river1951

river1951

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All Content by river1951

  1. Managing my time :-(

    river1951 replied to weetziebat's topic in Hospice, Palliative

    Hi Weetziebat! What program are you using? I'm a slow typist also, but I know it will get better as you continue-the firsat time our agency went up on computers they expected it to take us 1...

  2. Managing symptoms for a �good death�

    river1951 replied to NRSKarenRN's topic in Hospice, Palliative

    It has been rolling around all day in my brain since Katillac wrote this response: My turn to rankle I think the goal of hospice is to help. And to each patient that will be different, except for...

  3. A little help, please, JCAHO stuff

    river1951 replied to river1951's topic in Hospice, Palliative

    And yes, they are a pain in the *** and the #$%^ also!

  4. A little help, please, JCAHO stuff

    river1951 posted a topic in Hospice, Palliative

    Hi, Our QM department, bless them, has decided to fulfill JCAHO reqs we need to have an intervention for our care plans that tell us when to call the MD for O2 sats ( we must have a range) We tried to...

  5. A little help, please, JCAHO stuff

    river1951 replied to river1951's topic in Hospice, Palliative

    Well, we asked our medical director and he agreed with the wording "Inform the MD of unexpected O2 sat under 90%." The trouble is, our QM is HH driven and they don't always see the hospice picture. We...

  6. A little help, please, JCAHO stuff

    river1951 replied to river1951's topic in Hospice, Palliative

    No, there is no requirements to take O2 sats. In fact I discourage the nurses from doing them, we aren't treating machines and we expect the O2 sat to go down. No, I understand the requirment...

  7. Visiting Terminal Patient in the Hospital

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

    As hospice, we visit patients no matter where they are. Just sit, hold her hand and see if there is anything she wants you to do. Most folks are just afraid of being alone, your visit WILL be...

  8. Managing symptoms for a �good death�

    river1951 replied to NRSKarenRN's topic in Hospice, Palliative

    Two Weeks on Yahoo! Health So, interestingly enough, there is suddenly a movie, purportedly on dying well- It is only guaranteed (at least in the release I read) to play for 1 week in So. Cal. We'll...

  9. Managing symptoms for a �good death�

    river1951 replied to NRSKarenRN's topic in Hospice, Palliative

    Ow, I am such a right winger (tho left handed) and really enjoying this thread. I cn't imagine being new Age!!! I think a lot about the times I share with patients and like to talk about this stuff. I...

  10. Managing symptoms for a �good death�

    river1951 replied to NRSKarenRN's topic in Hospice, Palliative

    BTW, req_read, us left handers have a far harder time writing things and try to avoid it, tht's where the right brain vs left brain comes in! Have a great

  11. Managing symptoms for a �good death�

    river1951 replied to NRSKarenRN's topic in Hospice, Palliative

    Always, these discussions lead me somewhere else. An interesting experience I once has was when I was suggesting to a family they get lemon drops fpr the patient who had a very dry mouth. The patient...

  12. Managing symptoms for a �good death�

    river1951 replied to NRSKarenRN's topic in Hospice, Palliative

    For you, Introspective: Sometimes, when I am not sure how to help a patient, I just spend time sitting quietly with them. For me, this has broken down barriers and helped patients tell me how I...

  13. Managing symptoms for a �good death�

    river1951 replied to NRSKarenRN's topic in Hospice, Palliative

    OK, Req_Read (AKA Old Coot) one of my favorite stories was the 25 year old leukemic who got up in the night to push his bed because he wasn't getting "there" quickly enough. Not everyone goes...

  14. Hospice, Pediatric

    river1951 replied to Texas RN's topic in Hospice, Palliative

    What is PVL? I have limited pediatric experience. Will be very interested in hearing suggestions. California has finally approved hospice and curative treatment for children with its Medi-Cal program,...

  15. Managing symptoms for a �good death�

    river1951 replied to NRSKarenRN's topic in Hospice, Palliative

    Well, this is what I think. I think some of what happens has to do with the persons' ability to let go and not be in control. One of our many delusions as humans is our thought that we ourselves are...

  16. Have you ever felt threatened?

    river1951 replied to CHPN in So Cal's topic in Hospice, Palliative

    Our agency is in complete agreement with the "going with your gut" action. After all, how many times have you ever heard anyone say, "I wish I hadn't gone with my gut instincts?" Always be aware of...

  17. Managing symptoms for a �good death�

    river1951 replied to NRSKarenRN's topic in Hospice, Palliative

    Thank you, it is always great to read more good articles on such inportant

  18. need some advice

    river1951 replied to hospicemom's topic in Hospice, Palliative

    I actually had a patient like that once. We took her because she would die if her leg wasn't amputated, but she was tired of the pain and her surgeon wouldn't medicate her correctly. Once we got her...

  19. use of Cadd pumps in pain management

    river1951 replied to jwelhwel's topic in Hospice, Palliative

    Re: use of Cadd pumps in pain management "There doesn't seem to be a way to program in the prn doses. This CADD is used generally for chemo--the onco's office loaned it. The wife is giving the prn...

  20. Anyone's 1st job in hospice?

    river1951 replied to RN007's topic in Hospice, Palliative

    I would actually advise against hospice being aanyones' first job. 2 reasons for this- the more experience with sickness you get before beginning hospice really pays off- whether it's intensive care...

  21. The Worst

    river1951 replied to BeExcellent's topic in Hospice, Palliative

    OK, need more info on this- none of us can afford to have this happen- none of us could stand it. Please tell us about

  22. Edematous parts

    river1951 replied to bay bay's topic in Hospice, Palliative

    elevation, ice, and

  23. Help! What meds are not covered under hospice?

    river1951 replied to RN4hospice's topic in Hospice, Palliative

    Yes, our hospice would cover the digoxin also. With end stage heart, the meds to make comfortable are at the same time considered treatment. I'm ok with that, we have to keep folks

  24. Mentally Ill Patients and Hospice

    river1951 replied to SCgirl1962's topic in Hospice, Palliative

    This is a really hard place to be in for both the family and the patient. Sickness and stress increase the mental illness problem, these poor folks cannot deal with much stress. Getting the patient in...

  25. Revocation

    river1951 replied to silverwillow's topic in Hospice, Palliative

    Yes, unless you wish to be liable for the hospital trip and I'm sure it's not your home hospital. You could call a hospicw there to make a visit- I've done that if necessary and it can help, plus...