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shrinky

shrinky

Hospice, Palliative Care, OB/GYN, Peds,
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shrinky has 43 years experience and specializes in Hospice, Palliative Care, OB/GYN, Peds,.

Veteran( Navy Nurse ), Transplant fron the midwest to the South where it's warmer. Mother, grandmother.

shrinky's Latest Activity

  1. shrinky

    Older RN Student considering Hospice Nursing

    Normally they like you to have one year of experience before going into Hospice because it is such and independent work environment. However you do have the life experience and feel the calling so if you are able to ride with a Hospice nurse to get a feel for it then that is a good place to begin. It helps if you know your own feelings about death and dying, and have been exposed to it in your circle of friends and family. Hospice is one field where you either love it or hate it so it helps to find out as much as you can before going into this field. I applaud your desire to work in this field because I love it and will work here until I retire.
  2. shrinky

    My Grown-Up (Nursing) Christmas List

    Dear Santa, my wish is for me to be able to retire real soon, I am tired. I like the tropical paradise idea too, without kids and grandkids; could I also have a rich hubby too? I don't think that I am asking for much.
  3. shrinky

    Life, Death, and Other Matters of Consequence: Part I

    So many times we question our actions, but always try to do what is best for the patient and family. I am working with a family now helping them make a decision about removing their mom from the vent. They have realized that she did not want to be on life support and they have been trying to keep her here for themselves, so she will be coming off on Friday. The docs would have wanted to do it sooner but the family was not ready so we had to sit doen with the doc and discuss everything and once he understood their reason for waiting until Friday, everyone was on the same page. I digress. Your story was so beautiful and loved your last line. :redpinkhe
  4. You may have to be wiiiling to relocate to find that first job.. I just looked at ouy RN job openings and found at least one in every department and we hire new grads. We are located in SC and there are a lot of sick people here and we did get raises this year. We just sucessfully passed our TJC review and are progressive for a rural area. The lure of night life and the big city is understandable when you are young but if you need a job, widen your search. Good luck froma transplant, gotta love the winter here.
  5. shrinky

    Narcotic management in the home

    We are also a hospital based Hospice but we get our meds from our Cancer Center where we have our outpatient pharmacy for Hospice. We also count all meds each visit as we have to reorder their meds for our next visit. We ask the family to keep a record of meds given so we basically know how much pain our patient has so we can adjust accordingly. If we suspect diversion we take out only a few days supply at a time instead of 2 weeks supply. We also have them sign when meds are delivered and that is a part of the record.
  6. Usually people will praise me for doing what I do and tell me that it takes a special person to do the job that I do.. I simply tell them that it is a calling that I am honored to be a part of. I tell other nurses that this is what I went to school for, to care for the whole person, body, mind and spirit and it is fullfilling. I think that most people have a difficult time dealing with death or even talking about death so they become uncomfortable thinking about the event. We will all die sometime but not everone wants to think about it, it is really not morbid and can be beautiful and peaceful. Be blessed and proud of what you do for all of your patients. I'm sure you are a blessing to them.:redpinkhe
  7. shrinky

    Death stories?

    My stories are too numerous to count but I will say that as people are getting ready to leace this world they become closer to the spiritual world and do see what we cannot see. Most of them see loved ones who have passed on and others see angels, the gates opening or other beautiful things that cause them not to be afraid. I had one lady who had had polio as a child and was now dying on Hospice and she was a good lady, believed in God and went to church and wanted me to sing to her every time I visited ( I was her Hospice nurse). She started seeing men in black with big dogs and snakes and this concerned me so I would talk with her about what was happening and praying and singing hymns. At one time she told her husband that he was keeping her here and he eventually told her that it was ok to go, they do need permission. She did become peaceful before her death but it was a struggle before that time. People do need permission to die and I have seen people hang on because the family tells them to hold on and as a Hospice nurse I have had to help the family let them go. Death can be a scary experience and I believe God sends loved ones to us to help us not to be afraid, especially someone who was very close and loving to us. Maybe I'll tell more stories at another writing. Great thread.:heartbeat
  8. shrinky

    Family wants Diagnosis on Death Certificate changed

    I've had this happen once for the same diagnosis. We have to call the coroner when a patient dies and give them the diagnosis and the patient died of Liver Cancer with Hepatitis and HIV as co morbiditites. The coroner chose to put all on the death certificate and the mom was furious. Anyway he asked us if it was ok to remove it because only he could do so and we didn't have a problem. However in your situation that was the primary diagnosis. Some of our docs write cardiac/pulmonary arrest but also put as a result of________. So I think that it has to remain as a leading cause of the death or why would the person have died of CP arrest? I feel for the families because there is still a stigma attached to the diagnosis in most areas and people are sometimes cruel. Good luck.:typing
  9. shrinky

    Taking a leap of FAITH

    I had that same feeling while I was out on medical FMLA for 3 weeks after lap chole and R-CTR and was writing evals and reports with my left hand, I am R handed. I didn't want to go back to my job as a manager, hated reports, time sheets, etc. I went back but did not stay long and went to Hospice and that was 9 years ago. I still love what I am doing and realize that this is what I went to school for, holistic nursing, independent work and the respect of docs and peers. Good luck in your new job. :redpinkhe:yeah:
  10. Here in Orangeburg, SC our hospital recently hired 30+ new grads in all areas of care. It is a good place to get experience and we are not far from the beach and mountains. Go to www.trmchealth.org and there should be a job link. Good luck.
  11. shrinky

    Is this bullying?

    It is amazing that in all my years of nursing the one thing that has not changed is that we are our own worst enemies, meaning nurses. We should support each other and be professional enough to confront one another rather than going to the boss and finger pointing. Sending a general notice of lost charges then talking to individuals would be the more acceptable way of dealing with this soooo important issue. I realize in the economy we are in that it is important to recoup charges, but patients still come first in my book. I sure hope that somehow this situation gets resolved for the better so you no one leaves. Has anyone gone to the boss and told her how this is affecting morale and how some people want to leave? Sometimes it is good to have a gripe session and clear the air. Good luck and it isn't like this everywhere so hang in there.:heartbeat
  12. shrinky

    Trouble finding RN job

    In all of my 40+ years in Nursing I have seen shortages, then an over abundance of nurses so many times. There are jobs out there, we just hired 30+ new grads at our hospital. You may have to be willing to get experience at rural hospitals, the Navy as suggested, Army, Air Force, etc. I did the Navy thing many years ago and got great experience, of course it was during Viet Nam and we had many injuries to deal with, but I saw things I would not have seen in civilian hospitals. They serve families of military also so Peds, OB, Clinics, GYN are all available, and you can get to travel if thats your thing. So think about checking outside of your area if able to relocate and look for work in under served areas. So many of us will be retiring soon and there will be a major shortage then again. We are located between Charleston and Columbia in SC, the weather is usually warm, the mountains are not too far, neither is the ocean. Our night life may not be great but it is not too far away. Think outside the box and maybe you will have to call recruiters or go online. You may not get your ideal job the first time but it is a step to it. Good luck on your journey.
  13. shrinky

    How do you handle bad odors in a clinic setting?

    Oil of peppermint is very effective for bad odors, cancer and gangrene are the worst. When I change cancer wounds I use Vicks under the nose and it helps. A bottle of the oil with a diffuser or gauze strategically placed should do the trick.
  14. shrinky

    An Honor

    I think that too often we overlook what is important to the patient for their emotional and spiritual well being. I think it is so sad when my docs in the hospital write that the patient is hallucinating on my Hospice patients when they are doing a life review or seeing what we are unable to see. Great article, I have been in Hospice and Palliative Care for many years and we have difficulty also with SNFs accepting Hospice, most see it as a duplication of services as do many docs. God bless you in your continued work, you seem to be a genuine Hospice nurse.:redpinkhe
  15. shrinky

    do you think docs know what they're doing with your patients?

    Geriatrics has been a specialty that requires 2 more years of residency but he may get some in the next years. The founder of the Palliative Care Service at New York Mt. Sinai did a residency in Geriatrics before she changed to PC and is now head of CAPC. In all of her 9 years after college she never had a lecture or course in pain management, so how many other docs have any? No I did not think you were bashing docs, but I felt like I was maybe because I am so frustrated that our PC service is not being utilized for assisting with pain and other symptom management. Keep asking questions as that is how we learn and get smarter.
  16. shrinky

    Entirely off topic, short, vent!

    I can relate, my grands threw a book ,one at another, and guess what? It hit the screen of my laptop and fractured it. I do have insurance that covers it but I have to drive 40+ miles to take it to the geeks to have it fixed. May take a few monthes he says. It was a gift from my sis and I dare not tell her yet. Good luck with your move and sorry about your laptop.:angryfire