Allow Mystery

Thanks zenman, interesting philosophy! May you recommend some 'further reading' on Shaminism and more particular "death rites". As a Hospice Nurse, I have developed my own philosophy, and "spiritual practice", and also believe that "the body knows h...

Keep the LOL's! Best wishes!

In reviewing these older postings, I'm getting many answers

Hi all, I'm contemplating working in-patient as opposed to out-patient case management. I've been advised that working in-patient may entail up to an 8 patient load with a CNA, and acuity will not factor in. Pros for in-patient include (1)less trav...

I apologize for my blanket criticism of Msws and Chaplains in a previous posting, obviously I had a bad day. I, too, appreciate the team concept of Hospice, and I've seen good outcomes as a result. finn and Michael, I enjoy your postings and continu...

no signs of constipation .... what signs are you looking at have you done a rectal exam?

standard kits here; thorazine, vistaril, scopalamine injectibles

Hey finn I'm with you about these msws', I find them as useless as tits on a bull; they want the cush; info visits when they can assure that the nurse will be available at their beck and call; please don't let be get started; and how about those cha...

Recommended Initial Dose Conversion to Duragesic Patch (Jansen-Ortho 2006) 25 ug patch = 60-134 total oral morphine daily dose Many Fentenyl lawsuits out there for overdosing. Best Wishes!

Not to be disagreeable, but not wanting anyone to be misinformed. You may wish to check with yor pharmacist/MD for equivalency of morphine with fentenyl 12 mcg. Best wishes!

Yes, I too have seen this reaction to a Fentenyl patch. I suggest you stop the patch and see if the patient perks up. The 12 mcg patch is equivalent to approx. 40-55 mg of morphine/day. Best wishes!

Dear Req_read My condolences on the death of your father, thank you for sharing your intimate thoughts and feelings, your self awareness is extraordinary Dear finn11707 I'm sorry for your stress with the lack of support from your team, I applaud you ...

Admitted a pt on TPN against my objections (no other hospice would take pt and mgmt thought would be good PR). The day I admitted I gave two week notice. Pt suffocated with fluid and died the night before my two weeks were up, a miserable two weeks a...

Leslie, You mention sc continuous infusion; what medication do you use for the infusion? Thanks

They're testing you, draw your line in the sand and don't let them across. Best wishes!

I agree with leslie's advice. If unable to swallow, you may want to consider pain pump if he has IV access (port) or subq pump. Best wishes!

40-90 minutes/visit; 2.5 hours/admit does not include paperwork Best wishes!

Thank you Passion for your reply. Would you be so kind to share written literature (web sites?) on how oxygen can produce an undesired prolongation of life and suffering? I attempted to google the subject but was unable to come up with anything spe...

Interesting topic, just another observation that I have concerning the use of morphine. I have witnessed family/staff giving morphine very liberally and the only apparent effect was increased secretions requiring frequent suctioning and aggressive se...

Dear handyrn Excellent question and concern! My humble opinion is that the morphine may hasten the process (does anyone really know for sure). I usually try to maintain an actively dying patient with oxygen up to 4 lpm and Ativan on a q6 schedule, an...

Dear proud2b1 I was blessed to be able to provide care for my mother the last month of her life. I had been with Hospice approx. 9 months prior to providing my mother's care, and I believe I was led to Hospice to gain the knowledge and wisdom to be a...

Michael, intersting points you make. Ego could be the social mask that gets stipped away at the end; Ego served it's purpose on earth, for survival, but does not have a place after our time here; those that struggle with their death, don't want to ...

Well, finally, something I can relate to, maybe that lightbulb is getting brighter. Thank you Leslie for sharing your vulnerbility, we are all vulnerable but don't want to share or lie about. I've always been drawn and able to relate to the 'mentall...

Robin, thank you for sharing the conference call, I thoroughly enjoyed listening. I thought you did an excellent job hosting and hope you get more attendees next month. I thought Beth had some excellent input. I've enjoyed Michael's input on this ...

Dear Leslie & Michael, I'm slowly being dragged along with your insightfulness and only wish the 'lightbulb' was brighter. I'm sorry for the inference some time ago that "new age" did not belong in this post. "New age" is where we are, it's di...