gonzo1 17,455 Views
Joined Jun 8, '05.
Posts: 1,709 (45% Liked)
Can someone tell me how to block out a person that you don't want to see their postings anymore?
If people are seriously so in my space that they are touching my scrubs when I am at the store, they get what they get.
I don't rub myself on the produce at the grocery store, and I don't think anything is just floating off of my scrub top and contaminating the carrots, either.
(Nobody has ever stopped me in the store to ask me to look at their skin problem, does that really happen to you all?)
Yup- this license thing is a common theme. Those things are pretty durable. Don't just read the nurse practice act- Have a look at those who have lost their licenses, and what they did.
On another note..... I am kind of old, so maybe my perspective is different.
As far as I can tell, digital is permanent. It is probably not a good idea to make a permanent record of something you don't want made public, then give it to somebody you barely know. Or to give it to anybody, unless you plan to trust them with your well-being for the rest of your life.
I know, not the original question.
"Do not go gently into that good night...Rage, rage against the dying of the light."
That was my husband's philosophy after being diagnosed with pancreatic cancer in the summer of 2013. He'd fought bravely for two and a half years, and most of that time had been good. But the drugs his oncologist gave him had failed, and there were no other options than to go on strong chemotherapy, which the doctor admitted would only prolong his life for a few months and make him miserable in the meantime.
Faced with these horrible circumstances, Will and I broached the subject of hospice. Having worked closely with the various agencies in our area, I was quite impressed with their services and had learned a lot about end-of-life care. It was awful to think of Will as needing hospice, but his prognosis was so grim that it seemed entirely appropriate. He agreed readily, and so began his final odyssey.
It wasn't long before we discovered how wonderful our chosen hospice agency was. Will had a nurse and massage therapist, both of whom came once a week to check up on him and make sure we had adequate supplies. He also was given a comfort pack filled with drugs he might need for nausea, vomiting, pain and agitation. They didn't bring any morphine or Dilaudid because he wasn't close to dying at the time and was relatively comfortable, but promised they would when he needed it. So I never gave it a second thought.
Months passed, and although it was obvious that he was failing, Will remained pain-free...until that night.
It came on all of a sudden. He'd been having one of his bad days, but this was unlike anything he'd ever experienced before---a tearing, stabbing pain in his abdomen along with severe nausea and vomiting. My son, an LPN, grabbed the pain meds and antiemetics, and we gave him everything we had, to no avail. We called hospice so they could bring him the heavy-duty pain meds; unfortunately Will's nurse wasn't on call, so we ended up with another nurse who was clearly uninterested in driving the 25 miles to our home to deliver them. She warned us against calling 911 because he would be "kicked off hospice", but offered nothing of substance.
Meanwhile, my husband was crying in pain. This was a man who once broke an ankle as we were moving house and continued without stopping, never complaining, so we knew he was in desperate straits. By this time he was vomiting blood in large amounts and going into shock. We called hospice again, and this time the nurse advised us to admit him to the hospice house. It would be another two hours before he was transported, all without relief from the pain.
"Why do I have to suffer like this?" he cried out repeatedly, breaking my heart and making me feel helpless. I didn't have an answer.
At long last, the transport van arrived and we went to the hospice facility where nurses quickly prepared Versed and Dilaudid injections. It was still another hour or so until he got adequate relief, but the compassionate care he was given there stood in stark contrast with that of the on-call nurse. He passed away in the early morning hours, and thank God he was comfortable. But what he went through because of the unnecessary delay in pain relief is something that will haunt me the rest of my days.
After all was said and done, I reported these events to the grief counselor, who is still seeing me every few weeks to help me process what happened. Of course I will never know if or how that nurse was dealt with, but I felt better knowing that someone knew about it and had brought it to the attention of people who could actually do something to make sure it never happens again.
I don't blame the hospice agency; I blame the individual nurse. His own nurse would never have let Will suffer like that, and when his massage therapist heard about it she was appalled. They both came to his funeral and sent sympathy cards, and they are the ones I'll remember with love forever.
Yes, hospice is a wonderful thing, and I'm grateful for all the help my husband received prior to that last night of his life. But when hospice goes wrong, it goes terribly wrong, leaving survivors to deal not only with their loved one's death, but the awful feeling that they didn't do everything that could be done.
Wow...I am amazed at the outpouring of support and stories about negative hospice experiences. I had no idea that the problem of unprofessional nurses was somewhat common. It's oddly comforting to know I'm not alone, even as I ache for the patients and families who have been through unnecessary pain and suffering because somebody fell down on the job.
Yesterday I received a survey in the mail from the hospice agency. I will check off the boxes praising them, because other than that last night of my husband's life, the care was excellent. But I will also come down hard on that nurse, just as I did when I was talking with my grief counselor the first time she visited. There's plenty of room to write.
I work in LTC and so see a lot of residents working with the two hospice organizations in my area. I know which one I'll be pushing for when my Dad (stage 4 lung) needs it.
My grandmother, in another state, was on hospice when her cancer was diagnosed; Grandma wanted to be at home and there were several family members available to help--specifically my Mom, who flew down to stay with them until the end, and 2 aunts, all eager to help and willing to do whatever was needed. The hospice company did provide pain meds and a CNA came out weekly to give Grandma a bath and supply some briefs, but they gave my family no education on how to care for Grandma--no information about pericare (she had a foley and rectal bleeding d/t mets into the colon), no education on how to position her for comfort, no training on how to use a turn sheet; they provided a nice mattress cover that circulated pressure and so told my family that there was no reason to turn her. After my Mom's third phone call to me, in tears, asking how they were supposed give her care, I took time off of both jobs, flew out there and joined the care crew. As soon as I walked in the door, they all breathed a sigh of relief and jumped in to learn how to take care of Grandma. When I got there, she had untreated thrush and 2 stage 2 pressure ulcers on her buttocks. The ulcers never healed, of course, but they didn't progress either because we did turn her. The hospice didn't provide much in the way of pericare products and with Grandma passing blood, she needed more; before I got there, Mom and my aunts were cleaning her with wash cloths and soapy water once a day, because Grandma was too embarrassed to let them do more and they didn't know to insist on it, so I went out and found and bought the gloves, foams and wipes and after talking some with Grandma, she let us do more. The hospice nurse talked to the family about the dying process, describing cheyne-stoking but not the death rattle, so when Grandma started in on that, they were unprepared and horrified. It was, over all, a very poor experience with that hospice. I was just glad that I was able to get there to help show my family what to do. It wasn't that they were stupid or unwilling to get in and do stuff, they just had no experience with it and didn't know what to do. It made my heart hurt for other families going through the same situation without a nurse (or CNA) in the family to show them what to do.
It becomes a confusing role..you ARE a nurse, you and everyone else knows you are a nurse, but sometimes you just need to be the loved one. I hear you.
I am not sure why but it always seems like the pain knows that the nurse on call isn't the patient's regular nurse. Kind of like how we all dread a full moon. It's like the stars are aligned just right when the on-call nurse is the most frustrating individual to deal with.
A very good friend of mine fought her ovarian cancer for 5 years. When it came time to go on hospice, I am not sure if they just skipped over her routine daily medications list or what, but she was on enough dilaudid (not to mention other medications) that would knock out the respiratory drive of several elephants and maybe a couple of zebras prior to hospice. Hospice decided that 0.3 of dilaudid every 4 hours should be able to manage her pain?!?! Needless to say, the first day or maybe the second we had a similar experience with calling the on-call hospice nurse. It was like the Spanish Inquisition to get her to understand that 0.3 of dilaudid was like throwing a tic tac at the worst case of halitosis in hopes it would manage it. And YES we were out of medications and NO she is not comfortable. Why on earth would we have been calling in the middle of the night to report the patient was resting comfortable? In the end we prevailed and a special trip was made, the pain managed, and she passed peacefully.
I think going through experiences like this help us to be reminded to carry ourselves with dignity and integrity. To always try to do the right thing no matter the inconvenience it brings upon us. Because it is always the bad experiences people have that seem to be remembered forever. And we all don't want to be someone's bad experience. Thank you Viva for your post and shedding light on an issue that probably happens more than is talked about.
I've been an RN for 22 years, worked in oncology and critical care and am now a psychiatric NP who has been full time nursing faculty for 10 years. Through my career I have had multiple interactions with hospice in several states. I work closely with 2 local hospice agencies as they are clinical sites for my students. I have always been a huge proponent of hospice and the wonderful work they do for patients and families.
Personally: I lost my boyfriend/significant other/love/partner in June to metastatic pancreatic cancer. He lived for 18 months and worked every day for the first 12 months. He had grueling treatment and did not give up hope until his symptoms began to overrule. Based on my past experiences, and his decisions, he began hospice services the last three weeks of his life. We were fortunate that my job allows me to be off in the summer... I can't begin to tell you how disillusioned I was with hospice. The last week I called daily needing a hospital bed, oxygen, a bedside commode, and supplies which never triggered a visit from the nurse. He stopped walking, then eating, and had horrific diarrhea which was exhausting to manage. When I told the nurse over the phone that I was unable to get any rest (for several days), her response was "being a caregiver is hard work." On the morning of the day he died, I called regarding his pain. The only day he had pain was the day he died....it took 1.5 hours to get a return call to talk about the pain management. When he died (4pm) and I called, she told me that it would be awhile before anyone could get there and it would probably be the evening nurse (it was). I need to add that I felt that I had good rapport with his RN and never challenged her, instead partnered with her.....
Bottom line: as the only person caring for him and emotionally involved as well as exhausted, I let it go. I liked her, but really felt that as the RN, when his condition changed it should have triggered a visit. I feel she depended on me to be "the nurse," and as it was happening I guess I was on auto pilot. I have been negatively affected by the whole experience-trusting that the support would be there because they were "hospice," and then they werent.... Just wanted to share because this is not what I have seen in my role as a nurse. My small recourse was insistence that memorials did not go to this agency, but rather to the oncology practice. His oncologist and staff were such phone support during those last days when I felt so alone. When I couldn't make things better, his oncologist would assure me that it's not going to get better and that I was doing everything I should do.
I'm a pretty independent confident RN and hope that this doesn't happen to others without that nursing skill and judgement. Thanks for listening..
Wow...thank you so much for this article. I read it at the right time! It's truly a blessing. I have done home health and vaguely considered hospice but something about it always scared me despite my strong advocacy for comfort care at home at the end of life. I work med surg but have always has this interest in really helping those patients I knew were close to end of life dealing with cancer etc. Just this am I thought to myself, maybe I should revisit the idea of hospice nursing. Your article made me really want to do it for the fact that it broke my heart and I would love to contribute to this area with vigilance in the hopes that I can do something to keep this from happening to another individual who deserves to pass comfortable and in peace. God bless you for your insights as I'm sure this happens more often than many know.
You know, I've thought about taking this thing up a level or two, but I'm so worn out from all the festivities of the past three months that I just don't have the "oomph" to get ugly about it. All I want to do is heal as much as possible and move on with my life. I'm a long way from that, so I don't want to rehash it with the hospice agency and deal with that acute pain. I told my grief counselor about it, and she was more than willing to report what happened. She was appalled. Of course, I'll never know if that nurse was disciplined, but it's easier for me to believe she was.
This is isn't limited to hospice nurses, there are many different kinds of suffering. I don't believe that nursing is a calling and those I've known that might call it that were pretty ineffective providers. Good nursing requires strength, fortitiude and a work ethic with dedication to excellence even when the I don't wannas set in. The same thing that got my dad out of bed at 3am and to work on time for a 16 hr day, work ethic with an attitude of ownership.
That's a shame! How do you make those people care, I wonder? Maybe it'll take more complaints, a lot more, to light a fire under them. It's too bad other patients will probably have to suffer needlessly for something to be done. It stinks.
I agree with a PP, that this is what we need to remember when our feet don't want to walk anymore at the end of a shift, and we think that we just don't have any more to give. We do.
On a lesser scale, I had a woman beg me to blow-dry her hair one night. I almost told her no. I almost told her I couldn't find the blow-dryer, but I didn't.
When I put her to bed, she passed. Immediately.
I am so friggen glad I blow dried her hair. So, so, glad.
YOU did all you could for your hubbs. Others failed, and thats not on you, Viva. I'm so sorry. xxxxx
My dad was admitted to an inpatient hospice unit on a Tuesday. He had morphine ordered & during the day his pain was controlled very well. The night nurse, however, refused to give him more than the lowest dose ordered & she would only give that every 4 hours. She told my sister & me she didn't believe in giving high doses of pain meds. My response to that was that his need for pain control had nothing to do with her beliefs. It wasn't until Thursday night after much fighting with the staff that dad got a morphine drip. He died about 4hours later. I still have a lot of anger about how he was treated. This was also a hospice fail.
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