Latest Comments by vapn

vapn 524 Views

Joined: Oct 17, '10; Posts: 5 (20% Liked) ; Likes: 1

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    We wouldn't discharge for going to the ER, and we would even cover the visit if it was related to the hospice diagnosis. We have rarely discharged patient for "seeking curative measures", like going on a vent or having surgery, but we can pick them right back up when they are done with what they are doing.

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    It is a different world, but if you know your med-surg and are familiar with basic gerontology, then you should be fine. Take a leap, LTC has its rewards.

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    Hello, I am new to allnurses, but pretty excited about this forum. I have been an LPN for a few years now and I am planning to return to school, soon(always soon). In the meantime, I work in hospice and it is wonderful, but so busy. Looking forward to exchanging information and learning from my peers here. Thank you for all of your posts.

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    Quote from ErinS
    I had an amazing medical director once that explained it like this. If a patient has a symptom that is uncontrolled (ie. pain), it triggers the sympathetic nervous system (fight or flight) which triggers adrenaline release, hence prolonging life. So your supposition that the morphine allows the natural disease process to take over is correct. The morphine relieves the suffering, allowing the pt to relax and stopping that adrenaline release. .

    That is a great explanation! I'm stealing it. I know this thread is a month old, but the order is completely appropiate. Another thing to keep in mind is that with bone mets, lots of times pain can go from 0-60 in a short amount of time and it is very challenging to get it under control at "60" when there was really no noticeable progression of pain. Also, this was in the ER, which means the patient was likely at home with subtherapeutic pain control for who knows how long, also making it a challenge to get that pain under control. Kudos to you for following that order.

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    ebear likes this.

    I say you handled it well, but in most states, before performing such a surgery, you must have signed the consent...the one that says that you understand that you will be sterile 30 days before the procedure or surgery is performed unless it is an emergency.