Alcohol abuse, liver disease and hospice

[weavrvirgorising]

Our hospice has just signed on for the second time a patient who has cirrhosis and still abuses alcohol. She refuses most visits and I am thinking that she and her husband are just working the system for free drugs like Ativan and Morphine. When I asked her husband what he was interested in gaining from resigning on with hospice, he said he wanted to get someone to assess his wife after a bad fall, while drunk, down some stairs. I am at a loss as to what I can do as a nurse, if I will not even be allowed to do my assessments. Any suggestions?? Thanks...you nurses have helped me so much, I appreciate it. Maggie:no:

[finn11707]

Maggie--

There is an opportunity for lots to be addressed with this patient and ---as a team. Addressing the pain and an ending to it--perhaps a better ending can be planned than what is being played out now...I hope your MSW, the team along with Hospice director are all actively on board and helping you form a realistic and a safe plan of care and goals for this tough case. These are the ones that can certainly drain you if you are out there alone. You also can certainly 'consult' with APS--not refer--to see if they have safety recommendation---IF you are hanging out there alone...I hope that doesn't happen where you work, but it does lots of places. Document carefully if you are carrying the whole burden of this case alone. I had a very sad situation of this nature end in a suicide. Meet privately with your director, managers, MSWs if you need to, but don't carry it alone. Just my input. My thoughts are with you on this one.