signal the dog to break the pose.

2.Follow the three Ds program.

Many dog training experts recommend training a pup should follow this three-step program on the first commands. It is a program that centers on these three D –words (Duration, Distance and Distractions) that come in handy during training of a therapy dog to be providing emotional support.

a.Duration

Start by positioning the dog in a pose that you want and hold for about three seconds before you use the release work such good, nice, ok to show your approval. Increase this time gradually by few seconds after each interval until the dog learns to hold the command successfully on its own.

b.Distance

Move away from the dog slowly for about one step at a time to build its independence. Return to the starting position before your utter the release word.

c.Distractions

Build a strong foundation in the first two steps before you start introducing distractions. When the dog masters them, it is time to add distractions like mimic real-life experiences or getting another person to talk or pass or do something that will distract. It is a vital step because an emotional support animal is likely to encounter different environment when living or going for a walk with you. It is essential for the dog to master your voice and the appropriate way of responding at any time. It is an integral part of building the bond.

You should teach a dog the emotional support on how to provide emotional support and care after it understands the standard commands.

3.Sofa and paws command

Some treats help to coax a dog to get onto a sofa if it has not been doing it. Show the dog a gift and move it to the back of a couch as you excitedly call its name and add paws up. A reluctant dog might need rewarding for an extended time of getting rewards after climbing onto the sofa. You should also teach the "paws off" command for the dog to climb down from the sofa. You can begin by rewarding it until it masters the control.

Practice

You should aim at getting the dog to place all four paws on a sofa if it is small in size and take a down position. A larger dog with a weight that you do not want to bare soul only put the head or front paws on the sofa after “paws up” command. Practice the "paws up" and off command until the dog understands the meaning and follows the instructions even without a treat or reward.

4.Laying on the sofa

A dog will provide you with emotional support if it learns to lie along your body vertically with the paws on your shoulder and places its neck next to yours. The posture suits a dog that is small to medium size. A large dog should learn to put its paws across your legs or place his head on your lap when you occupy a sitting position.

Use the paws up command and down command to train the dog about the position to occupy when it is lying on your lap or vertically to you. Give the dog a treat when it takes the correct place to offer emotional support until it masters the command before issuing the paws down command. Back and forth training will teach the dog on how to apply pressure (shoulder or lap depending on its size) without expecting a food reward.

5.Train the dog to identify signs of anxiety

Train the dog further after mastering the above techniques to determine when you are in a stressful situation by mimicking the symptoms that you experience at such moments. Practice it when you are calm and reward the dog after following the commands because it will learn the action to perform when you need it at times of anxiety.

Emotional support animals calm people in unique ways. Learning how to train your dog to be an emotional support animal is an essential step because it can provide affection and dedication during difficult times.

Scrubs are not just a work uniform, but they also represent a symbol of a profession. Another purpose of the scrubs is to ensure the safety of the patients through proper hygiene. The difficult task is to keep them clean without bacteria. It takes much effort especially for nurses who run a hectic shift.

Nurses have much responsibility to prevent compromise of patients’ health by ensuring that they wash their scrubs properly and disinfect them. Disinfection of scrubs cannot be on dirty linen, and it is essential to clean the scrubs thoroughly before disinfecting.

How to Wash and Disinfect Scrubs

1.Separate scrubs from other clothes

Scrubs are dirty because they gather man contaminants at work. It is essential to separate and wash them separately from regular clothes. The right way is to separate the scrubs soon after arriving home by placing them is different laundry bag or hamper. Make a habit of carrying a freezer bag and store your scrubs in it n the way home if you change to regular clothes at the workplace. It is efficient in sealing the dirty scrubs until the time to laundry.

You can wait to accumulate several dirty scrubs before washing to conserve water and energy. Separating a large heap before cleaning is necessary because a washing machine will clean well if there is adequate room from clothes to move around. It will not clean thoroughly if the scrubs are squeezing too much.

2.Check the scrubs for stains

Scrubs are likely to have stains, and it is essential to remove them before washing. Different stains require a particular thing to remove them. A small amount of vinegar or bleach on blood stains will help to clear. A mixture of vinegar (one part) and two parts of water will remove the coffee stains.

3.Washing the scrubs

You should wash the scrubs should be in cold water and detergent. Ensure that the setting is at normal. The first wash should clean the scrubs inside out to prevent abrading. Check them for stains after the first wash is complete because they can set during the second round of washing that needs hot water. You can proceed with a second wash after determining that there is no residual. It might be necessary to soak the scrubs for proper disinfection if the stains are still visible. The soaking should not be for too long because the bleach mixture has properties that might damage the fabric.

4.Use bleach for stains in the washer

Bleach helps to clear stains, and you can use it in a laundry machine with a bleach dispenser. It helps to dilute the bleach before adding it to the laundry load. Some washers do not have a dispenser, but you can still use bleach by filling the tub with hot water before adding ¾ cup of bleach. Remember to add it to the washer before the scrubs. It is essential to avoid using full strength bleach on the scrubs because it might weaken the fibers and completely remove the color.

The regular wash with warm or hot water and spinning in the dryer will eradicate most germs, but it is efficient as disinfecting. Taking an extra step of disinfection is essential. White cotton scrubs need disinfection by adding sodium hypochlorite (chlorine bleach) to a wash cycle. Do not directly pour bleach on the clothing. Pour chlorine bleach into a washer bleach dispenser or dilute it with water before adding to a washer drum.

Oxygen-based bleaches do not provide any disinfectant qualities when you use them the for home laundry process.

Pine oil disinfectants are suitable for colored scrubs or those that are not cotton material. You should add them at the start of a wash cycle and are more effective in warm and hot water. The product should contain 80% pine oil for maximum efficiency. Phenolic disinfectant is another superb alternative for disinfecting colored scrubs

5.Tumble the scrubs dry in high heat

Wash the scrubs using the highest heat setting and tumble the dry for about 30 minutes to help in killing the bacteria. Cleaning scrubs in the regular laundry steps, adding disinfectant and machine drying kills any virus and bacteria on the fabric. By following regular laundry steps, adding a disinfectant, and machine drying, any virus in question, even the AIDS virus, will be killed.

Pain is an unpleasant physical sensation that occurs due to injury and illness. The unpleasant sensation is subjective because it depends on the intensity that a patient feels.

A nurse who is caring for a patient who is in pain should know how to access the type and intensity of pain for appropriate management of the discomfort. Pain is in two types that a nurse can distinguish according to the cause, duration, and onset.

Acute pain: The onset is slow or sudden with the intensity ranging between mid and severe. It might happen to occur after surgery, medical procedure, critical illness or trauma. The duration of acute pain is less than six months.

Chronic pain: This type of pain lasts for more than 6 months with an intensity range of mild to extremely incapacitating. Chronic pain can in some instances restrict a patient from performing daily activities and usually leads to despair.

Nursing Care Plan for Pain Management Diagnosis

As we noted, pain is highly subjective, but the description by patients about the pain they are experiencing is the best indicator. A nurse cannot prove or disprove what a patient is feeling but also cannot assume. It is also essential for a nurse to ask about the cause of pain and the period that it has been in place.

A nurse should also observe nonverbal indicators of pain such as moaning, facial grimace, crying and guarding. Nursing Care Plan for Pain Management Goals and Outcome The goals and expected the results for nursing care plan for pain management are:

Nurse burnout is a mental, physical and emotional state that occurs because of chronic overwork. It might also occur due to continued lack of support and fulfillment with a job. Nursing working environment exposes the professionals to many stressful issues that might lead to burnout. Everyone in nursing can get burnout although there are those who are more risk due to their personality and working environment. It is a condition that affects the mental and emotional wellness to the point of changing the quality of life. Such a person is not in the appropriate state to offer quality care to patients.

Patient infection rates increase due to nurse burnout because they will be getting care from someone who does not have complete capability to offer the kind of care that a professional should provide.

Whats the link between Nurse Burnout and Patient Infection Rates

Overwhelming Nurse Burnout symptoms

Burnout causes exhaustion, low sense of accomplishment and job-related cynicism. It might even develop to clinical depression if untreated because unaddressed problems accumulate over time.

These burnout symptoms make it curtail that ability of nurses to interact well with patients, notice the risk of infection or offer standard care that helps patients to heal as well as preventing infections.

1.Irritability

Irritability is a frequent human emotion and is a sign of burnout when excessive or chronic. Irritability occurs because a nurse is frustrated by the work and might reduce the input at work to the extent of negligence that exposes patients to a risk of infection.

2.Reluctance and intolerance

Burnout can make nurses to feel reluctant about doing some things and intolerant to changes that help to prevent patient infections. Reluctance to work also interferes with professional efficacy meaning that the nurse offers a raw deal to patient care.

3.Calling in sick frequently

Nurses with severe burnout and are unaware of self-care methods are likely to feel sick and take more off days to recover. Nurses who suffer burnout because of staffing shortage will hurt the nurse to patient ration when the call in sick. It will reduce the number of nurses attending to patients. The nurses at work might not be able to provide adequate attention to the patient and can miss things that might cause patient infection.

4.Exhaustion and fatigue

Nurses work for long busy hours, and it is not unusual for professionals to get some fatigue. Constant exhaustion even during the off days is dangerous and is a sign of burnout. Fatigue can be emotional and physical, but both make it difficult for nurses to do their challenging jobs. Exhaustion can cause an inability to focus, confusion and difficulty in making decisions leading to these mistakes that increase the risk of patient infection.

Nurses with burnout are likely to have impaired memory, attention and functionality that decrease attention to the detail. Nurses with burnout are at more risk of making errors due to diminished cognitive function, vigilance and an increase of safety lapses. Such mistakes place patient at more risk of infection as the nurse is not in the right state to enhance preventive measures.

Burned out nurses are detached from work and unknowingly develop negative attitudes towards the patients. All the factors that are causing fatigue impair the capacity to deal with technically complex and dynamic nature of efficient nursing care.

Nurse fatigue that leads to burnout is dangerous to nurses and even their patients because they will be the recipients of poor quality care even without their knowledge. For example, a nurse who is struggling with burnout can make mistakes when reading a patient’s record and fail to administer medicine that could prevent opportunistic infections that can occur in a patient under treatment for another condition. For instance, a patient with a wound or burns will need to a prescription to prevent infection by bacteria that enters into the body through the damaged skin. A nurse who fails to administer the medication because of distraction by burnout increases patient infection rates.