It shouldn't have happened this way.... - page 3

Okay, so I work part time with hospice. I like it. It's a nice break from feeling like I'm torturing souls their last days on earth up in ICU because their family of freeloaders are all living off their granddad's check.... ... Read More

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    Thanks,'s good to know people are doing the right thing somewhere...

    When I was in telemetry, and had someone who was close to passing, I'd put telemetry on them just so I'd know when they started getting ready to go...I never wanted to walk in and find my patient had been dead for the time it took me to bathe and do wound care on someone else. What kills me is, they weren't that busy (no admissions, no codes, and the nurse had 1 other hospice patient who was no trouble at all, care being given by a very self reliant family, and 2 walkie talkies that got dc'd the next day. Whoever took that BP knew the pt was dying...why didn't they just pick up the phone? They wouldn't have had to do anything but be there for the pt during their last moments on earth.
    terrirn143 likes this.

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    In light of what I've seen in my years of nursing, hospice should have never become an option in hospitals. Hospice was created for pts. to get nursing care AT HOME around familiar surroundings & FAMILY. That whole concept is missed these days.I know it started in hospitals due to more days of insurance coverage that way but the pt. gets cheated. In a hospital, if pt. becomes "hospice" that means a step-down in care given & time spent in the room by staff, not more as some here seem to think. Hospice is comfort care only so interventions are few.It is probably much better in the home setting as it originated because there the pt. & family get the staffs undivided attention as they should. That won't happen on a busy hospital floor. And forget familiar surroundings which are a comfort to a dying pt. & more conveniant for family.The post Oct 4th says family were called- where were they?? Seems they failed the pt. also. It is all very sad, but again, hospice should be @ home- none of this would have happened.
    mc3 likes this.
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    There is absolutely no excuse for her having died alone. Having the call bell out of reach is the same as using a restraint. I agree with the caller that a write up is warranted. But not just for one person but for the nurse, CNA, and anyone who was assigned to the patient along with the charge nurse that night for that particular floor. Agreed, the CNA who took the blood pressure should have notified the charge nurse or the nurse assigned to the patient and someone SHOULD have called the family. My mother died in an emergency room on January 4, 2010 with only my father present who had been summoned after my mother had not received an appropriate level of care following a fall with sustained head injury three days prior. I live in another state from where my mom lived but my brother didn't and was very close to my mother. My brother was not notified until after my mother had died because there was so little time. The woman in this should not have happened the way it did....we all have to die alone but the dying process should be filled with our lived ones, comfort, and dignity whenever possible.

    Terri, RN BSN
    RN since 1990
    Hospice Nurse LPN and Soozul like this.
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    Write up.. Someone is not awake at 4am.
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    What I see here is a hospice patient in an acute hospital. That is a large part of the problem. With so much going on with surgical patients, etc. it is easy to not go into the room of the person who is not pushing the call light. Sad, but true. I make it a priority to give them pain medications even if they do not look to be in pain. How the heck do I know? I just know they are dying and it ought to be as comfortable as possible. If a patient is to be lingering in this dying state, the patient ought to be in a different type of residence. Maybe that would have made a difference. We do not have hospice at our hospital. People go home, or go to nursing homes on hospice. If our patient is dying, we do comfort care. In the story given, it appears that perhaps the case manager, etc. did not suggest a better place for end of life. Home would have been best, if possible.
    Soozul likes this.
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    I've got agree with Needshaldol; a hospital is the wrong setting for a hospice pt, but perhaps that was in the works and she died too quickly for that to occur. I work in a SNF and it breaks my heart when one of my beloved pts dies in the hospital - I KNOW that they are not getting the loving care that we could give them, simply because we know the pt's history, likes and dislikes, and their life history.

    Nerdtonurse (that's me, too - I was a high falutin' secretary - no matter what my actual title was - for 20 yrs before I became a nurse) I'm so sorry that your pt suffered like this. I'm glad that you are going to pursue it. Did you speak with any of the nurses at the time of the event? I've had many shifts were we're crazy busy avoiding the serious stuff like a code, and on paper it appears as if we had an easy time of it, when it was all of the maddening work that kept things from going to heck - but you wouldn't know unless you got report from me (:

    Soozul likes this.
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    In response to Needshaldol, I also do these things- part of being a conscientious nurse.I always call family c a turn of status or events (not hospice pts,) but in this situation, the nurse probably thought the family didn't want to be there or they'd been, c her being hospice.I don't know that I would have called family under those circumstances. We call the hospice nurse who is off-site when the pt. passes. Where I work, family overflow in a situation like this.They usually do most of the care which is basically being c the pt. Some don't even like the nurse coming in.
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    Quote from nerdtonurse?
    When I was in telemetry, and had someone who was close to passing, I'd put telemetry on them just so I'd know when they started getting ready to go...I never wanted to walk in and find my patient had been dead for the time it took me to bathe and do wound care on someone else.
    At my hospital we are actually not allowed to do this. Once a patient's DNR order (we have a 3-tiered system) has indicated that no meds to correct dysrhythmias will be given, the telemetry is removed.

    I agree with you, and I wish this was an option for me. When patients are hospice in the ICU (it happens occasionally if death is expected soon after withdrawal of care), I'm not sure if the monitors stay on the patient. But for MedSurg and stepdown, those patients can NOT be monitored.

    As the others have said, I'm very sorry to hear this. I applaud you for your work - I do not like having hospice patients. I prefer the rush of emergent interventions! I hope that your discussions with your boss end in something positive.
    Soozul likes this.
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    Hospice pts. NEVER have tele- comfort care only. I have never heard of hospice care in the unit either.
    Hospice Nurse LPN and leslie :-D like this.
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    I have yet to hear of an acute care hospital accept "hospice" in the hospital. When a patient goes on hospice, the hospice team takes over. How does this work in an acute hospital? We have a palliative care team, but they do not give orders. What we do is "comfort care" which to me is exactly like hospice, or rather hospice in an acute care facility. I truly do not understand how hospice works in hospitals, perhaps; these are "for profit" hospitals?

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