abnerRN

Have you tried Haldol? It seems to work for some of our patients.

I have a couple of suggestions: First with pancreatic cancer, the patient tends to be very thin..if this is the case the Duragesic doesn't work properly, 2. We use MSContin extended release given every 12 hours, with MSIR for breakthrough pain with really good results. 3. If and when the pain becomes intractible, Dilaudid around the clock or Morphine Sulfate sub q around the clock is effective. Also with the Duragesic, try on for 48 hours, then change instead of 72 hours.

To a certain extent I find the comment amusing..what about us nurses that see patients in their homes, are we supposed to have a clean pair of scrubs between each patient?? Get real

I for one believe we are called to hospice..follow your heart There are perdiem and prn positions at our hospice keep trying to find a way Personally for me the pay is fine, but it's the daily blessing of assisting families and patients through this life event that makes me love this

I'm with you in the actively dying patient Tylenol is usually ineffective and the temp will go down on its own. I prefer cool cloths on the forehead and a light sheet only for cover. And you're right the Tylenol is usually at the request of family, I just explain that A suppository is invasive and therefore not really comfortable Most familiy members only want a comfortable death and are usually satisfied when reassured.

Hey V: Welcome Mid 20's is still young I went back to school at 35 became an lpn, continued on to become an rn while working fulltime. Hard?? I think it was, but it's a blur now!!!! Primary license in Missouri, now a hospice nurse in Florida..

welcome to Hospice nursing, I too feel that this is where I belong and truly am blessed to be involved in end of life care. You don't mention his disease, but it sounds like he's reaching an end poiunt: By refusing all except pain meds he may be saying he's tired of the fight. Restlessness is quite common near the end, especially if there is unfinished business or the patient is still in anger or denial. Have you offered the services of your hospice's chaplain? Sometimes the patient just needs to be allowed to vent his anger and you just support him. Sometimes they can be drawn out to verbalize what they are feeling, sometimes not. Just be there for him and support him as best you can.

I'm with the other nurses: I'll bet your perimenopausal: I'm 45 and have had night sweats for 4 years now, along with some other lovely symptoms.

In Missouri, Illinois and Florida (and I assume all other states) each individual LTC facility must have a copy of the survey results and the plan of correction in plain view for residents, families and staff to look at. Also, re-survey results must also be available

seems to me someone is forgetting that the residents are the ones who matter. It should never be made more convenient for the employees at the resident's expense. I agree that if 11-7 shift gives showers, these poor residents will be getting up at three in the morning. Where I came from showers were given on 7-3 and 3-ll. And only some of the residents were up and dressed before 7-3 came on.

The non-profit hospice I work for in Palm Beach County utilizes LPN's in continuos care, under the mangement of an RN case Manager and also offers tuition reimbursement as well as helping with CHPN certification

How very sad and unfortunate that there are still nurses who withhold pain medication based on the addiction principle. Bone pain from CA is the most diffucult to relieve, our team MD advocates NSAIDS together with opioids. ASAP!!for crying out loud, this lady is suffering unecessarily!!! :madface:

what you experienced with your mother is a common occurence during the final days and hours of dying people. Some call them "visitations" I don't think of them as hallucinations as I had an experience that made me a believer. I had a patient who kept speaking to "David" in the three days before she passed. At her memorial service there was a picture of this patient and a younger man who it turned out was her son that had died 25 years before, and his name was "David".

I have been an RN for 8 years, 7 of which were in long term care. I have recently switched to hospice nursing and agree with those who say hospice is a calling. I was drawn to this field through working with dying patients and their families in nursing homes. i come away from each case blessed in some way. Yes at times it is sad, especially with the younger patients, but bearable because we make a difference in the lives of these people and their families Dying is a fact of life for everybody and dying in comfort and at peace is the best option to me. If you feel drawn to this it may very well be your calling