357maggie

That actually IS the case where I work. The EC has a totally different assessment form, hand off form, computer status board, and many other differences from the floors. I didn't know this until I was floated down to the EC.

This is exactly the position I found myself in. I started having panic attacks, worrying about my patients, when they were promised so much more by the agency than I was able to provide. Even tho the company told me they had my back, I felt as if I was a team of one, not part of an interdisciplinary team. I am burned out and not sure where I will be able to work. Lots of online help is available in finding a new job - I say get out of there. Best of luck to us both!

Thank you all for all your help. My patient's struggle is over - she died that night. Mine has just begun. Expect lots more questions from me. I have been grabbing anyone I can find at the office to answer my questions, but I have a LOT more to learn!!

I have not seen that book, but I will look for it. Havent seen much in the way of organized training or resources yet, still looking... I am sure it is there, it has to be there, right? Maybe?

I know how stressful and frustrating it can be to not hear back. I recently left a major hospital because I could not get HR to help me transfer to another, less physical unit after I underwent cervical fusion on their dollar from herniating 2 discs at work. I WANTED to stay, but just not on that unit. Weeks of calling HR, leaving messages daily. And not one call back. Nursing shortage? Hello!! I hope this new job with Odyssey fits you like a glove!

So have they found anyone to replace you with yet, to get the new patients? To get your existing patients? They have you on-call your last week there? I'm glad for you that you are leaving! :yeah:I feel for the patients. But you need to take care of yourself, and protect your license!

Do you mean an interdisciplinary team? Yes, sort of. We are in a lot of flux: borrowing a manager till a new one is hired, no chaplain of our own, two SW(which one do I call for which patient), 2 other RNs that I havent bonded with yet... Just havent found my groove yet. My mentor is on another team. We DO have a meeting tomorrow, and I plan to ask LOTS of questions. But I have questions now. Like How close is she to dying? I told them it could be hours, it could be days. But I havent been at bedside with enough actively dying pts yet to know how close she is. There has been the rattle, can I call it the death rattle at this point? But it comes and goes. Some apnea 5-10 secs.BP 90/40. When I turned her on her side, her saliva was brown, like old blood? What was that?

Wow. I dont know. If consents werent signed, has she been admitted? That is a really gray limbo area. Had she been in the hospital at the time of her "admit" to hospice?

Well, we all are, aren't we? Somebody, anybody, chat with me. I am new to hospice. Been here since Thanksgiving, and am going thru the "I don't know what the hell am I doing" stage. I had a good mentor, who worked with me for three weeks. Now on my own, I feel like I am drowning. I have my first patient that is declining. Lung ca with mets to the brain. Last Wed I saw her for the second time, it was her and her husband's anniversary. She was alert, having trouble finding words, complaining of double vision. History of IBS that was under control, she told me she was having BMs daily, that had been loose for 2 weeks, returning to normal over last 2 days. Got in to the office today to find she has been on crisis care all weekend, for agitation and constipation. Family reports no BM in 10 days. Dtr said "Dad told me the anniversary was important to her. Not so much her birthday next week." They have her zorked on ativan and roxinol. Her abdomen is distended. No urine in the last day. Husband has refused digital exam since start of CC, afraid the disimpaction will be too painful. I got orders to disimpact, give an enema and put in a foley. I was able to explain to the husband that as painful as disimpaction may be, the constipation will cause more, longer lasting pain. In turning her to her side, she peed, so foley was delayed. So the questions that the family is asking me: (I hedged pretty well. "Fake it till you know it" was one of the gems my preceptor stressed) If Mom was not sedated would she: still be dying? be in pain? be eating and drinking? I got more, will see what you have to say to this first. HELP!!