beckyjo

I need advice from experienced hospice nurses. I have a patient that I care for at home. She is an elderly lady with IDDM, Chronic renal failure, Left above the knee amputation the other leg is turning black. the only dialysis access they can get in her is a subclavian. My problem is when I speak to the family they say they know that she is going to die and they just want to keep her comfortable. but thier actions are much different. The daughter refuses to give the pain medication on a regular basis. I have explained to her numerous times the ratioanle for giving it routinely. I questioned her about her mothers acceptance of death. She said that she has had her coffin made for the last 2 years and she has the clothes picked out to be barried in. When i spoke with the son he stated that I was wrong about her wanting to die, he said she still has "zest for life". What am I doing wrong here????? What can I do to help this family? I think they are really going to have a rough time when she dies. This is a Arabic family.

I had a quadraplegic patient that asked me to hold the kleenex while he blew his nose. He liteally filled the kleenex! I tried so hard not to have a disgusted look on my face as i felt the warmth of the mucous in the kleenex. I thought I was going to vomit right there. beckyjo

No I am not required to use OASIS, but I will take anything you got!

Yes please send them & thank you so much.

I am desperately looking for anyone who can send me some sample forms for charting nursing care for home health agencies. I am trying to improve my agencies documentation but don't have a lot of resources here in the middle east. I just need other forms to look at so I can get an idea of how to improve mine. (Ideas don't come natural to me). I need things like careplans for home health, forms used to document the nursing visit, medication sheets things like that. IF anyone can help I would be forever in your debt. Becky

Don't come to the middle east! I have yet to see a high tech hospital or a good salary.

I used to work with a nurse that was a Jehovah witness on a med surg floor. The way she dealt with the blood transfusion was if she had a pt who required a blood transfusion, she would set the whole thing up and then she would call one of us to come and push the start button on the IV pump. After that she monitored the infusion and discontinued it. Actually I worked with her a long time before I even knew that she was a Jehovahs witness. SHe just called on me one time to push the button for her and I thought how strange until she told me that she was a Jehovahs witness and then I thought that was a good way to deal with it. Hope this helps.

hollykate, Thanks for the advise. I am currently working in home health in the middle east. One of the most frustrating things for me is I cant' seem to get close enough to my patients to develop a therapeutic relationship. I do know some of the language but not enough yet. I am use to working in the hospital (Med/Surg) and the most rewarding part for me was getting to know my patients well enough to understand why they are not taking their medications or following their diet or why they don't want to get off insulin. I use an interpeter for things like getting a detailed history or education. BUt your right it really puts alot of distance between you and your patient. I am always looking for ways to get around this communication gap, but I don't feel that I have really succeeded. YET!

I agree that open and honest communication is the best way to develop a relationship with a patient, but what happens when you can't communicate with a patient because they can't speak your language and they come from a totally different culture?