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ICU, SDU, OR, RR, Ortho, Hospice RN
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Sabby_NC specializes in ICU, SDU, OR, RR, Ortho, Hospice RN.

Aussie nurse now living in the USA.

Sabby_NC's Latest Activity

  1. Sabby_NC

    NCLEX is kicking my butt! so discouraged!

    It is so easy to let the frustrations sneak in, you have some good advice but do not give up. Have you practice using those CD's you can get, I practiced multiple NCLEX questions and that is how I got the feel of how the test would be. I so agree with Davey in the response to questioning and also you need to take a break as well getting overwhelmed with this will not be advantageous for you. I wish you all the very best.
  2. Sabby_NC

    Coming Out of the Darkness

    Thank you BC for a very well thought out, well written article. Takes a lot to share such a personal story. God Bless you my dear.
  3. Sabby_NC

    Welcome to the Forum - General Aussie Chat

    Hi Nursehayley I am originally from Hobart but am now living in North Carolina USA. I hope you enjoy nursing as sure has been wonderful for me.
  4. Sabby_NC

    My Little Mandona

    What a beautiful loving story Justhere.
  5. Sabby_NC

    Post mortem care

    thankyou michael excellent post :)
  6. Sabby_NC

    How to Gain Respect in the Workplace

    Too funny Zoe I do not remember wearing anything back to front or inside out BUT give me time :chuckle
  7. Sabby_NC

    I Contracted HIV

    Hugs to you. How are you feeling today hon? Look forward, look ahead and keep the FAITH.:heartbeat
  8. Sabby_NC

    Happily Addicted to allnurses.com

    tn that was great now you have me singing this hahahahaha well done
  9. Sabby_NC

    Over sedated? Grrrrrrrr

    My suggestion is ongoing education in treating restlessness, agitation etc with this LPN. Reasons for symptom managment and what they mean. Idea on titration of medication and reasons for this instead of just D/C IV, SQ etc. Thank you for being a great advocate for this poor man in turmoil. You win my smiles this morning. :)
  10. Sabby_NC

    Flu Shot ??

    have not had the flu since 1976 and do not get the flu vaccine. i did receive it only once in my life time since living in the usa and it landed me in bed sick as a dog with a reaction so no way jose
  11. Sabby_NC

    Fentanyl Patch

    I agree. My first thought was that this maybe a disease process decline and not related to the patch at all. What about gels etc or is the patient still able to swallow meds effectively without pocketing etc?
  12. Sabby_NC

    MORPHINE and Dying Patients

    Oh Shay make that a double ARGGGHHHHHHHH FROM ME too!! :banghead: I am with you too, Leslie can nurse us both
  13. Sabby_NC

    Finally Passed On My Fifth Time!!!!!

    Congratulations and thank you for your perserverence, it has certainly paid off RN :yeah:
  14. Hospice also has a role in serving the community through educational speeches and work shops. Our liaison educates staff in Nursing Homes, Assisted Living Facilities, Doctors offices, and hospitals about the services Hospice provides. Hospice is acutely aware of the ethnic diversity in our community. We are educated in the different cultures and customs. Hospice empowers the patient and families to have some semblance of control over death and dying. A hospice team involved in the care of a patient and family normally consists of an RN Case Manager who coordinates the care of the patient, assesses and makes changes where needed, Hospice Aide who provides personal care needs and comfort to the pt, Social Worker who works with the pt and family in resources that can better assist them, Hospice Chaplain to provide much needed Spiritual Support and Volunteer services (if requested), who provide respite for family members and company for the patients. Most people these days prefer to die at home and out of the clinical setting of a hospital. They choose to be in their familiar surroundings, having the support of family around them, their pets and familiar smells. They inform us of their goals for care, of their wishes in how they choose to have us care for them. We once cared for a mechanic and his goal was to come home from hospital and die in his garage/ workshop that he had managed for many years. We turned the third bay of his work shop into his bedroom with hospital bed and other equipment required for his care and comfort. His wish was to die surrounded by those smells he loved. He was able to fulfill his wish with hospice and his family by his side. Our primary goal as a Hospice Team is to honor patient's wishes and goals as they decline with their life limiting illnesses. Our aim is to educate and prepare ahead of time in the changes they may see or feel. Being educated certainly alleviates some of those fears and stresses families go through. We desire that the death of a patient be as spiritual, comfortable, peaceful, and dignified as possible. I would like to share a personal experience with you about a patient I cared for. She was my patient for nearly a year. On entering her home for the very first time I met a very frail but fiercely independent woman living alone following the death of her husband many years before. She was a very reserved lady who rarely showed any emotion. Assessing her was difficult as she only responded in "yes or no" answers. It was obvious she was in pain as she would flinch or pull away during my assessment but when asked if her pain had increased she would always say 'it is about the same', she rarely spoke about the changes she had noticed or symptoms she was experiencing. Initially I visited her once a week at her request. A good portion of my visits I would sit with her and educate gently on the importance of sharing with each other changes either one of us had noticed. Over a few weeks she felt more comfortable with me, we had built up a trust and she was able to share more about what was going on with her and her thoughts. She stated she never wanted to talk about her pain or other troublesome symptoms because all it did was remind her of the life limiting illness she had. She felt like she was losing control of her independence that she had known for many years. We discussed her goals for care and what she desired from Hospice in assisting her with this illness. Her goals were to have control over what was happening and as she became weaker how she could still have this control. Once we all fully understood her goals and desires, I noted more changes in her sharing things with me. This lady had a strong faith, loved playing the piano at church and was well loved in the community. Once I was able to change her pain medication, with her permission, she was able to enjoy life a little more. I saw the humorous side of my patient. She shared her life history with me, how she was fluent in many languages which she taught at school. She was an avid reader of many styles of books including biographies and novels. She started asking questions about her health and what to expect. I educated both the patient and family by supplying resources for them to read, and explaining the processes that they may see. I spent time with the daughter and her children educating them of their role and how they can be of great help to their loved one. As I was doing this it struck me how much they loved one another but rarely showing emotional or physical contact. This was just the type of family there were! As time passed the condition of my patient changed to the point she was no longer able to be left alone. Firstly she stated to the social worker that she should go into a nursing home so she would not be a burden on her family. The social worker mentioned to her that her daughter and granddaughters wanted to care for her and how this could be both a memorable and special time in their lives. After this was mentioned she decided that it would be wonderful to remain in her home. Her family moved in to care for her. She was becoming too weak that speaking was too hard so she made little lists for me to discuss on my visits. Some things she wrote were crazy little things to make us all laugh. Oh how her sense of humor carried her though this illness. Her family struggled with the personal hygiene needs so I sat with the patient one day and asked her if I could bring a Hospice Aide in to assist her. She grabbed her note book and wrote 'I do not know, I have never been good at decision making' to which I replied now you tell me, I could have had the aide in months ago. Her eyes lit up and she just chuckled and chuckled along with her family. Our Hospice Chaplain visited her for her Spiritual health, this woman's faith was so strong and she never once said 'why me' she took each day as a gift. Her own minister visited regularly. As her appetite and health deteriorated we were able to supplement her caloric intake with Ensure Products, bring in a hospital bed, over bed table and bed side commode to better provide comfort measures for her. Pain medication was changed over to liquid which was most beneficial and easier for her to take. Nausea was controlled with medication and lavender scented massages. For her restlessness her family played music or read to her, rarely did she require medication for this. Not too long before the active dying process started, I sat down next to her bed to inform her of this process. She always wanted me to be upfront with her and keep her informed of the changes I noted. She grabbed my hand which was something she never did with anyone. I asked her if there was anything I could do to make this transition more comfortable or peaceful for her. Was there anyone she wanted to see or could I write a letter for her? At this stage I knew we had made an impact on this lady's life. She looked at me smiled and whispered "I love you, you are a beautiful person, I would like you to be with me before I die, I want you to pronounce my body and be here for my family". I left her home in tears that day because this is what I love to do. This is my passion to work in Hospice and assist people such as this dear lady. What an honor to come into a person's home and life, facilitate changes where possible to allow a person the right to die with dignity and to die the way they choose to. The night time phone call came, her blood pressure was low so I gathered up my equipment and headed up to be with her and the family. We were all about to take turns doing the patient's mouth care, giving her regular medications to ease her breathing and pain, and reposition for comfort. We all sat around her bed, I listened as the family shared stories about their life and how the patient would use humor every day. We all laughed as these stories unfolded. I learned in depth about her prankster ways and dry sense of humor. As I sat with the family for 3 hours before my patient died, I realized what a difference hospice had made in their lives. They were able to do all they could in caring for their loved one; nothing was too little or too much in how they took over their roles of caregivers. With all the education, they were able to make a difference and they were able to do the very things they thought, at one stage, were impossible or frightening. My patient died a very peaceful, graceful and dignified death. How this woman impacted my life, the lessons she taught me are immeasurable and how our patients can educate and teach us. Yes Hospice does make a difference for patients and families who are facing a life limiting illnesses. Being part of the disciplines within our organization working together with pts and families to educate and prepare for the final stage of a person's life, is what I get up for every morning. I am always asked, 'how can you do hospice nursing'? Why? Because the Lord gives me the strength to get up each day, the words to educate, the arms to comfort, the hands to hold and emotions to show that, I too am human.
  15. Sabby_NC

    No She/he Did Not!!!

    That was about the turd one hahahahahahahahaha :lol2: :lol2: Gawd Maud my sides are hurting toooooo funny!!!
  16. Sabby_NC

    NCLEX HAIL STORM 265 Questions

    :ancong!: :ancong!: :ancong!: :ancong!: