river1951

river1951

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All Content by river1951

  1. Do comatose patients need pain medicine

    river1951 replied to sophie2's topic in Hospice, Palliative

    Depends why they are comatose. Do they have injuries that would cause pain? If so, provide relief, regardless of consciousness level (as prescribed). If they don't have conditions which would cause...

  2. Do comatose patients need pain medicine

    river1951 replied to sophie2's topic in Hospice, Palliative

    At our agency we use two different scales for non-verbal patients, the PainAD for dementia patients and the FLACC for non verbal, non demented patients. They are easy to use and would answer your...

  3. vital signs

    river1951 replied to hcan's topic in Hospice, Palliative

    Not only are they valuable tools, they are another way we show our caring for the patient. I had a patient once tell me after I was listening to his lungs he now knew the difference between nurses and...

  4. Medical Director taking new patients?

    river1951 replied to tahijajan's topic in Hospice, Palliative

    It really depends on the medical director. My last job, the director was the director of two other hospices and he was great about taking patients on. Where I am now, occasionally the medical director...

  5. Help!!! My team member isn't being a team player!!!

    river1951 replied to RNDYN2CU's topic in Hospice, Palliative

    You help no one by letting them get by with behavior that is not correct. The worse a habit she gets in, the harder it will be for her to do her work. I encourage my nurses to take a break when they...

  6. MSWs doing admissions

    river1951 posted a topic in Hospice, Palliative

    We are anticipating having our MSWs doing our start of cares. (Admissions) I would like to hear from others that use this process to make sure we see all the pitfalls before we begin. I appreciate...

  7. Hospice and Labor Unions

    river1951 replied to williamssu's topic in Hospice, Palliative

    We have the CNA. We are part of a large system, and voted as such. I'm not sure if we had voted independently it would've passed. As it is, the nurses are represented, I have a slightly jaundiced view...

  8. Cross Posted from Home Health Nursing: Narcotic Diversion

    river1951 replied to Katillac's topic in Hospice, Palliative

    We have very occasionally run into this problem in hospice and we have had a meeting up front with the suspect and patient and told them we will refer to law enforcement/adult protective services....

  9. What's the difference?

    river1951 replied to req_read's topic in Hospice, Palliative

    If it was that easy, we would've already finished it. Speaking of this difference how do you move a chaplain from prostyletizing to talking about the patients' beliefs? I have one who is a great...

  10. What's the difference?

    river1951 replied to req_read's topic in Hospice, Palliative

    I've always believed religion is created by and run by man as a recognition of the higher power and spirituality is a gift from the higher power (however you see that!) to man. Interesting...

  11. Reference books

    river1951 replied to RNLolaRN's topic in Hospice, Palliative

    Handbook for Mortals- Joanne Lynn, MD and Joan Harrold, MD Symptom control in hospice and palliative care, Peter Kaye (probably out of print), Symptom management algorithms, a handbook for patient...

  12. What makes you love hospice?

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

    Hi, Yes, I've found hospice much different from home health. Yes, in our area, nurses go out to pronounce patients, do night on-call. Families are either very grateful or not so much (after all- huge...

  13. cultural question

    river1951 replied to kessadawn's topic in Hospice, Palliative

    Another thing that is good to do in this situation tho it sounds weird till you really think about it, is to dress the baby and take a picture. This helps the mother grieve. After all, there may not...

  14. Preceptors/how to pick a good one

    river1951 replied to river1951's topic in Hospice, Palliative

    Yes, all very good pints to ponder and I have talked with both the great preceptor about work load, and the poor charter about how to improve. Our hospice used to not decrease the workload of the...

  15. Preceptors/how to pick a good one

    river1951 posted a topic in Hospice, Palliative

    Hi- Am having a dilemma- we have a nurse who does a great job precepting. We are getting a clear message from her she doesn't want to do this anymore. Our other nurses are too new or have traits I'm...

  16. I feel like just giving up...

    river1951 replied to mc3's topic in Hospice, Palliative

    Be excellent is... Also, must watch out for self if patients are kept on despite not declining. This could hurt you down the road, we are always responsible for our own practice, and we should know...

  17. uniforms or street clothes

    river1951 replied to nurselearner's topic in Hospice, Palliative

    We wear street clothes, though I know 2 nurses who where lab coats over in the home. I think both are fine. I always thought street clothes were better since in our urban area, people think we carry...

  18. Has anyone read this?

    river1951 replied to aimeee's topic in Hospice, Palliative

    Finall I can thank all who have replied to my question about rural hospice. It is the nuts and bolts I need since the place I am moving is trying to start their hospice and I am concerned re: the...

  19. Has anyone read this?

    river1951 replied to aimeee's topic in Hospice, Palliative

    I've been in the field a while, now in the office. Looking forward to moving next year to a small county (1460 pop.) The clinic there when I visited, said they would like to try to start their own...