marachne

marachne

Hospice, Palliative Care, Gero, dementia

Member

  • Content

    349

  • Visitors

    9,966

  • Followers

    0

  • Likes

    16

All Content by marachne

  1. Death stories?

    marachne replied to Teachchildren123's topic in Hospice, Palliative

    OK, I know most of these stories are of the moving/sweet/awe inspiring kind, but I want to share a funny story. We had a pt with metastatic breast CA. Bone and brain mets. She had been on our in-pt...

  2. REAL Pain or ADDICTION?

    marachne replied to captain morgan's topic in Hospice, Palliative

    In general, I agree that having multiple kinds of opiods usually doesn't make sense -- it's often more confusing to the pt and just not necessary. BUT there are things to consider: poor kidney...

  3. How far can a hospice nurse go, spiritually-speaking?

    marachne replied to GardenerGirl's topic in Hospice, Palliative

    One of the things I was really impressed with during my palliative care fellowship was the chaplains and the chaplain fellows. Their fellowship was so much harder than ours! None of us were all call...

  4. Pain management in LTC

    marachne replied to bluegeegoo2's topic in Geriatric, LTC

    I agree, and am enjoying this forum greatly. The only thing I'd add is that practice also changes...albeit slowly. It's discouraging to think that it takes an average of 10 years for new data to...

  5. Pain management in LTC

    marachne replied to bluegeegoo2's topic in Geriatric, LTC

    Leslie, thanks for the clarification. I agree that sometimes our creativity (both in house and in the field) can be an incredible help in taking care of our pts. As I said, I hope that my comments...

  6. Pain management in LTC

    marachne replied to bluegeegoo2's topic in Geriatric, LTC

    Yeah, I'm not saying it isn't done and done w/o problems, I'm just not comfortable with it (esp in a home setting where monitoring isn't as close, or a LTC setting where there's a high pt/licensed...

  7. My grandmother in hospice??

    marachne replied to HMP83's topic in Hospice, Palliative

    Like someone else asked, where was this? rural or urban? Hospice is wonderful, and there's lots of really good hospice orgs. out there, but that doesn't mean there aren't ones that aren't good (or...

  8. Pain management in LTC

    marachne replied to bluegeegoo2's topic in Geriatric, LTC

    ok, i'm new here and clearly leslie ("earle") is smart with a lot of experience and knowledge, but that doesn't make anyone infallible. one thing to keep in mind is that practice changes, and while we...

  9. Methylnaltrexone

    marachne replied to marachne's topic in Hospice, Palliative

    ah, thanks. I think some abbreviations have become very context-driven. (Granted, this was the context, but maybe not the context my head was in)

  10. Methylnaltrexone

    marachne posted a topic in Hospice, Palliative

    Methylnaltrexone, is a peripherally acting opioid antagonist (it blocks the mu-opioid receptor peripherally but does not cross the blood brain barrier so has no effect on opioids central effects -...

  11. Methylnaltrexone

    marachne replied to marachne's topic in Hospice, Palliative

    Thanks for the responses Leslie. now, possibly stupid question: OIC? sorry, not getting the abbreviation

  12. Methylnaltrexone

    marachne replied to marachne's topic in Hospice, Palliative

    What was the dosing? Was it a one-time thing, or did you need to repeat? Any side effects? As I said, I have a feeling the cost/lack of coverage is going to keep it from reaching common

  13. Congestive Heart Failure

    marachne replied to Monica Zilko's topic in Hospice, Palliative

    one other thing: you asked what you can do as her carer -- you can be the eyes and ears (and nose!) of your client, as well as her advocate -- share anything w/the nurse and dr that you think is...

  14. Congestive Heart Failure

    marachne replied to Monica Zilko's topic in Hospice, Palliative

    How is this for timely? Also, just in general, I recommend this site -- really knowledgeable, nice guys (one's an NP), always nice to have someone do the "digesting" for you, then you can follow up...

  15. Congestive Heart Failure

    marachne replied to Monica Zilko's topic in Hospice, Palliative

    no apologies necessary! I know I get confused between generic names and brand names often (example, I'm so used to saying quetiapine that the first time someone started talking about seroquel I didn't...

  16. Congestive Heart Failure

    marachne replied to Monica Zilko's topic in Hospice, Palliative

  17. Do nurses support physician assisted suicide?

    marachne replied to NightOwl0624's topic in General Nursing

    We had a palliative care consult that seemed to illustrate the tension exactly: Anesthesiologist. Had had cancer for 6 years, no one (including his kids) knew except his wife. Had decided at the onset...

  18. Pain management in LTC

    marachne replied to bluegeegoo2's topic in Geriatric, LTC

    One of my favorite quotes about "agitation" and dementia: "A person with dementia who is "agitated" is a person with unmet needs." Sometimes (often) it's pain, but it can be other kinds of discomfort...

  19. Pain management in LTC

    marachne replied to bluegeegoo2's topic in Geriatric, LTC

    Oh, good reminder. Esp. when I was doing my palliative care fellowship, there were few things that made me crazier than docs ordering scheduled opiates w/o an appropriate bowel regimen -- and I mean...

  20. Do nurses support physician assisted suicide?

    marachne replied to NightOwl0624's topic in General Nursing

    I have not read everything on this thread, so if anything I'm saying is a repeat, apologies. First of all my "credentials" for talking about this: 1) I live in Oregon 2) I've done research on PAS...

  21. Pet Peeve

    marachne replied to BookwormRN's topic in General Nursing

    Why is it that there are Medical Students, but we have Student Nurses? Seems like more of the demeaning of the profession. If they want to be medical students great, but call my students nursing...

  22. Pain management in LTC

    marachne replied to bluegeegoo2's topic in Geriatric, LTC

    pain is definitely undertx in LTC, esp in the confused. One thing to be aware of is that non-verbal pain can be expressed differently in people with dementia. Get a hold of a copy of the PAINAD - it's...

  23. OHSU or Linfield

    marachne replied to lilikoi's topic in Oregon Nursing

    I don't think it will have any effect on clinicals. For one thing, OHSU students are at many different settings, not just OHSU (just like there are students from other programs at OHSU). As student,...

  24. Anyone in PhD program?

    marachne replied to babyNP.'s topic in Post Graduate Students

    I think it's a good idea to have some idea what you are interested in. It becomes a kind of ritual: the beginning of every term, everyone goes around, says their name and their "area of interest."...

  25. What should I do?

    marachne replied to dohzenOFF's topic in Post Graduate Students

    FWIW, the only studying I did for the GREs was to go through the practice disk about 3-4 times. I did very well on the actual