silverwillow

silverwillow

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All Content by silverwillow

  1. SNF asking hospice to change meds

    silverwillow posted a topic in Hospice, Palliative

    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...

  2. Attending memorial services, funerals, condolence calls etc

    silverwillow replied to nurselearner's topic in Hospice, Palliative

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

  3. Revocation

    silverwillow posted a topic in Hospice, Palliative

    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...

  4. Medical Director taking new patients?

    silverwillow replied to tahijajan's topic in Hospice, Palliative

    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...

  5. SNF asking hospice to change meds

    silverwillow replied to silverwillow's topic in Hospice, Palliative

    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,...

  6. The dreaded 911 calls

    silverwillow posted a topic in Hospice, Palliative

    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...

  7. Sub Q Butterfly

    silverwillow replied to Irishgirl's topic in Hospice, Palliative

    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

  8. The dreaded 911 calls

    silverwillow replied to silverwillow's topic in Hospice, Palliative

    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...

  9. The dreaded 911 calls

    silverwillow replied to silverwillow's topic in Hospice, Palliative

    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...

  10. frustrated and overwhelmed

    silverwillow replied to kelluvanurse's topic in Hospice, Palliative

    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...

  11. Vital Signs

    silverwillow replied to RNinRubySlippers's topic in Hospice, Palliative

    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...

  12. frustrated and overwhelmed

    silverwillow replied to kelluvanurse's topic in Hospice, Palliative

    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...

  13. Inpatient for Symptom Management

    silverwillow posted a topic in Hospice, Palliative

    Just curious on what others' experiences were as far as needing to use GIP for management of acute symptoms/caregiver breakdown? How long in? Any trouble placing

  14. Inpatient for Symptom Management

    silverwillow replied to silverwillow's topic in Hospice, Palliative

    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...

  15. Inpatient for Symptom Management

    silverwillow replied to silverwillow's topic in Hospice, Palliative

    I just had my first GIP. It was a hard case. Caregiver breakdown (complete) and acute management of symptoms. She had hospital GIP. It lasted a few days and I'm still exhausted. I hope I don't get...