LPN doesn't want dying patient to go to hospice.

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I have a patient who is dying. At the suggestion of nurses on here I went to the DON today and suggested the patient be discharged from home health and referred to a hospice service. She thought it was a wonderful idea and wanted me to call the patient's oncologist and tell him exactly what I told her: that the patient was now going downhill rather quickly and I felt that hospice could offer her a better service than home health.

The patient has 24/7 private duty LPN's. I called the LPN who is the regular at that patient's house and asked her who the oncologist was. She asked why and I told her I was going to talk to him about switching the patient to hospice care and the LPN screeched into the phone "WHY? WHAT ABOUT US?!?!?!?We're doing everything they would do!!!" She got really angry. She said, "Don't call the doctor until you talk to the patient and her family first! So I said I would come by tomorrow. I have a feeling this LPN is "working" on them and telling them that bringing in hospice would be ridiculous, etc. etc. etc.

Can you hospice nurses help me? I would like to explain to the patient and her son what hospice will do for them that we can't do. One thing I can think of right away is that when the patient dies, home health will be out of there right then. With hospice, I believe there is back up support for the family after the patient dies.

Thank you in advance.

I do wonder who is paying for the round the clock nursing staff. I have never heard of Medicaid being so generous as to pay for that kind of one on one nursing care.

This 24/7 around the clock private duty nursing care is compliments of TennCare, which is an extension of Medicaid here in Tennessee. Taxpayers foot the bill for indigent patients to receive this care at over $20,000 monthly for each patient.

TennCare is stretched so thin it is almost bankrupt.

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Wow. In our state the best you might do is that sometimes Medicaid will pay for a few hours per day. If you can't get by with that, its off to the nursing home.

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It's no wonder they're going bankrupt. I've never heard of such a program. We have a program that will give CNA services for a few hours a day - and this is cheaper than paying for nursing home care and allows people to stay at home. I'm very surprised that Tenn doesn't send people like this to a nursing home which would be a lot cheaper and probably would not bankrupt them.

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I don't think you made a mistake at all. You did what you thought was right for your pt. When/if she dies soon you will sleep well at nite knowing you tried to ease the transition for her and her family. You only suggested......anytime you advocate for a pt you should be proud of yourself as it is rarely the popular decision with everyone involved.

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I don't think you made a mistake at all. You did what you thought was right for your pt. When/if she dies soon you will sleep well at nite knowing you tried to ease the transition for her and her family. You only suggested......anytime you advocate for a pt you should be proud of yourself as it is rarely the popular decision with everyone involved.

ditto

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You acted as the patient advocate and for that you are to be commended. Perhaps, next time you will discuss your intentions with the family first. This would have saved you some anguish. Don't give up on the profession. It is obvious you care.

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motorcycle mama-

I don't see where you made any mistake. If your intent was to help provide the best possible care for this pt at the end of life, you did what you thought was best. Don't let politics get in the way of your seeing that. If someone doesn't stand up for those who need help, where are we as a society?

If nursing is the "business" that you really want to get out of, take another look around- there are tons of different areas where you can make a difference.

Good luck.

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Specializes in Hospice, LTC.

Maybe you should switch over to hospice nursing!

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Specializes in med/surg, hospice.
There was a big mess over my suggestion of hospice. The LPN (I say she is the one who got the mess started) but apparently every doctor the patient has ever had was called and the main office this morning called me and said doctors had been calling the home health office to let us know the family did NOT want hospice...come to find out, one of the nurses working private duty on nights also works for hospice and she made the same suggestion I had to the oncologist before I even thought about calling him.

But at any rate, I made a huge mistake. Shame on me for trying to be a do gooder, I guess.

I really want to get out of this business. It just has me torn up all the time.

((((((((motorcyclemama)))))))))) (hugs)

You did the right thing- you just got bitten by a passive-aggressive, bullying culture. It's sickening how many truly disturbed folks there are in health"care". C'mon over to hospice :redpinkhe . 'taint perfect but the water's fine .

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Something doesn't sound quite right. The LPN at present giving care should be thrilled at the idea of being involved with the hospice authorities., hence being assured that their care will be magnified in its efficiency quotient.

Can't visualise all the doctores being confused about ordering hospice.

Surly one primary doc would talk with patient & between them decide

good luck to the patient

safta24

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Specializes in Nephrology, Cardiology, ER, ICU.

This post is over two years old so perhaps the situation has changed.

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Thanks , I didn;'t notice the date, I'm sure the situation is

no longer as mentioned.

Safta24

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