aimeee 8,764 Views
Joined May 12, '99.
Posts: 3,492 (2% Liked)
Haldol is sometimes used as part of a whole cocktail of meds which is used to tone down an over reactive system to bring nausea under control...we sometimes use suppositories in our home hospice which contain ativan, haldol, reglan, and benadryl. This often brings relief to people for whom nothing else works. Other hospices use metaclofen suppositories (I don't know the precise composition but I know haldol is one of the ingredients.) I won't form an opinion of the appropriateness of its use in this circumstance because there is no way I could know the full picture, not having seen her complete MAR, not having seen the patient, not having a history to look at.
What I do wish for you now, is to find a way to peace in your heart and heal the grief and the anger that you feel. I hope you will pursue some bereavement counseling. If you have too much anger with this hospice to accept their services, you can ask for that support from another hospice. Most will be very gracious about accepting you into their support groups.
I started as an admissions nurse in hospice care after experience in long term care. It worked well as a transitional role for me. As an admissions nurse the main focus is on the documentation of the baseline condition of the patient and the history and appropriateness for hospice care (how well they fit the medicare guidelines) and identifying the most crucial issues for the care plan and getting things started. Collaboration with the team is not only expected, but required, so there is a lot of learning that happens with that process. Explaining the hospice benefit and obtaining signatures may also be a part of the admission process depending on how your hospice handles this (it is in ours but many use social workers or "program reps" to do that part).
It takes longer to develop the expertise in the symptom management areas because you don't get to see first hand the results of interventions that you put into place. You have to seek out that information by talking with the team. But there is a lot less pressure to know how to handle everything because you know you will be handing things off immediately to someone more experienced. And, unless you work for a very small hospice, likely your knowledge level will be part of what's taken into consideration when admissions appointments are assigned. It certainly would be in my department. If we are admitting someone that we know has a lot of difficult issues, we would try to match that person with an admissions nurse that could best address them. We try to give the "green to hospice" nurses the more straightforward admissions at the start.
Pain control: What do you most commonly use? Do you ever fear using too much Roxanol? How do you explain the difference between Roxanol and Morphine Sulfate? Our Medical Director tells me they are TOTALLY different drugs. Yet they are both MS, so I do not understand this. Yes, I know Roxanol is stronger... but that isn't what he meant.
Bowel regime: What do you do when you get a patient (new admit) and apparently he/she hasn't had a bm in 7-10 days? (eek!) Is unable to tell you.. and facility he has been at "hasn't paid attention?" (eek!) What would you have done? Ordered?
Last but not least... (boohoo) HOW do I get supplies that I would LIKE to use, but aren't on in stock (perhaps expensive)??? And I work for a non-profit... (eek!) Help!
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