Comfort kits - page 3

We have a comfort kit but would like to maybe change it some, so I was wondering what other hospices have in your comfort kits, I have heard of different kits for different diagnosis, ie: specific... Read More

  1. by   Noey67
    My experience with ekits are very much what others have stated. I have also worked with HP an they go over kill on what is needed. Have thrown away so many HBR supps, and haldal its horrible. BUT! The idea of the kit is s necessity

    I use to work for an agency that insisted that ekits are not ordered for each patient... guess how many emergency calls came in to triage with no ms roxanol ?? for pain, or all of the sudden sob? It happened alot, and nurses are not god. We have NO idea when they these symptoms may or may not appear, but if they do, and there is no MS in the house.. the issue falls on the case managers shoulders.. like everything else.
  2. by   okielpn75
    Quote from Noey67
    My experience with ekits are very much what others have stated. I have also worked with HP an they go over kill on what is needed. Have thrown away so many HBR supps, and haldal its horrible. BUT! The idea of the kit is s necessity

    I use to work for an agency that insisted that ekits are not ordered for each patient... guess how many emergency calls came in to triage with no ms roxanol ?? for pain, or all of the sudden sob? It happened alot, and nurses are not god. We have NO idea when they these symptoms may or may not appear, but if they do, and there is no MS in the house.. the issue falls on the case managers shoulders.. like everything else.
    Perhaps in your job that is the case as well it should be since the case manager is SUPPOSED to be ultimately responsible for the management of the patient care. Unfortunately in my job as well as others in Oklahoma the primary nurse for the patient has become the case manager and the RN simply holds a title.
  3. by   tewdles
    Quote from Noey67
    My experience with ekits are very much what others have stated. I have also worked with HP an they go over kill on what is needed. Have thrown away so many HBR supps, and haldal its horrible. BUT! The idea of the kit is s necessity

    I use to work for an agency that insisted that ekits are not ordered for each patient... guess how many emergency calls came in to triage with no ms roxanol ?? for pain, or all of the sudden sob? It happened alot, and nurses are not god. We have NO idea when they these symptoms may or may not appear, but if they do, and there is no MS in the house.. the issue falls on the case managers shoulders.. like everything else.
    Your agency gets to decide which comfort packs they want delivered/used. Our packs never have any HBR supps, some don't have morphine, some have levsin rather than atropine...
  4. by   rngolfer53
    Quote from volsfan
    To pjtk,

    As a home hospice nurse I review all comfort pak contents with my families b/c the families are usually the first to give the medications in the middle of the night or on weekends while they await for the weekend nurse to arrive. I have found it to be a good practice since there are multiple medications and when there is an "emergency" for the families they should be educated and feel comfortable about the contents of the kit. If they are left uneducated they are more likely to make a mistake if the hospice nurse is trying to instruct them over the phone. This generally takes an additional 20-30 minutes to review during a visit, but it sure does help. I would call the hospice you are with and speak with the manager. If how your nurse treated you is the company policy regarding the kits I would interview other hospices. If not, I would request a different nurse. Education is the major part of our job and at the very least she/he should have spoke to you in greater detail regarding the kit.

    Gail
    Even with good family education, in the middle of the night, with their loved one in pain or other distress, family members tend to forget what they've been taught.

    I used to do overnight call, and I always made sure the family was familiar with the CK, and how/when to use it. Many times, they would start to recall what the CM had taught with just a little prompting.

    Too bad it's impractical to conduct periodic drills with families, to make the timely and correct use of the CK automatic.
  5. by   rngolfer53
    Quote from KamaNaples
    I have a question, that i need answered. My Hospice group snowed my mother the other night and i am now in charge of her medicine. This CarePak, that i received...If I terminate Hospice services, am i still allowed to keep the CArePak for my mother? Another questionis, that if i terminate them, am i allowed to uses the rentalas that they leased out for my mother, i.e ox, bed, etc... until she passes? is this going on my mothers medicare/aid?
    thank you so much for the answers.
    KAma
    Just a quick comment on yor mother being "snowed." Something to take into consideration. Hospice patients are critically ill, and energy is at a premium. If someone is in pain, having shortness of air, anxiety, etc for any length of time, he/she is going to use a lot of energy because of the stress those symptoms place on an already sick person.

    Nutrition is often inadequate at the end of life, so spent energy takes longer to replenish. I've seen many times where patients have had a busy day with visitors, etc, need very little medication, and sleep for much longer than usual and are harder to arouse for the next 12-24 hours. In these cases, the "snowing" is less due to meds than recovery. Even pleasurable things take energy.

    Not to say that patients don't get snowed sometimes, but just be careful not to mismatch cause and effect, as that can lead to loved ones suffering unnecessarily.
  6. by   rngolfer53
    Quote from leslie :-D
    when my mil was on hospice, her comfort kit had a healthy variety of meds.
    but the times i wasn't at the house, no one else knew what ea med was used for.
    i wrote out their uses, next to ea med.

    morphine- pain
    ativan- anxiety/agitation
    haldol- confusion but also nausea and agitation.


    they would then pick the med that best suited her symptoms.

    i do wish all e-kits had this.

    leslie
    Ours had color coded labels--yellow Haldol, green Ativan, etc--and matching colored instructions, but sometimes people still didn't get it. Some from the stress of the moment, some from inadequate teaching (especially where several people are providing care), and some just from being too far down the left slope of the IQ bell curve.

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