[doodlemom]

Oh well. You really tried to help the patient. It sounds like the people around her are running the show. If the family ends up wanting hospice, the request would have to come from them.

[aimeee]

Yes, good for you for advocating for the patient. When people who are hurting "don't want hospice" I always wonder if they really understand what they are rejecting or if they think accepting it means "giving up". Its unfortunate that often the people who need it most emotionally cannot accept it. When you couple that with all the misinformation that people have about hospice (some of it from their own doctors!) it can be very challenging to even get to the informational visit stage.

I do wonder who is paying for the round the clock nursing staff. I have never heard of Medicaid being so generous as to pay for that kind of one on one nursing care.

[motorcycle mama]

Originally Posted by aimeee

I do wonder who is paying for the round the clock nursing staff. I have never heard of Medicaid being so generous as to pay for that kind of one on one nursing care.

This 24/7 around the clock private duty nursing care is compliments of TennCare, which is an extension of Medicaid here in Tennessee. Taxpayers foot the bill for indigent patients to receive this care at over $20,000 monthly for each patient.
TennCare is stretched so thin it is almost bankrupt.

[aimeee]

Wow. In our state the best you might do is that sometimes Medicaid will pay for a few hours per day. If you can't get by with that, its off to the nursing home.

[doodlemom]

It's no wonder they're going bankrupt. I've never heard of such a program. We have a program that will give CNA services for a few hours a day - and this is cheaper than paying for nursing home care and allows people to stay at home. I'm very surprised that Tenn doesn't send people like this to a nursing home which would be a lot cheaper and probably would not bankrupt them.

[sumrluvr73]

I don't think you made a mistake at all. You did what you thought was right for your pt. When/if she dies soon you will sleep well at nite knowing you tried to ease the transition for her and her family. You only suggested......anytime you advocate for a pt you should be proud of yourself as it is rarely the popular decision with everyone involved.

[doodlemom]

Originally Posted by sumrluvr73

I don't think you made a mistake at all. You did what you thought was right for your pt. When/if she dies soon you will sleep well at nite knowing you tried to ease the transition for her and her family. You only suggested......anytime you advocate for a pt you should be proud of yourself as it is rarely the popular decision with everyone involved.

ditto

[whyfret]

You acted as the patient advocate and for that you are to be commended. Perhaps, next time you will discuss your intentions with the family first. This would have saved you some anguish. Don't give up on the profession. It is obvious you care.

[pushinrn]

motorcycle mama-
I don't see where you made any mistake. If your intent was to help provide the best possible care for this pt at the end of life, you did what you thought was best. Don't let politics get in the way of your seeing that. If someone doesn't stand up for those who need help, where are we as a society?
If nursing is the "business" that you really want to get out of, take another look around- there are tons of different areas where you can make a difference.
Good luck.

[ssmith2307]

Maybe you should switch over to hospice nursing!