river1951

river1951

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All Content by river1951

  1. Managing symptoms for a �good death�

    river1951 replied to NRSKarenRN's topic in Hospice, Palliative

    Gee, I only know a few hospice nurses who are religiously rigid. I think most of us have seen too many off the wall things to swallow the party line as it were. Consciousness itself is an intangible....

  2. Managing symptoms for a �good death�

    river1951 replied to NRSKarenRN's topic in Hospice, Palliative

    Well, Michael, I'm glad you have time to write. I for one, enjoy reading it- am too right brained myself to get the words straight. But I'm glad the rest of you can. I sure missed a lot when it was...

  3. Hospice On Call Compensation Structure

    river1951 replied to Katillac's topic in Hospice, Palliative

    Our nurses get time and 1/2 for all their time they are doing hospice related work. There is a minimum for going out- it is 3 hours at time and 1/2. They also get mileage. Our census is 70 plus they...

  4. Managing symptoms for a �good death�

    river1951 replied to NRSKarenRN's topic in Hospice, Palliative

    No, no, none of this is too way out there. They are the experiences we all have on a day to day basis. This is the meat of what our work is- excuse myself to that person who thought we were all nuts....

  5. Managing symptoms for a �good death�

    river1951 replied to NRSKarenRN's topic in Hospice, Palliative

    It's not America, it's human beibgs doing what they do best, mistaking temporary comfort for hearts ease. Other wise, well

  6. Sitting for certification in March--anyone else?

    river1951 replied to chris_at_lucas_RN's topic in Hospice, Palliative

    Those equianalgesic questions are the bugaboo of all! I don't like them either. I've just done this work 11 years so I guess you probably get to internalize a hospice way of thinking in all that time....

  7. Managing symptoms for a �good death�

    river1951 replied to NRSKarenRN's topic in Hospice, Palliative

    Ok, guys, how I see it- this is one of the gifts from doing this work is to realize both the importance and uselessness of our lives. The importance refers to any moments we have the ability to touch...

  8. Managing symptoms for a �good death�

    river1951 replied to NRSKarenRN's topic in Hospice, Palliative

    Yes, Leslie, it was for that reason. He had been a bomber pilot in WWII. No easy fixes- my ownb father in lawfelt guilty he had volunteered to bomb Dresden- of course that was after he had worked...

  9. Managing symptoms for a �good death�

    river1951 replied to NRSKarenRN's topic in Hospice, Palliative

    Which leads me to a place I always wonder about. I have only had terrible problems managing symptoms a few times. Occasionally, in these cases, some light is shed by someone in the family on an...

  10. Managing symptoms for a �good death�

    river1951 replied to NRSKarenRN's topic in Hospice, Palliative

    Yes, families can be interesting. We have had several instances of severely abused children coming back when mom or dad was dying and care for them. I never get over being amazed at the generosity of...

  11. Sitting for certification in March--anyone else?

    river1951 replied to chris_at_lucas_RN's topic in Hospice, Palliative

    You will do fine, it is specific to our practice but not terribly difficult. I sat last year and had not studied. Did fine. You will

  12. Managing symptoms for a �good death�

    river1951 replied to NRSKarenRN's topic in Hospice, Palliative

    Well said! Standing by with the paddles. That was always what I told my patients- I will walk with you. You will not be alone. I think the relationship is what can make a difference. I always used...

  13. Pancreatic Ca and Nausea

    river1951 replied to SCgirl1962's topic in Hospice, Palliative

    Great job! Now she can enjoy her

  14. Managing symptoms for a �good death�

    river1951 replied to NRSKarenRN's topic in Hospice, Palliative

    Good audio quotes. I really enjoyed that-

  15. Pancreatic Ca and Nausea

    river1951 replied to SCgirl1962's topic in Hospice, Palliative

    I agree with the gel, here we use a BDR gel with 25 of benadryl, 10 of reglan and 4 of dexamethasone. It must be used 3 times daily till the nausea and vomiting stops, then 2 times faithfully. Hope...

  16. Managing symptoms for a �good death�

    river1951 replied to NRSKarenRN's topic in Hospice, Palliative

    OK, this comment pulled me out from the bed I've been hiding under the past week and a half. I think this place you've described req_read, is where the thing called the therapeutic relationship comes...

  17. Hospice Calls when I'm NOT on Call

    river1951 replied to AtlantaRN's topic in Hospice, Palliative

    I am a supervisor at a hospice and I wouldn't dream of treating one of my nurses this way. Everyone knows you need your time off to regenerate your energy. With a nursing shortage, there is no reason...

  18. Does patient need to know the diagnosis?

    river1951 replied to Ms.RN's topic in Hospice, Palliative

    of course you are right about informed consent. Unfortunatelt in our world we sometimes see patient to whom the MD has never given their prognosis. Sometimes, we have found it happens when the family...

  19. Something I've never seen!

    river1951 replied to doodlemom's topic in Hospice, Palliative

    Ow, that sounds awfully painful. If it is odorous, we have had good luck with flagyl solution and wet to dry. We have also used diapers to cover an area completely to prevent leaking. At least this...

  20. Husband Doesn't Get It...

    river1951 replied to AtlantaRN's topic in Hospice, Palliative

    Or it could simply be that they are still being treated as children by their dad and not allowed to have input and are not good at verbalizing what help they need to help their Mom and Dad. Many...

  21. 30 y/o paraplegic dying from decubitus ulcer...

    river1951 replied to Jo Dirt's topic in Hospice, Palliative

    Well, every time I've seen a person this young dying from a decub, the story seems to always start with a tale about what the patient would or would not allow. I agree, it is a sad tale but none of us...

  22. Whacked Family Dynamics

    river1951 replied to AtlantaRN's topic in Hospice, Palliative

    Slurred speech? Who IS taking the meds and drinking beer??? Seriously, you can't take anything for granted. But if the patient says there's no durable power, there isn't. Even if she made it years...

  23. Managing symptoms for a �good death�

    river1951 replied to NRSKarenRN's topic in Hospice, Palliative

    Well, whether people want to discuss it or not, it is important. I have thought about it a lot and my conclusion is that we hospice nurses have to help patients be aware of their options. They...

  24. Documenting hospice pt wound care

    river1951 replied to nurselearner's topic in Hospice, Palliative

    We document wounds weekly, 1st visit of the week: length, width, depth, any tunneling, color of wound bed, smell, drainage, what treatment done and freq of treatment, how patient tolerated treatment-...

  25. Time spent at visits and other things!

    river1951 replied to mc3's topic in Hospice, Palliative

    Whew! Many teaching needs here. What is your docs' day job? He sounds like he is not a palliative care specialist. Those doses seem lees than adequate depending of course, on the patient. I'm sure...