vwevans

In our agency we write orders for Morphine Sulfate Solution 20mg/ml, give 0.5 to 1mL every 2 hrs prn pain, which is esentially the same order as you have but 2 hours instead of one hour. I prefer the 1 hr because an hours is a lifetime if you are hurting.

Do any of you have, or know where I can find, nursing care plans specific for Hospice care?

I work for DaVita in Texas and so far I am satisifed with the company. They have the best training program I have ever been involved with, allow you to learn at your own pace, and have been very supportive. Because they are a large nationwide company, I have many opportunities to relocate, travel, and stay with the same company. They are very strong supporters of their patients and are very strong in patient care and education.

We have a 5 bed inpatient unit. I staff 1 RN and 1 CNA on the day shift and one RN and one LVN on the night shift. As the manager, I am also available to help. Our SW is on the unit 20 hrs. per week helps as needed also. I would never have a 1:8 ratio. In order to give quality care and educate families you would never be able to do it well. I find it to be an emotional ride and not just the physical work that you have to deal with.

I am a male nurse (for 23 years) and I wear all white. It always surprises me when either the patient or family remarks about the all white uniform. Most of the time they are glad to see someone who looks professional and can be distinguished as a nurse just by the uniform. Seems to make them more comfortable. I am vocal about someone who wears something, white or otherwise, that is not ironed, looks dirty, or slept in. I tell them, without being critical, that they really do not look like a professional nurse. I suppose it just comes down to each person's self respect. If we want to be treated more professionally, then we need to act and look professional.

The facility I work at only has the Baylor Plan for RN's. It is great. Here you work weekends; 2 days and weekends are considered either Fri/Sat/Sun. Some work on Fri/Sun, others work Sat/Sun. You work 24 hours and get paid for 32. We get insurance and holidays as full time, but PTO (paid time off) is at 1/2 the time. The pay comes out to be around $45-$48 and hour when all hours are counted.

At the hospital I work, we generally have 8 patients. Recently I brought up the question regarding passing of medications for the 9 pm pass. If you give only 10 min. per patient, then that is a minimum of 80 minutes. This is very conservative as it does not take into account prn meds you have to stop to give, blood sugars that are due at 9 pm., having to wait in turn to get to the med dispense cart, crushing meds for G-Tubes, or for poor swallowing patients, IV meds, etc. We were made to sign a form for a commitment to "good patient care", yet when I brought up that the "time" of medication administration was one of the 5 rights and that either the meds were given untimely, or documentation was falsified if you gave them at 11 or 11:30 pm. My manager would not answer. What do you think?