Crisis Care

[calliesue]

Had a pt on hospice this weekend. She was on crisis care where a hospice nurses sits with her to help manage care of pt.

I was in and out of room all day. Offering and giving roxinal, ativan , and atropine when needed.

Checked frequently with hospice nurse to see if anything needed.

Hospice nurse says no.

Pts family there and she asks me to check v/s and lung sounds cause hospice nurse "Can't hear" Ok , no problem.

Every time I went in room hospice nurse was sitting down reading a book, That is while family was in room.

When my pt died this afternoon , Family asked me to double check, to make sure.

So I did , again not a problem. Confirmed no pulse or BP present.

I did not mind cause family knows and trusts me.

How ever after hospice lvn calls hospice RN to pronounce.

The family leaves and both hospice nurses leave I go down my hall and stop in to kind of say bye to my pt . Maybe 45 minutes later.

Guess what no postmortem care done. None. Didn't change her or her linens , close her eyes or her mouth. Did not touch her after death.

So I and other staff cleaned her up and did what we could for her. Took off a brief that was soiled and wet can't describe the odor,Obviously not just her final episode. It reeked.

Now I am wondering how you could take so little pride in your job.

How you can not get that this lady had value and worth and that you just striped her of her dignity,

No lie I would be ashamed to have left a pt in this condition.

Do not understand how hospice nurses who are usually all about compassionate care could mess it up so bad.

Can usually play devil's advocate, but just can't summon a defense.

Sad day in hospice history.:bluecry1:

[mc3, ASN, RN]

I am a hospice nurse, and I'm greatly distressed after reading your post. There is no excuse for this, none at all. I would be on the phone pronto with whatever hospice agency sent this nurse. And I would expect a report on what they will do in the future to keep this from happening again. This is inexcusable!!!

The only "reason" I can think this happened is (don't flame me, please - I'm talking from experience!) the nurse that was on was agency, and they didn't understand what the job entailed. Irregardless, it's inexcusable. I apologize for all hospice nurses!

mc3

[Penelope_Pitstop, BSN, RN]

first of all, let me say i'm very sorry to hear about your distress. i don't know how this person can be a hospice nurse...it sounds as if she is going against what hospice nursing is all about, you know?

[color=#483d8b]it kind of reminds me of a case on my floor. this patient was not a hospice patient, but she was a total care patient (fifty something lady with history of brain injury, nonverbal, couldn't swallow, arousable only to physical stimuli, etc.) and her parents hired private duty nurses/aides for around the clock care. however, these ladies were always sleeping, reading or watching television. they did nothing to help the patient, aside from keeping a notebook full of information about the staff and what we were and were not doing. also, they called the parents often and informed them of what was "going on," and then we received calls from the parents, so did the doctors, et al.

[color=#483d8b]what i learned from this case is that while a patient is my patient, that patient is my patient. even if someone else is supposed to do something (including techs/aides, what have you), it is ultimately up to me to see that the patient is cared for, not someone else (even if that someone else should!)

[color=#483d8b]you did nothing wrong; quite the contrary, you are a great nurse. (i want to stress that, after the above paragraph!) that is why, sadly, things like this will most likely get left up to you. don't worry about stepping on the hospice nurse's toes, if this situation comes up again. if he or she is offended by you checking the patient yourself, it's probably because he or she's defensive for his or her lack of action.

[color=#483d8b]sidenote, it may be required for her to contact the hospice rn to pronounce. other than that action, i don't see any action from her at all!

[color=#483d8b]once more, sorry to hear from your loss. and thank you for caring for your patient so well. in the end you did your job, but i know it's still bothering you. have you considered hospice yourself? sounds like you'd be a natural!

[color=#483d8b]big ol' :redpinkhe

[color=#483d8b]jess

[leslie :-D]

another hospice nurse here...

and i agree w/everything mc3 said.

i am so very appalled...and truly sorry on behalf of the hospice profession.

this makes me sick.

right now, i'm not sure who i'd report this to.

if it's the employer, i'm not totally convinced they don't hire warm bodies, vs a true hospice nurse.

but believe me, i'd do my homework and decide who to go to.

and would try my darndest to ensure events like this, never happen again.

if i was there, i would have had a word or 2 with them outside.

but that's me-

when i'm truly that upset, i speak my mind.

gosh, i'm so sorry the pt and family, had this experience.

it should be a crime.

leslie

[DutchgirlRN, ASN, RN]

guess what no postmortem care done. none. didn't change her or her linens , close her eyes or her mouth. did not touch her after death. so i and other staff cleaned her up and did what we could for her. took off a brief that was soiled and wet can't describe the odor,obviously not just her final episode. it reeked.now i am wondering how you could take so little pride in your job.

god bless you and the other staff who cleaned her up and gave her dignity in death. how sad that a nurse could treat/leave a patient like that. i would be reporting those involved to the powers that be. i would hope it would be taken very seriously.

[proud2b1]

Sorry about this horrible situation!I to over the weekend dealt with a hospice nurse.We have been told before by her,we dont work weekends!Anyway,I am taking care of a women,in bad shape.I kept her comfortable with her prn's.In the mean time the family member called the hospice nurse to tell her how things were going.After the call the family member comes to me and says The hospice nurse told me to tell you to go ahead and give her more roxinol.I politely,made a call to this hospice nurse,and advised her to specifically get me some legal orders that stated I could do this.She did.I never had a problem doing this,it was the fact that she gave an order to a family member,to tell me!!!Like what was she thinking.She did come out and apologize for stupidness!!!

[sharlynn]

Are you sure it was a Hospice nurse and not just a sitter? Many hospices have sitters so a patient is not alone at time of death. These sitters are not nurse aides, they are just caring volunteers. That would explain why nothing was done.

I don't know of any Hospice that could afford to have a nurse staying at the bedside!