FLArn 8,536 Views
Joined Jan 6, '02.
Posts: 532 (62% Liked)
Thank you for your article. When so often we are told that we should never shed tears, I agree that in certain settings and in certain situations, tears are an expression of caring and emotional support for the family. When a patient I have taken care of for a long time dies and I am the one who attends the death if the tears come, they come. This is esp. true of my pediatric hospice patients. Thank you for reinforcing that we can be effective nurses and human at the same time.
For what it's worth, our protocols for flushes were updated in 09 and for central lines not in daily use the protocol is to flush the lines with 5 ml NS followed by 5 ml 10 unit/ml heparin (except Groshongs , then no Hep) twice weekly and prn with meds (SASH). Of course yo know with a 10cc syringe! LOL Hope this helps. If you use a IV specialist nurse for midline/PICC placements she could probably get you a copy of the most recent INS approved protocols.
The only reason the hamburger was "forbidden" was because she was in a LTC facility. Had she been at home with hospice or in a hospice residential unit she could have had a hamburger or any other food item she desired.So sad that is not the case with all hospice patients regardless of setting.
Once placed by the MD and verified by X-ray, a g tube shouldn't migrate and verification of placement by auscultation would be sufficient for general purposes. However if the balloon ruptures or as in the OP the stoma enlarges through leakage of stomach contents (which IMHO requires eval by the MD -- but that's a separate issue for another day) and the g tube comes out replacement would require verification via X-ray to be sure of proper placement.
The Hardest part of the LTC med pass for me always was running to the supply closet when I found the empty bottle of test strips, ... then to replace the tylenol bottle with 1 tab in it, etc., etc......:selfbonk:
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