mchospicern

Latest Activity

1. Palliative Care

   mchospicern replied to ozynurse's topic in Hospice

   Many home health care agencies offer Palliative Care programs to patients in the home. Those served typically are patients who are not eligible for the medicare hospice benefit because they are not terminally ill and/or they are receiving curative ...

2. hospice diagnosis help

   mchospicern replied to karbyr's topic in Hospice

   Depending on the fiscal intermediary who pays your hospice on behlaf of medicare, "Decline in Health Status" may be the preferred dx, rather than "adult failure to thrive." Last time I checked, CAHABA liked AFTT, and Palmetto likes Decline in Health...

3. It's really sad when....

   mchospicern replied to CountrifiedRN's topic in General Students

   When I was in nursing school, someone asked my son (5) what his favorite dinner was. "#7" he responded. :)

4. Do your dying patient's have company?

   mchospicern replied to mchospicern's topic in Hospice

   A hospice chaplain once pointed out to me how people who have have lived through near death experiences seemed to have less fear of dying. Has anyone ever asked a dying person if they've ever come close to dying before?

5. Do your dying patient's have company?

   mchospicern posted a topic in Hospice

   It has been my experience that the dying are not alone. Unscientifically speaking, about 90% of the people I take care of tell me, near the end of their lives, that they've been visited by deceased loved ones, and sometimes by kindly strangers. Thi...

6. Full code status in LTC

   mchospicern replied to itsme's topic in Geriatric

   No CPR should mean no CPR. What if the person arrests while still in the nursing home bed, but with EMS on scene? That law is ridiculous. Who makes up these things? The person doesn't have to be competent, just has to be able to make a mark on a...

7. Anyone with effective HA remedies?

   mchospicern replied to delirium's topic in General Nursing

   Ibuprofen can increase blood pressure, and, if the headache is R/T HTN, could make things worse. Also, Ibuprofen is hell on the kidneys. I'm an EXCEDRIN woman myself, but never more than 2 tabs daily D/T rebound effect. NOTE: Excedrin Migraine ha...

8. what to do with DNR

   mchospicern replied to angelbear's topic in General Nursing

   Regarding insulin at the end of life, it has been my experience that blood sugars often stabalize somewhat at the end of life, and often we do discontinue long-acting insulins, as well as decrease the frequency of blood-sugar checks, but I wouldn't e...

9. What would you do about a LTC resident like THIS!

   mchospicern replied to tattooednursie's topic in General Nursing

   I once took care of a woman who was nasty, not to that degree, but was pretty brutally verbally abusive. She seldom had visitors, but one day I caught her neice coming for a (very brief) visit. The neice told me this lady had been nasty her whole l...

10. long term night shift work versus health

    mchospicern replied to JetLPN's topic in Geriatric

    Night people are awesome. I was the night house supervisor at a LTC for a year. What a team! We were a small, cohesive bunch who had to rely on each other. It was great. Havoc on my health, though, because I never could sleep during the day. Hm...

11. Full code status in LTC

    mchospicern replied to itsme's topic in Geriatric

    WHAT THE HECK IS GOING ON IN MICHIGAN!?!?!? That's awful! How sad for the patients who deserve to die surrounded by a praying family and the staff who've been caring for them, not paramedics beating on them and shoving tubes into them and shocking ...

12. Loss of a brother

    mchospicern replied to mona b RN's topic in General Nursing

    mona b., I am so sorry for your loss, and for the helplessness you have had to endure watching your brother become more ill. My prayers to you and your family. I was taught to believe my patients. When someone says they have pain, I beli...