I am new to hospice - looking for info
I have a question about the emergency kits that are placed in the home. Do you place it there on admisssion with instructions to "leave it alone" unless instructed by the nurse to open it. OR do you review the medications in the kit at the time of admission - explaining what they are for etc with the instruction to put the kit aside and open if instructed by the nurse. We have to document instruction but it seems overwhelming to the family.I would like to see what the various policies are. All the medications in our kit are labeled with the usage information and the pharmacy med sheets are in there, but do you put any other "simplified" instructions or information about the medication itself. I have found that some people have no idea what a suppository is and you put it WHERE??? So if not instruucted before hand - it might mean a visit by the oncall nurse at 2 am.
For the meds that the patient is already on - do you provide a medication schedule for the home.
How do you instruct patients when talking to them about prn meds. So many say - just tell me when to give them and I will but I don't want to have to fuigure it out. This is mostly for roxanol and ativan usage but could be other prn meds as well. If any one has developed or knows of resourses for educating the family in an effective way please share. We use communication books in the home to write instructions but maybe because it is a notebook it just doesn't seem official.
Thanks for feedback
Oct 29, '06
We vary depending on the situation. If it looks like the time is near when the contents of the emergency kit will be needed, it makes sense to go through it, provide some education, and then focus on teaching them the signs that will show its time to call for additional instruction. At other times, it is plain that the family isn't ready to think about those things yet and then it is enough just to give them a rough idea of what is in it and try to get across the reassurance that we will educate them about it when the time is right.
You are right about how difficult it is for some people to make the judgments about PRN medications. Exhausted, stressed, grieving people often cannot integrate new information. It is often necessary to put the meds on a schedule so they are not afraid of having to use their own judgment about giving them.
The med sheets that come in the packages may be impossible for them to comprehend under stress. You may find it necessary to write out your own instructions in just a few key words or to draw up a schedule for them. This is where the ART of nursing comes in...figuring out what will work for the unique individuals.
Oct 31, '06
The hospice I used to work for used the comfort kits. They were ordered with each admission with the medications specific for the diagnosis. We placed them in the fridge of every home so anyone knew where they coulod be found. It was taped up and the families were instructed to not use these meds unless instructed by hospice. Every home has a medication sheet. Every med was written with both drug names, dose and we have a spot for the hospice nurse to check off breakfast lunch supper and bed. The PRNs I would put an arrow through the breakfast lunch supper and bed and in bold, AS NEEDED ONLY. I would also put what the med was used for and I would circle the yes or no if it was covered by hospice or not. Then they knew which meds to fill on their own.