EmptytheBoat

I've had two cases within the last few months, pt. w/projectile vomiting just prior to death, both cancer patients. I've explained this to the families as the body's method of expelling the buildup of toxins from the cancer. In both cases, the episod...

Dear cherokesummer, Please don't worry yourself at this time with possible mets, nothing to be done. From your origianal posting, it appears to me that your FIL is imminently dying, and your focus should be on keeping him comfortable. If this may be ...

Dear cherokeesummer, Excellent suggestions from ktwlpn, you may also try a tray of cat litter under the bed, cat litter will absorb some odors. I would also address the source, possible UTI and/or yeast infection which may be pallatively treated wit...

Dear NurseCherlove, Thanks for your input, you had some excellent thoughts. Bowel obstruction may have been a factor especially with one of the two patients, she had rapid growing tumor(s) in the peritoneal/abdominal areas. I've considered the drug i...

Thank you leslie, I was hoping for your input. Best guess with my two patients would be metabolic imbalance, both patients had extensive, rapid growing tumors throughout their bodies (sarcoma and melanoma). I'm glad to hear this is rare, I've experie...

My experience with assisted living is not good, and unless you are willing/able to provide continuous care, it is unlikely that symptoms will be managed as the patient's disease progresses. The ALF's I've been involved with require the family to be a...

No warning on impending vomiting, both patients semi to fully comatose, non-responsive to verbal stimuli at the time. Neither had brain mets, both had extensive tumors, thus my assumption of the body purging itself of toxins. Do any of you instruct t...

Dear cherokeesummer, I'm glad the fever responded to Tylenol. There have been other threads here regarding elevated temps, some Hospice nurses treat the temps, others don't. Others here have addressed causes of increased temp, may I also add the pos...

Dear Atl John, Dying isn't always pretty, but it's challenging. You present as a very compassionate guy, and Hospice is all about compassion. Best wishes and God Speed!

Hello River, Here in Louisiana, LPN's are used as mc3 describes in Florida, LPN partnered with RN to manage a case load. I've mostly worked with a part-time LPN, or a shared LPN (with other RN case managers) and has worked very well. I've not worked ...

Don't wait until he gets worse, titrate medication until you get your patient comfortable; and let your total assessment determine his comfort level, use your education/experience.

In this situation, the pleural taps are pallative, and Hospice needs to step forward. Your mother needs to be supported throughout, but issues need to be addressed and resolved, denial/avoidance isn't an option. God Speed!

Why the rush to judgement? Drive-by Hospice? Where's is your coordinator/administrator? Is marketing dictating nursing care? What pallative care can you provide with this situation?

Spelling and literacy would be a start. Best wishes!

Duragesic came out with a 12 mcg patch, I understand they are expensive, relative to higher strengths, but gives another tool when titrating medications.

Dear Sukichaz, I'm sorry your Mom (Happy Mother's Day) is going through this but what a loving and supporting family she has. To answer your questions: (1) You don't necessarily need to taper down the Fentenyl patch, if your Mom is not having any p...

LPN's in Louisiana are invaluable, we couldn't manage without them. skittlebear, don't fret, not much to chart on a death; no pulse, no respirations.

Being a Hospice nurse means that God has entrusted you with the compassionate care of the terminally ill to transition from this life to the next in peace and comfort, and to provide strength and support for the caregivers and families to accept His...

As a fellow Hospice nurse, I'm empathetic with your situation, psychosocial issues are challenging. Sometimes it's difficult to distinguish if someone is being nosy or genuinely concerned. Once I establish a boundary, I usually use diversion/humor,...

Dear mim-o, I'm sorry you and your family are going through this experience with your loved one, and I'm thankful that you have a good Hospice team and your loved one is comfortable. Hospice is a wonderful program and under utilized. Please use your ...

I've had it both ways, SW helpful with consents and allieving some of the families' fears; then, merely present to complete their psychosocial assssment and distracting/delaying the admit. I've also had both the SW and Chaplain present at an admit, ...

Dear Windsong, I'm sorry your posting was not an April fool, if I were to think of an April fool for hospice, or either a nightmare, I couldn't have come up with a more demanding situation. I can't imagine the stress you must be having, you are not ...

April fool or just a fool?

cookie102, the fact that the patient (and/or family) does not want to officially sign on with hospice may have been the cause of your frustration. If taking call, you should of had access to the patients medication profile before your visit to deter...

mpingo: I'm a hospice nurse, I've worked with/for several different hospice organizations, and I've not been made aware of any specific protocols concerning medication. Each pateint is assessed and evaluated and an individual plan of care is establis...