Quote from pattyzaccy
Nurse for 23 years I always regarded hospice nurses as angels but lately my views are getting disappointed...Lately our facility has been using this form of care alot...is just old age a terminal disease? One nurse came on my shift for 8 hrs. when asked what she would be doing she said just to monitor resident's breathing!!!!(she was dying!!) doesn't comfort measures include at least change of positioning? sips of ice chips? talking reading etc? No this Rn. talked on her cell phone most of time, applied makeup in resident's bathroom and watched her favorite sitcoms on tv !!! This was crazy!! Another nurse different resident charted foot massages on a resident with necrotic and big sores on both feet bandaged which changing dsds caused such pain we medicated him with morphine prior to dsd changes!!! Whats going on I'm not viewing these nurses as angels anymore!!!
No, old age isn't a terminal disease, nor is TMBD (Too Many Birth Days) a hospice diagnosis. But debility is. Latest figures suggest that up to 10% of a LTC's residents may be hospice appropriate, which is why you may see more hospice patients.
And hospice nurses aren't necessarily angels any more than med/surg, L&D or any other nursing specialty. You'll find good and bad practitioners in every arena.
Should you run into this kind of situation again, you might ask her, as the case manager and end of life specialist, what comfort measures she thought would be appropriate for her patient. Take what she says, add the ones she doesn't list, and ask sweetly, "So that we have good continuity of care I need to be clear about which of these tasks will you be performing and which ones I'll need to plan to do." After all, it's supposed to be a collaboration.
If that doesn't do it, you could ask your DON to contact the hospice's Director of Patient Services and ask for clarification of what the hospice nurse's role is in the situation. Sure beats questioning your views on what all hospice nurses are based on the behavior of two.
As to the charting on the foot massage, well, there's lots of ways to approach that. But posting here probably won't be effective.