I am a med-tele nurse experiencing hospice because my dad is there. I've staying there most the time. It has been very confusing to me so I'd like to know more about what hospice is meant to be. I don't feel my father's pain/restlessness has been managed very well. Over the weekend, he was seen by the weekend doc. When we met we had told her he was finally in a good place and had the best night the previous night due to change in his meds the day before. That evening, he ate and conversed with family. I spent the night. The nurse had given him po pain medicine at midnite and I heard him gurgling shortly after. So I went to check on him and he was so sedated he couldn't even focus on me. His respirations were decreased. I went to get the nurse. She explained to me that this was his"disease process." I told her no, I'm sorry, I think he's overly sedated. She continued to explain the "disease process" until I finally said please come to the room to assess. He continued to be sedated throught the night, so I got charge nurse (who apparently was notified earlier by nurse, but did not bother to come to room). She said it appeared he got to much, it just needs to wear off. He was so sedated, I couldn't get him to stay awake enough to urinate, so I was concerned how that would happen. My mom was distressed. Finally in am, I was able to get a little more response after calling pt advocate. But even MD argued it's his disease process. (Turns out she majorly increased pain meds earlier that day, even after we had told her he had the best night the previous night.) Foley inserted and eventually he woke up, but very aggitated. I requested MD be called for plan. MD, not so receptive, d/c'd all scheduled meds and only made available PRN. He's been consious, slightly loopy, ever since, but eating. We met with the regular doc that had seen him during the week and got him back on plan. It was such an agonizing, frustrating experience. I feel they have an attitude of he's in hospice, so there's an underlying excuse of "he's dying." But I feel he should dye in his own course, not because of negligence. Is it wrong to think that these circumstances should be corrected? It was also very frustrating because during the night, other than nurse/ charge nurse, there were no other resources for help. Any thoughts would be appreciated.
Nov 19, '12
It sounds like your dad is in an inpatient hospice setting?
It seems more like you are wondering if this hospice is practicing appropriately rather than what hospice "is".
As the case manager to include you in the next IDT, so that you can interact with the entire team and may speak to the goals for your father's care.
Without knowing the details of your father's diagnosis and symptom burden we cannot evaluate the care...
Are you certain that you would describe his care as negiligent? If so, then contact the state ombudsman and make a complaint.
Nov 22, '12
At night there are always less resources so that cannot be changed. During the day you should discuss the plan of care with the ID team. What would you like to be done? Are his symptoms to out of control to be managed at home? P
This is a difficult time for you all so I hope you are able to have more positive experience.