Just when you think you've seen/heard it all.........

sapphire18 · Jun 23, 2012

Whoa...I guess you're right, just when you think you've heard it all...

Doesn't hospice usually have strict guidelines for "6 months or less to live" and such??? :confused:

MomRN0913 · Jun 23, 2012

yeah, what was the hospice admitting diagnosis?

Ruas61, BSN, RN · Jun 23, 2012

They quickly booted him off- he had end stage liver disease but well compensated. He was quite terminal looking apparently and rallied after a bit. That's the jist of what I know.

steffuturelpn · Jun 23, 2012

WOW at a lost for words

CherylRNBSN · Jun 23, 2012

Why are you surprised? End stage liver dx. And what is the etiology of the liver dx? ETOH?

I'm thinking...perhaps a long term alcoholic? Now realizes he/she has an end stage dx, and is scared to death, and using typical long term coping mechanisms.

I watched my father smoke while succumbing to lung Ca at age of 46.

I did not judge him. The time for that had passed. He was terminal. While it hurt me to see him smoke, I knew that he was addicted, and dying. I only felt...so very sorry for him, and the demons he just could not fight. Despite some very fine qualities/gifts. Just very sad.

Hospice is all about end of life comfort. The time for shaming is over. They lost their battle against their disease.

While the pt. may be compensated now, they will be back. And they will die from their disease. And they will need compassionate care. In spite of their addiction. Maybe even because of their addiction.

I really don't see how anyone can wrangle their way into Hospice care. The criteria is there, or it is not.

I really caution you to be careful....suspend judgement. And amp up the compassion. Because you will need to do lots of both to be a good hospice nurse.

Some human beings are just less equipped to deal with...life. Let's help them deal with the scariest of all...death.

What a privilege.

tothepointeLVN, LVN · Jun 23, 2012

Oh yeah I've come across this before with ES Liver failure in particular. When it was finally time for him to pass his family wanted him to stay in the hospital because he lived in a boarding house but he got caught drinking in the hospital so they discharged him to home.

jt43 · Jun 23, 2012

End stage liver disease can be very painful, the patient deserves pain control, addict or not.

tuhcoolyuh · Jun 23, 2012

I don't understand... why is somebody who is dying of liver failure not a good candidate for hospice? Also, is it not painful to have ES liver disease? Why are we labeling him as a med-seeker?

Ruas61, BSN, RN · Jun 23, 2012

Hospice terminated his status with them and referred him to our ECF.

They were the one who determined that he was not fitting their category after taking him on.

I was just blown away in that particular moment that someone would actually seek hospice for the narcotics alone. (Which was the implication in the information presented.) I also had the same reaction when I found a set of parents having sex in their child's room when in the hospital many years ago.

The rest of comments and decisions is speculation and assumptions of other posters.

Carry on.

Whispera, MSN, RN · Jun 23, 2012

Presented information implied that he was only there for narcotics? Implications can be interpreted incorrectly. End-stage liver disease if painful. He's dying. So what if he wants or needs narcotics. Isn't that what comfort care is?

People do rally while in hospice and some go home, wherever home is, until they need to come back again. Also, sometimes the rally is right before the end. I see where he might not need hospice after awhile, but if he is end-stage, he's still in pain. Maybe he ralled because he had appropriate pain control while in hospice.

edmia, BSN, RN · Jun 23, 2012

Hospice terminated his status with them and referred him to our ECF.
They were the one who determined that he was not fitting their category after taking him on.
I was just blown away in that particular moment that someone would actually seek hospice for the narcotics alone. (Which was the implication in the information presented.) I also had the same reaction when I found a set of parents having sex in their child's room when in the hospital many years ago.
The rest of comments and decisions is speculation and assumptions of other posters.
Carry on.

You were blown away?

If I have a terminal illness ever, you bet I will be asking for all the meds coming to me. I will deserve them. And I hope I don't have ignorant, judgmental care providers around me to deprive me of a dignified death.

Carry on.