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Day 4: Wednesday, March 9 The day began with an early-morning meeting between a small group from Gallaudet and Reps. David Bonior of Michigan and Steve Gunderson of Wisconsin, both University Trustees. (Two congressmen and one senator are regularly appointed to serve on the University’s Board. Also on the Board at this time was Sen. Daniel Inouye of Hawaii.) The day before, Bonior had contacted Jack Gannon, the director of the University’s Alumni Association, and requested the meeting. Another attendee was Hlibok, president of the Student Body Government. At about this same time, Elisabeth Zinser arrived in Washington, D.C. She had agreed to begin her presidency early and felt that her presence would help bring the protest to a close. One of the first things she did was to meet with I. King Jordan in the offices of the public relations firm working on behalf of the Board of Trustees. Together the two then went to meet with the four student leaders, who urged Zinser to step down. She refused. Zinser and Jordan then went to the National Press Club, where Spilman had just begun a press conference. At this press conference, Jordan publicly announced his endorsement and support of Zinser. He said “I was asked by the Board’s chair to meet with Catherine Ingold, the University’s Provost, and get her help in arranging a meeting on Wednesday with the student leaders and Zinser. The four students, Zinser, an interpreter, and I met in a small, stuffy room in one of those discount motels on New York Avenue-Room 105-I still have the key somewhere at home. Zinser asked that the students give her a chance to prove that she could lead the university well, but they kept repeating the four demands. They assured her that no one was against her personally, but they wouldn’t budge until their demands were met.” “After the meeting in the New York Avenue motel room, the students and the interpreter left. Zinser and I were picked up by a car and driver. I thought we were headed to Myra Peabody’s office (the Board had hired her company to manage the publicity surrounding the presidential announcement) and was surprised when the car stopped in front of the National Press Club where Peabody had arranged a press conference to be held. The room was packed with media people. Judge (Thomas) Jackson moderated the press conference. [)Board Chair) Spilman announced Zinser’s appointment, and Zinser spoke about her goals for Gallaudet. I never expected to address the press conference and wasn’t prepared to say anything when they asked me to come up to the front. I remember when I stated that as dean of the College of Arts and Sciences, I supported the Board’s decision, the look of disbelief and disappointment on the face of Mary Lou Novitsky, who was covering the press conference for Deaf Mosaic…” “After the press conference, I returned to campus. The faculty were meeting in Elstad. I arrived just as Harvey Goodstein was urging the group to join the protest. When he finished, he saw me standing backstage. He came over and gave me a hug and said he would always be my friend, but that he would continue to fight…” “That night [after the press conference announcing Zinser’s appointment], I went home and thought about it some more. I said to myself, ‘Sure, I’m a dean and should support the Board of Trustees, but hell, I’m also deaf and will be for the rest of my life, and that’s more important.’ Then Pete Merrill [a former Gallaudet president] called and advised me to ‘listen to your heart and do what it says.’ So, I talked to Linda and told her that I’d changed my mind and had decided to go with the students.” Meanwhile, the faculty of the University and of Pre-College, along with staff people, met to decide whether they supported this now-student-led protest. There was some dissension and opposition in the faculty meeting, but, in the end, the votes in both the faculty and staff meetings resulted in complete support of the protest. At 4 p.m. Zinser and Spilman met with Bonior and Gunderson. Obviously the congressmen’s earlier meeting with Gannon and others had influenced them greatly, as both men urged Zinser to resign. That evening Bonior publicly announced his support of the protesters. Throughout the day, reporters and supporters flocked to Gallaudet’s campus. The late Mitch Snyder, then director of the Community for Creative Non-Violence, came to lend his support. That night Hlibok, Zinser, and Deaf actress Marlee Matlin-who had won an Academy Award for Children of a Lesser God in 1986-were interviewed by Ted Koppel on ABC’s program Nightline. Marlee Matlin was a prominent supporter of the historic March 1988 "Deaf President Now" (DPN) protest at Gallaudet University. As a celebrated Oscar-winning actress, she used her public platform to advocate for the appointment of the university's first deaf president, supporting the movement's focus on self-determination
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🧴 1. SKIN ASSESSMENT – DETAILED NOTES 📄 ⭐ Purpose of Skin Assessment * Identify early signs of breakdown * Detect circulation or oxygenation issues * Prevent pressure injuries * Monitor healing or worsening conditions 🧠 What You Assess (Head-to-Toe Skin Check) 🔹 1. Temperature * Warm = normal * Cool = ↓ circulation * Hot = infection/inflammation 🔹 2. Color * Pallor → anemia / ↓ oxygen * Cyanosis → poor oxygenation (BLUE = BAD) * Redness → inflammation / pressure 🔹 3. Turgor * Pinch skin (usually chest or forehead) * Normal = snaps back quickly * Tented = dehydration 🔹 4. Moisture * Dry → dehydration * Diaphoretic → fever, stress * Excess moisture → breakdown risk 🔹 5. Integrity * Intact vs open areas * Look for: * wounds * tears * ulcers 🔹 6. Capillary Refill * Press nail bed * Normal = < 2 seconds * Delayed = poor perfusion 🔹 7. Edema * Swelling = fluid buildup * Check severity (pitting scale) 🚨 PRIORITY AREAS TO CHECK * Bony prominences (sacrum, heels, elbows) * Skin folds (obese patients) * Under devices (oxygen tubing, stockings) * Areas with ↓ sensation ⚠️ HIGH-YIELD FINDINGS * Non-blanchable redness = Stage 1 pressure injury * Cool, pale skin = ↓ perfusion * Moist skin = ↑ breakdown risk 🩹 2. SKIN TRAUMA & PRESSURE ULCERS – DETAILED NOTES 📄 ⭐ What is Skin Trauma? Damage to the body’s protective barrier ⚠️ Causes of Poor Wound Healing * Malnutrition * Poor blood flow * Infection * Smoking * Medications (steroids) * Age 🧬 Wound Healing Phases 1. Inflammatory * Redness, swelling * Body sends immune cells 2. Proliferative * New tissue forms * Wound starts closing 3. Maturation * Remodeling * Scar forms 👉 Know the ORDER!! 🔥 Types of Wound Healing * Primary intention → clean, closed (sutures) * Secondary intention → open wound heals slowly * Tertiary intention → delayed closure 🚨 PRESSURE INJURIES ⭐ Causes: * Pressure * Friction * Shearing ⭐ Risk Factors: * Immobility * Incontinence * Poor nutrition * ↓ mental status 🔴 STAGES (VERY TESTED) Stage 1: * Non-blanchable redness * Skin intact Stage 2: * Partial thickness * Blister / shallow wound Stage 3: * Full thickness * Fat visible Stage 4: * Muscle or bone exposed Unstageable: * Covered with slough/eschar Deep Tissue Injury: * Purple/maroon skin 🚑 INTERVENTIONS (PRIORITY CARE) * Turn every 2 hours * Keep skin clean and dry * Use barrier creams * Promote nutrition (protein!!!) * Assess skin daily ❌ DO NOT: * Massage reddened areas ⚠️ COMPLICATIONS * Infection * Dehiscence (wound opens) * Evisceration (organs out = emergency) 🧴 3. SKIN CONDITIONS – DETAILED NOTES 📄 ⭐ COMMON CONDITIONS 🔹 Dryness / Pruritus * Dry, itchy skin * Causes: * dehydration * irritants * allergies Treatment: * Moisturizers * Antihistamines * Steroids 🔹 Urticaria (Hives) * Raised, itchy welts * Blanch with pressure Treatment: * Antihistamines * Steroids * Epinephrine (severe) 🔥 Psoriasis (VERY TESTED) * Chronic autoimmune disorder Signs: * Silvery scales * Red plaques * Common areas: * elbows * knees * scalp Treatment: * Steroids * UV therapy * Biologic drugs 🔥 Cellulitis (IMPORTANT) * Bacterial infection Signs: * Red * Warm * Swollen * Painful Treatment: * Antibiotics * Elevate extremity 🔥 Shingles (VERY TESTED) * Reactivation of chickenpox Signs: * Painful vesicles * Burning/tingling Key Point: 👉 Contagious to people who never had chickenpox 🔥 Skin Cancer Types: * Basal cell * Squamous * Melanoma (most dangerous) ⭐ ABCDE RULE: * A = asymmetry * B = border * C = color * D = diameter * E = evolving 🧠 Nursing Diagnoses: * Impaired skin integrity * Risk for infection * Pain * Disturbed body image 🛌 4
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