Ginapixi, BSN 5,088 Views
Joined: Dec 28, '07;
Posts: 122 (40% Liked)
; Likes: 74
started in L&D ended in Hospice now "retired"
30 year(s) of experience
yes! it is done with gloves and i have done plenty of blood draws in the hospital setting as well as in the home (though MUCH less!), port access etc, always with gloves - However, i have started nursing back in the day when gloves were for the OR, may be (!) dressing changes and guess what, we used to clean and sterilize syringes as well as hypodermic needles and had less infection rate than we do now!
so don't get your panties all in a bunch if some one does it with out gloves - patients at home have their own home germs IF the nurse does excellent hand washing the infection danger is probably way less than in a hospital setting
I hear a lot of agencies will pay per visit, especially off hours; a case load of 15 should be manageable if there is back up if needed; who covers nights/on call? and how large is the area you cover?
I used to work for a company who paid salary to RN, hourly for HHA and LVN; case load of 30+/- 2 RNs, 1LVN one admission RN who ran under marketing and had to fill in for nursing when ever needed (which was more often than not); on call (from after office close to the next morning and the weekend) was on rotation between RNs and the DON, so one week/month; this was not too bad 90% of the time; but once we were to cover continuing care, some times up to 3 days - you work the night and were expected to be back on day shift the next day! no extra pay mind you ..... turnover there was rather huge!
seriously, the med dir should have talked to the case manager as well as at least one of the family doctors
where i worked patients always kept their family physician or other doc as attending, the hospice med dir was only a back up and support; other physicians is no reason to discharge a dying patient! if i was family or a doctor friend of that patient i would report that hospice!
I have seen similar cases quite a few times. Some times it was denial on the side of the family, some times over-protectiveness, some times selfishness... the reasons are many and for those working with death and dying on a regular basis often hard to understand.
Over the years I have come to the conclusion that each family has their patterns of dealing with unpleasant events. Those patterns are not easily changed and much less broken! It takes a lot of patience and understanding, listening and feeling for the right moment, when some family member (or the patient) dare to open the door a crack. The patients often know and do not dare to talk about it either. As long as we value life on this earth more than honesty, as long as we play pretend games, we as the caretakers of patient as well as family have to be patiently and gently pushing toward a place of rest for all. Not an easy job!
thank you for posting this!!!!!!!!!!!!!!!!!
So wrong on so many levels
Equestrian, i am so thankful for you and nurses like you, the ones with a heart! far too often have i encountered nurses who do not want to get their hands dirty, do not want to be bothered, just put their hous in and do as little as possible - they went into nursing for the pay; probably realized at some point it is not at all what they expected and caring has never been their strong suit to begin...
so to all who want to go into the hospice field, if you do not care more about the patients than yourself it is not for you - oh and you must find a balance as well, so you do not drain yourself in a short time!
FlufferNutter, your heart is in the right place, go follow your heart
over the years i have come to the conclusion that yes, the company needs to treat you right, but they are about all the same; the difference ? The colleagues you work with! they are the ones that either support you or... burden you (no one has stabbed me in the back really) If you are OK with what the company gives you in terms of benefits and pay then it is really up to the people you work with;
on call can be overload or not bad; i hope it works well for you!
remember why you changed job fields!
seriously what ever happened to nursing care? does an enema in the case you state not fall under basic nursing care? what in the enema is medication?
I got out of hospice care because we could never care properly for patients after hours (had orders but no meds and so on) and I cannot work with human beings who suffer based on all protocol and no compassion! How can you stand working under those conditions???? tewdles makes a good point!
we live in such a fake world!
most patients know very well that they are dying! some may deny that fact, but they know once hospice is involved.
Some families try to spare the patient, some patients try to spare the family, but the longer one works in Hospice the more one realizes no one is spared that way; so yes SW to the rescue!
it sounds to me like the woman neither reads nor speaks English, so you also have cultural believes to consider....
I'm not offended, but I do think these tools are needed. I work in an in pt palliatve unit of a hospital. We accept pts on who needs the service the most. 2 pts at home, the family can no longer provide the needed care. As long as they have a life expectancy of less then three months we'll take them, however we only have one bed. So who do we take? That's when the pps is used. I understand your point, but think they do have a place.
I can see that some may take offense at my comment, but it has bothered me for quite some time that nursing, even hospice nursing, has become such a business. We need to fit people into categories in order to get the needed support for them; some patients really need the help but are not willing to accept it even if they qualify; others really need the help but we cannot get it for them because they do not quite qualify; then we get the ones who will take any thing because they qualify. How many times have I done the "aid's work" because it was needed at the time of my visit, then was told I spent too much time there, yet we are also not allowed to give help off the time sheet. To me it will always be a financially driven business (and i worked for a non profit!) and not a patient driven care service as long as we have categories and constantly growing regulations.
stories like yours "by Marties" just make me wonder! thanks for sharing!
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