windsong

No! not a April fool , but maybe I have been a fool. Blessings. Windsong

I hate to sound like a cry baby, but I really need some advice. Here is my problem. I work for a hospice and I am the only RN. Iam over the outpt. which I manage the Lpn's and also I have a pt. load of about 30 pts. myself. I live an hours drive from our corp. office. We have been in need of a couple more RN'S . My employer has yet to hire any. This has made it very stressful for me. Lately we admitted a pt. who lives a 200 mile round trip from where I live. She is seriously ill. My problem is trying to deal with how does my employer expect me to give this pt. appropriate care living so far? I am on call 24/7. This is a problem too. My life at home is falling apart and so am I. I am having anxiety attacks and trouble sleeping because I feel I can't handle all this responsibility by myself. My employer only gets angry when I express my opinion. I love my job and I don't want to be forced to give it up. I have been hanging on in hopes things will change. There has been one RN to apply recently. I am hoping they will take the job. This particular pt. has lung cancer . She is in the end stage. There is no one to stay with her 24hrs. a day. We have a very beautiful inpt. unit but she refuses to come to that. I don't think she realizes how this disease progresses. I don't understand why my employer keeps piling on the pt's when we don't have adequate staffing . This too is bothering me. What would you do? How would you manage a pt. who is so ill living so far away? I don't want my pt. to suffer while she waites forever for me to get there. Any advice is welcomed .I am desperate at this point. Blessings, Windsong

Hi, I am new here. I have 5 years experience in hospice nursing. You are right about the patient needing the meds in her home long ago. Here is a solution for future problems. The nurse who admits a hospice pt. should anticipate that pt's . needs in advance. Look at the DX. Ask yourself does this pt. have the potential to have a increase in the need for pain meds? Will this pt. have anxiety? Will this pt. experience nausea? You would assume the pt. will need some meds in the home to take care of these needs when they arise. It is better to be prepared in advance than waite until someone calls you at midnight and tells you they are in pain and nauseated. It is difficult to contact a doctor and pharmacy at that time of the night. Make a emergency kit for each pt.s needs and keep it in a lock box in their home. Then there will not be the worry about having to deal with it in the midnight hours. I would also make sure you speak with the nurse who admitted this pt. I would find out before hand , if the nurse made sure the pt. got everything they needed. That way you won't be caught by surprise when you make your visit. I have been stuck many times in terrible situations after hours, because the previous nurse did not take care of the pt's needs or failed to inform the on call nurse. It is difficult also when you the nurse who is visiting lives a long way from that pt. The drive is hard enough to deal with much less the problems you may encounter because someone else failed to complete their assignment. This can be very frustrating for the pt. and add even more anxiety to all their other problems that they are dealing with. It all comes down to plan and oraganize. These two things will head of a world of problems and help increase the comfort and care of your pt's. Blessings, Windsong