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.
The hospice company I work with, we provide a service called "Crisis Care" we keep staff at the bedside around the clock. This is started, if there is a change in the level of care, significant change in vital signs, LOC, intake, etc. or if death is emminant. We also provide it for caregiver brakedown. We are located in South Carolina
sometimes all the crap we deal with sucks but ultimately you did what was best for the pt. be proud of that and keep it up even if some ppls feelings get hurt. you are the patient's advocate, not staff or family advocate. without you who is looking out for them??
just read post and you mentioned that you do crisis care for caregiver breakdown. our company has stated medicare states that is not an appropriate reason for cc. any written back up for that. i have many situations where cc would be very helpful but cant order because of that stipulation.
Hopefully the family is ready to accept the decline and has all the facts re:Hospice intervention.I am not a Hospice nurse but I am an advocate of pain management. Unfortunately though, the Doc is more likely to O.K. the reccomendation for analgesics and sedatives from Hospice nurses, because that is thier area of expertise.{much admiration Hospice!} And hopefully the ethics of the LPN will allow her not to sway the family in the direction of her own beliefs.
Unfortunately, we are selfish (human) and think we know what is best for the pt. and only we can do it. A hospice nurse can provide the same service but also get meds at home and administer them, educate the family on the dying process, provide a chaplin in home and also a social worker to work with the pt and the family in how to let go and help with this transition. Also, a lot of Dr. will not want a pt to die at home an not be on hospice~most likely when they get called the pt is dying, they want them to go to ER. Bad statistics for the docs to have the pt getting acute treatment such as chemo and die at home.
Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
While this issue remains very relevant to this day, please be cognizant that this discussion is 2 years old. Therefore, any advice bestowed upon the original poster might be arriving entirely too late.
Mamanurse62
27 Posts
The hospice company I work with, we provide a service called "Crisis Care" we keep staff at the bedside around the clock. This is started, if there is a change in the level of care, significant change in vital signs, LOC, intake, etc. or if death is emminant. We also provide it for caregiver brakedown. We are located in South Carolina