Latest Comments by jammycakesRN

Latest Comments by jammycakesRN

jammycakesRN 1,029 Views

Joined Mar 27, '11. Posts: 25 (28% Liked) Likes: 9

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  • 0

    There's also a fairly new SNAP Vac that's disposable you might check into. Not sure about charity availability.

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    Many of our patients use medihoney in place of santyl. They aren't the same, but similar & medihoney is much more affordable for our patients.

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    Look at Healogics. They have HBO units all over the states, might come in handy if you transfer often

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    I've made several reports to APS. They've never done anything to help. And if they interview the lady & she denies the treatment to them (like she does the doctor) they won't help her either.

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    You are in a very dangerous situation & I would get outta there YESTERDAY!

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    Some people are under the impression that patients in their home are safe & stable, which is not always the case. These days hospitals are pressured to discharge patients too soon. Which means home health nurses walk into a home with a patient that is VERY sick & in need of LOTS of monitoring. Impossible to do in a 30-60min visit. Make sure you are confident in making decisions about care alone, because there's not another seasoned nurse sitting down the hall...you're it. I have great nurses in my agency & they are great at helping when they are available. But they are busy with their own patients and aren't always able to answer the phone when I call.
    I've gotten patients sent home with physician orders for procedures I've never even done before @ the hospital or clinic, much less in a private home & nobody available by phone to answer my questions. Once I googled the procedure & ended up watching a video on YouTube!

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    I worked in physicians offices during nursing school as a float nurse & my very first official job as a RN was with home health. I haven't had any problems whatsoever with my clinical skills. Now the paperwork nightmare is a whole other story, but I LOVE everything else about home health.

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    GrumpyRN63, peanuts16, and NJnewRN like this.

    I'm tired of working 10-12 hrs/day for 8 hrs of pay. I never have time to get it all done & they just keep piling it on! At this point I think I'd work anywhere that I can go home to my family at a normal hour & actually have a life!

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    Yeah, that's not even close to being the case. I went to every supervisor I had AND consulted with our sister hospice company. My supervisors told me that we could not provide the "hospice care" he required BECAUSE we have a sister hospice company & they needed to be referred to hospice. I was in no way " blowing her off".

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    We use unna boots frequently & they work well for most of our patients. Clean well with cleanser, apply unna boot wrap toes to 1" below knees, then Kerlix wrap, then coban wrap. Change 2-3 times a week.

  • 1
    tewdles likes this.

    He passed tonight. Maybe he can finally get some rest.

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    The home health agency I work for has all benefits and pays more than the hospital. I know our hospice dept also offers benefits, but not sure what they pay.

  • 1
    tewdles likes this.

    I'm not really a fan of sticking around per se. But, seriously, if I tell him I won't ever see him again once he chooses hospice...he will NOT choose hospice. I discussed it with my director & she was okay with it. I don't think there will be much time for too many visits.

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    Ok. Here's an update. He has agreed to have hospice come talk to him tomorrow. I hope he will agree to let them help him. He said he wasn't going to like it if I wasn't going to be his nurse. His wife agreed & I explained that they can't have home care & hospice, but if they want me to, i would continue to visit them on my own time. I don't want them to feel like I'm abandoning them & I don't want him to refuse hospice just so I'll keep coming.

    Physically he continues to decline. I'm not familiar with the timeline of these kinds of things, but last week I noticed his teeth look like they're thinning or something, they almost look transparent on the edges. His skin around his eyes look really dark & his temples are very sunk in. Earlier this week he began to not be able to control his bladder. Today he seemed very confused and wasn't able to answer questions correctly.

    Do any of you experienced hospice nurses know about how long he has, based on those signs? It breaks my heart to see him go thru this, but I'm going to continue to be there for them.

  • 1
    tewdles likes this.

    Quote from modgoth1
    I understand that the patient is refusing hospice care and that is within his rights. You can at least educate the wife on end of life care. Perhaps you can provide her with informational brochures and/or reliable websites that she can read and investigate further.
    This was the reason for my original post. I'm not a hospice nurse & don't really know the info she needs for end of life care or about available resources. For me, in the home health field, calling in Hospice IS our "end of life resource" for our patients. I make the referral & viola' I'm done. And an awesome hospice nurse takes over to do a wonderful job.

    At the visit today the wife provided a new DNR order. At least I'm not going to have to break his ribs with CPR.


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