jonga

My patient has a wound vac to a dehisced abdominal wound. It's been a week already and the wound is healing well. It's approx 10 x 2 x 1 cm with no s/s of infection and scant serosanguinous drainage. When should I discontinue Vac therapy? My pt is on hospice and not a candidate for wound closure with sutures. Also what dressing would you recommend if Vac is discontinued?

Final Journeys and Final Gifts by Maggie Callanan are wonderful reads. Written by a very down to earth, funny and sensitive hospice nurse about her experiences. Dying Well by Ira Byock On death and dying by Elizabeth Kubler-Ross Handbook for Mortals by Joanne Lynn, Joan Harrold and Janice Lynch Schister. This is a fantastic resource for patients. It a practical guide to people facing serious illness and covers just about everything. What I love about it is that you can also go online and print off sections of the book that you can give to your patient.:)

I have just taken the exam and am happy to say that I passed it. I have only been a hospice nurse for just over a year but decided to take the test because I want to be the best I can be in my chosen field. We get little to no education at the hospice where I work so it's up to me to keep learning and up to date. Since becoming a hospice nurse I have read many books on death and dying which have been invaluable. To prep for the exam I bought the study guide and took the SAE questions available online through the CHPNA website but due to a heavy workload I didn't study as much as I should have! But I have to say, the best education has been experience gained from my pt load and from my patients themselves. No one has encouraged us to take the exam at my hospice and most people, nurses included, didn't even know that certification in our field existed. I didn't get any reimbursement or kudos for passing but I personally feel I learned a lot. Good Luck!

Thank you to you all for replying and your words of support. Sadly I lost my pt yesterday. I was fortunate to be at his bedside at the time of death and thankful because he did bleed. Not the massive, arterial rupture which sometimes occurs but a slow, steady stream through his mouth. Lots of suctioning, ice packs etc. I had been keeping him very sedated and pain free, so I know he wasn't suffering but I was very sad for the family. No matter how much you prepare them for the worst it's a distressing thing to see.

I have been caring for a head and neck cancer pt in his home for the past 6 months. He has a trach and a G tube and has had extensive surgery, radiation, chemo etc. The last clinical trial has failed and his tumors are progressing. As well as internally they are now presenting externally on his neck and in his ear canal and he has increased facial swelling d/t lymphedema. He is in his 50's and his wife is his primary crg. She is amazing and dedicated and I am trying to prepare her for the worst case scenario with this type of cancer - a massive hemorrhagic event. I have a suction machine, dark colored sheets on the bed and have instructed her to keep plenty of towels on hand. However, this is my first experience with this type of potential death. I'm hoping that I can be there to spare his wife this trauma but, in reality by the time I get there, no doubt it will all be over. No one in my hospice has had hands on experience of this. Is there anyone who has? If so please let me know your experience and any advice you may have. He is a wonderful, proud and brave man and I want to do everything I can for him to have a "good death".