melsch

melsch

Hospice Palliative Care

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About melsch

melsch has 16 years experience and specializes in Hospice Palliative Care.


Latest Activity

  1. Advice on creepy doctors?

    You are in Canada, get your union rep involved right away. They are your best protection. Don't worry about losing your job, labour laws will protect you, but document everything and try not to go to a meeting with management without your Union rep...
  2. consientious nursing

    I am not sure what you mean by intellectual disabled, but I work in a palliative inpatient unit and from 7 am to 11 pm we have 1 RN, 1 LPN, and 1 Care Aide for 12 patients. From11 pm to 7 am we have 1 RN and 1 LPN for the same patients. This is ver...
  3. Often patients wait until they are alone to die. I have even encouraged family to leave for an hour or so if a patient seems to be hanging on for some reason to see if possibly it is just that they want to be alone, with the reassurance that I will ...
  4. Inpatient center patient load

  5. I don't know how you nurses deal with death

    I work in hospice and I think your perspective changes when you deal with death on a regular basis. I don't see death as a bad or awful thing for the patient, I see death as something normal that everyone must go through, and my job is to make it as...
  6. Night shift and daylight savings....

    We used to do that, but now we get paid for the hours worked. It is much better and no one gets short changed as it never worked out fairly.
  7. Allergic to Morphine Sulfate but on Hospice Care

    The pt was probably dying anyway, and didn't die from an allergic reaction, but we always use a lower dose of dilaudid rather than morphine if they say they have an allergy to morphine. If the patient is still able to take meds orally we sometimes g...
  8. Mandatory Flu Vaccines- How do you feel?

    My employer mandated we get the shot this year, or wear a mask at all times from December until march. I figured it would be easier to get the shot than have a mask on at all times. I got the shot yesterday and thankfully I have sick time because I...
  9. Bowel regimen

    This is our protocol: Has there been a BM within the last 48 hours? If yes give two sennosides 8.5mg at hs. If NO, give two sennosides 8.5mg twice a day. If BM within 24 hours continue and monitor if no advance to: Increase sennosides 8.5 mg tid...
  10. What's the weirdest baby name?

    I have a cousin who just gave his new daughter juniper as her middle name, first name is normal though. I also have another cousin who is half native who's Dad wanted to call him Bluemoon. My aunt refused, but he still ended up with it as his middl...
  11. Sympathy strike...would you do it??

    Where I live nurses are considered an essential service which means we are not allowed to reduce our numbers below what is considered enough staff to look after the patients. What we have done is work to rule, which means we only do essential jobs -...
  12. is this a nursing trick you would use?

    We do this as well. And if a patient has a gown on we sometimes place the top sheet under the gown, next to the patient. Don't tie it or it could be a restraint. It doesn't always keep them from taking off their pad - but it slows them down a bit...
  13. inpatient hospice nurse/pt ratio

    I am in a stand alone inpatient hospice. We have a mix of end of life, respite, and symptom management patients. We have two 12 bed units. Day and evening shifts have an RN, LPN, and a care aide, for each side and on nights there is an RN for each...
  14. I have to agree with the shaving cream suggestion. It really works. Put some on your cloth and start cleaning. Once the fecesis all soft just wipe it off and give the a rinse with clear water.
  15. Hypothetical Ethical Issue

    I asked myself the same question as I work in hospice and wondered what I would do if he was in our facility. We did have a man who raped and murdered a young girl a while ago and I just looked at it as he was just another body and someone had to lo...