dsgrandmarn

I have the second editions of the HPNA Core Curriculum and Study Guide. Does any body know if those will be current enough for a 2013 exam?

That has to be wrong! We dilute almost everything that's given IV in my hospice, What are people thinking?!

Our docs always order it for SQ. As for documentation, you could be saving someone else time and aggravation plus the obvious and always important CYA. Thanks for watching out for those who come after you. I will do the same from now on when there is a question.

Is is possible for you to get some counseling so you don't feel so alone in your struggle? . Nature seems to program mothers and daughters to have these relationship challenges at this time- my theory, for some time, has been that it is to make the coming separation easier. Maybe not much comfort but I have been through it and seen many friends in the same boat. Pick your battles, try to keep things in perspective- 10 years from now will this (whatever the issue )seem important ? Hang in there, this too will pass.

What a great story! It renews my faith in people. Plus, without opposable thumbs, these kitties will never get on Google and then complain they didn't get proper care! Thank you for what you did and I think that the number of responses you got gladdens my heart as much as anything else. Good job!

It is my understanding that if you have a legal order for pain med then you are legally obligated to treat the pt's pain unless, of course, she refuses. I think this is true even if you have DPOA who disagrees. Any legal experts out there?

Thanks for everybody's input. I appreciate your ideas and sympathy. I don't have the answers to the more detailed questions about Medicare, not my forte at all. Keep the ideas coming. I'll probably be sharing them at work at some point.

I may be missing something but from what you say I can't see what you did wrong. Others are judging based on hindsight, which is always easy. You made the right call based on the facts you had AT THE TIME. What you ended up doing is standard everywhere I've ever worked- LTC and hospice. Others love to second guess but try not to let it get to you. They weren't there. Hang in there.

We have been told that, starting in April, we are going to have to chart every patient contact we have during the shift. All we have are a few computers on wheels and some stationary ones, None of these are very friendly and it can take 2-3 minutes to log on. My facility is an inpatient hospice unit and most of the time we are so busy giving pain meds that we often can't chart until the shift is over. None of us has any idea how we are going to be able to do this without better technology. Anybody already doing this? With what sort of technology? Thanks for any ideas.

Well said ! I am so tempted to post it at work, especially the part about trays and the kitchen. Thank you!

Yes. At our hospice there are several stories about patients " seeing " one or more children ( that no one else can see ) in their room or running up and down the hall shortly before they die. And, yes, we usually do pass that info along in report. We call them " the kids " and in fact one nurse reported seeing the kids at the same time as the pt. did ( although nobody else around saw them ) .. The nurse is still with us and fine, although the pt. has long since died. I have tried to " google " this phenomena without much success but I find this fascinating.

Could somebody please tell me what size syringe is the best for med. administration and flushing a saline lock? Thanks very much!

I feel for you. I have also struggled with falling asleep on the way to and from work. Lollipops, pretzels, any hard candy have helped. I also bought a gadget from an online security company that clips onto my ear and sounds an alarm if my head falls too far forward. I haven't yet had it go off, (haven't fallen asleep again) but it makes me feel safer. I fell sound asleep at a stoplight one block away from work ( on my way TO ) with almost no warning signs of sleepiness and that REALLY shook me up. That's when I ordered the alarm. Hope this helps. Oh, also, a really good audio book can also keep you awake. Stephen King,John Grisham, etc can be pretty rivetting. Good luck!

I need help! In my new position I give a lot of IV meds but since my orientation ended I've gotten confusing info about correct syringe sizes to use with saline locks and central lines. Could I hear from others on this? What size syringe for flushing and actual injection of med into line for central lines and saline locks? During orientation my preceptor used 10 cc for everything but now I see and read conflicting info. So far I've had no trouble with this but it worries me and I want to do it right. Thanks!

HHC LPN's idea is the best by far. I love it!:balloons: