tewdles 27,817 Views
Joined Jul 10, '09.
Posts: 4,871 (60% Liked)
I am dismayed that the nurse who had a legal medical marijuana card was not hired because of it...
Would that also have been true if the nurse had tested postive for ativan or some other med for which he/she had an RX?
Like the other medications included on the drug screens, marijuana actually has proven medical benefit for some people in some circumstances, often with fewer side effects than other more "traditional" medications.
You comfort atheists they way they want and need to be comforted. It is individual for each dying person while we are using the basic elements of listening and hearing the person.
We don't treat atheists any differently than we treat any other type of person. It ALL hinges on them, their needs, their lives, etc.
So...if they need me to leave them alone, I leave them alone. If they need me to hold their hand, I hold their hand. ETC, ETC, ETC. It really can be just that simple.
Regardless of the fact if I am a Christian or not, I think that this is not the most appropriate forum to extend your personal belief. I just wish that people would not be so fanatic about their faith that they lose all sense of appropriateness and push their agenda for proselytizing in a nursing forum.
When families are requesting unreasonable nursing visits because they are not able to complete the daily and ongoing care we are VERY direct about the need for either other in-home caregivers or placement in a facility. We will arrange an urgent respite, if necessary, to give them a few days to make appropriate arrangements. Most hospices CANNOT afford to set dangerous precedents of daily nursing visits simply to reassure the family...there are other, less expensive, and possibly more effective ways to provide that support. I certainly am aware that we have the occasional VIP patient for whom the agency execs may want that sort of attention. However, those are the very people who can generally afford addtional supportive care and we do not hesitate to be very clear about our role and availability.
I don't intend to sound "hard nosed" but if you allow a few demanding people to misuse the professional staff in terms of frequency of visits it has the potential to create dangerous staffing patterns for the other patients on service...and THAT is not acceptable.
It is ALWAYS difficult when a team member drops a ball...lots of splainin and butt kissing to do after that while working to get the pt back into a state of well-being.
Perhaps a meeting between field and admission teams to discover how your processes might be tweaked or what additional safe-guards could be put in place to better support one another and insure that patients have what they need?
After working in Med surg for 4 years on two very difficult units, I have been offered a job as a home hospice nurse. No more working every other weekend, no more working holidays. On call requires only 2 days a month. And i'm hoping for once i will be in a position where my nursing skills will be much more appreciated. I am so excited to be working with families to help them through their difficult times and to make the patient comfortable in their last days of their life. I am a little nervous, but excited at the same time, for a big change. Any advice to a new hospice nurse out there? Any good tips that you wish someone had told you when you started? Thanks!
The hospice I currently work for has standing orders for Atropine 1%, 4 gtts Q4 hr SL prn secretions...another hospice allowed same #gtts Q2 hr prn. we also have standing orders for either scopolamine transdermal or levsin if the atropine is not working well. I agree that position is helpful in controlling this troubling symptom. Make sure that you educate the family as well as possible as the noise is often more distressing for them than the symptom may be for the patient.
Standing orders for managing these common symptoms of the dying process should be in place for your hospice, if they are not you can get some support from your national and regional hospice and palliative care orgs to help your agency come in line with the standards of care.
Our agency encourages the nurses (and other disciplines) to attend the visitations. One of the things that is troubling to families is the fact that their loved one dies and at the same time they lose all contact with the team that they bonded with. Visitation attendance helps both the family and the staff to experience "closure" of that relationship with less time requirement and social pressure for the hospice professionals.
I think I still look quite a bit like my image there on the brochure...LOL
Unfortunately, not all of the family members have good social or coping skills...stress increases the likelihood that people will behave badly...
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