Need Assistance (Hospice care)

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i need aome advice/education...i am working at a va hospice floor.

we have a resident who appears to have proteus in/around his trach....no culture being done...no treatment ordered for it. another man, yes he has cancer of the bladder. his urine is turbid and very foul. he has had some tenderness in the suprapubic area. this urine is so foul, his room reeks of the odor. no cultures have been done. i brought this to the attn of the np and md. the response was, well we dont do cultures or aggressive treatment on hospice patients. i am furious. the residents are here for cancer, but they will probably die of sepsis! hospice is comfort care, but does that mean also to let them die of an overwhelming infection?

we apply antibiotic ointment to eye infections. we treat skin tears and bedsores. is culturing and treating a infention inside the body really considered "aggressive" treatment? please open my eyes here: what is the standard of care?

thank you for responding.:scrying:

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Specializes in hospice.

I'm really sorry your pt's are having to suffer needlessly. We have always treated UTI, URI, ect. in hospice. I cant imagine a physician saying that is aggressive treatment. In my opinion, it is comfort care. Is there any way to go around these 2 people?Sometimes we do not do cultures. we treat with ABT by the symptoms. It would take too long to collect the specimen, take it to the lab, and wait for results. One physician says, if it walks like a duck, quacks like a duck, its probably a duck.Another physician will go ahead and order the UA/culture, but start on ABT after collection so treatment is not delayed.Stand your ground, it makes hospice look cruel and uncaring.

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What steps do I take to correct this?

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