silverwillow

Latest Activity

1. Attending memorial services, funerals, condolence calls etc

   silverwillow replied to nurselearner's topic in Hospice

   We also post the memorial service times in our office and someone from our department will attend to represent us all.

2. Medical Director taking new patients?

   silverwillow replied to tahijajan's topic in Hospice

   It is in our medical director contract that they will be willing to assume care for patients who are from out of town and have no primary physician. He is always great about taking them, and we have never had a problem. In many cases, as stated by ot...

3. SNF asking hospice to change meds

   silverwillow replied to silverwillow's topic in Hospice

   Exactly, and in my patient's case, the Ativan is not for chemical restraint. It's unfortunate that hospice patients in SNF are subject to the red tape of it all. For patients at home, we make Ativan, Roxinal, etc available for when they get imminent ...

4. Revocation

   silverwillow posted a topic in Hospice

   We have a patient that went out of service area and is now having symptoms and wanting to go to the hospital. Does he need to sign a revocation before he recieves care in the hospital? What do we do if he doesn't sign one?

5. SNF asking hospice to change meds

   silverwillow posted a topic in Hospice

   Does anyone else have any experience with skilled nursing facilities asking hospices to lower patient's Ativan doses so that the patient meets Obra 22 guidelines? I have a patient that takes Ativan 1 mg every 8 hours prn. She has COPD and needs it. S...

6. Do you think patients should have the right to use medical marijuana?

   silverwillow replied to Brian's topic in General Nursing

   Definitely decriminalize it. I cannot believe it is still illegal, actually. The prohibiition didn't work and resulted in increased gang activity. I think law abiding farmers, not gangsters and mobsters should be growing it...and then yes, tax it too...

7. Sub Q Butterfly

   silverwillow replied to Irishgirl's topic in Hospice

   That's the same kind that we use. The direction of the bevel is a non-issue because it points straight down and is just secured with a tegaderm.

8. The dreaded 911 calls

   silverwillow replied to silverwillow's topic in Hospice

   Thanks. I feel much better after your post. He is not eating. I figured since we weren't going to be able to transfer him anywhere we might as well start him on morphine IV since he's inpatient anyway. He was still pretty restless. We now have him up...

9. The dreaded 911 calls

   silverwillow replied to silverwillow's topic in Hospice

   Thanks for your response. He has occasional agitation where he tries to climb out of bed, but I'm not sure how much more we can actually sedate him at this point. He's pretty sedate already, just arouses occasionally. His symptoms are otherwise manag...

10. The dreaded 911 calls

    silverwillow posted a topic in Hospice

    Second time this year, I just had a spouse completely fall apart and become completely unable to care for the patient, called 911 in the middle of the night and called me after the paramedics left with him. Now I have him inpatient and can't seem to ...

11. computerized documentation programs?

    silverwillow replied to terri hudson's topic in Hospice

    We use PTCT. It isn't bad once you get used to it. It's kind of a headache if you have to use it for any OASIS stuff, but for hospice documentation, I think it works fine.

12. frustrated and overwhelmed

    silverwillow replied to kelluvanurse's topic in Hospice

    The more I read this, the more I realize I should count my blessings. We work 40 hours Monday-Friday, with 7 days on call, then 7 days off. 4.75/hour for carrying the beeper from 1700 to 0800, two hours automatic call pay if you're called out, in add...

13. Vital Signs

    silverwillow replied to RNinRubySlippers's topic in Hospice

    I agree, and do them on a case-by-case basis. Often, family members expect it, perhaps trying to keep their own type of 'death gauge' going, so they can prepare themselves. I often remind them that I would be happy to take the patient's vitals, but I...

14. frustrated and overwhelmed

    silverwillow replied to kelluvanurse's topic in Hospice

    Sorry to hear that you had so little orientation. If they are so busy there, they should have just let you do revisits for awhile to let you get ahold of the hospice philosophy, which as you know is alot to learn in itself. Gaining confidence about d...

15. Inpatient for Symptom Management

    silverwillow replied to silverwillow's topic in Hospice

    Thanks for the support everyone, it helps. At least I have the weekend to recover. :) It was a 3-4 day stay. Not sure if that is normal. Lots of work trying to chart it all since our agency has one method and the hospital another.