Kittypower123 BSN, RN

...the foley leaked all over the floor.

Hmm...sounds like A-Fib.

That is not actually the case. AZ patients who qualify for hospice meet a FAST of 7A and a PPS of 50 or less. They may still be ambulatory (loss of that ability is further down on the scale) and still feed themselves. In addition, decline is document...

I was watching The Walking Dead and the town they were in was attacked. Not by zombies, by other people. Anyway, a woman is carried into the clinic with a large slash wound to her abdomen. The lady who was the "doctor" (she was actually a psychiatris...

All the things mentioned above are good points. I think it's important as well to involve the nurses at the LTC in the decisions about changes to POC and/or meds. They know what's going on with the patient and don't want to feel like their being judg...

Sometimes patients with Alzheimer's have increased agitation with Ativan. Perhaps try Haldol instead rather than in addition to. I've seen Haldol and Seroquel given together work well too. When all else fails, I have seen Thorazine work. Also, that d...

Hopefully you have a copy of the FAST with you for reference. It's important to remember that you cannot skip an item. Start at number one and continue until something doesn't apply to the patient. Numbers 1 through 5 are one item each. Once you 6, t...

I'm sorry that your mom is ill. You are going through a difficult time and difficulty in many aspects of life is not unusual. If your mom is not already on hospice, I would recommend getting hospice involved. They will have social workers and chaplai...

Just this week I had to talk to the Medicare Part D for a patient. I gave the name, dosage and diagnosis for each non-covered med as well as the hospice diagnosis. Once I had done that, the person I talked to processed the meds and faxed the prior-au...

It hasn't happened to me personally, but I did know a nurse who went through something similar. You need to allow yourself time to deal with your grief. Do something else for awhile and if you decide to come back to hospice in the future you'll be be...

Havd you tried Methadone? I have had very good results with methadone for bone mets pain. It takes 3 days to build up in the system so you have to wait before titrating. For my patients with bone mets, I talk to the doc early about getting methadone ...

I've dealt with death personally and I'm surprised to hear you say that you "got over" the death in your family in two weeks. When someone you are close to dies, you don't ever "get over" it. You grieve, deal with it and move on, but it changes you. ...

I think I'd ask for more time at the HH, not just shadowing, but helping the nurses and actively seeking to be involved with procedures you're not familiar with. You need to get hands-on as much as possible with someone there to guide you and help yo...

I also worked in LTC first. I learned a lot and feel that I was better prepared for hospice.

We had a patient with a similar problem. We used zinc oxide applied daily (after cleaning the legs of course) covered with abd pads and wrapped with kerlix. We did the wound care daily and the wounds really improved. We were eventually able to reduce...

Could you get an order for Haldol cream/gel? Easier to teach the caregiver to administer and safer for CG and patient.

I'd suggest going straight for your RN, LPN's have limited roles in hospice and many aren't hiring LPN's anymore.

At our hospice, the patients with G-tubes were admitted with them. We won't make them stop using the g-tube but will only pay for the formula if it is the patient's only source of nutrition. If a patient stops eating, or progresses to the point that ...

I hate it when they run!

The theme song to Mission Impossible

Having worked in long term care for some time, first as a CNA, now as a nurse, I know how important touch is to the residents. A hug, a hand on the back or shoulder, even a quick squeeze of the hand lets residents know that they are not alone, that s...

Reminds me of when I was a CNA, I found a gentleman on the floor under a table in the dining room. When I asked him what he was doing, he told me he was trying to fix the thing-a-majig on the train. Apparently, he used to work on trains.

The job of a hospital or other healthcare facility is to provide an environment of healing for the patients. This includes protection against facility acquired illness. Influenze can be particularly harmful to patients in the hospital who already ha...

Look up your facility's protocol and follow that. It doesn't matter what the regulation says. If you violate your facility policy, you will be cited. This happened at our facility when one of the nurses did not administer meds seperately and flush in...

Been there done that. Generally I'm pretty good at getting out on time, even with the charting. Sometimes though, I have one of "those" nights and just can't get out on time. I've found that if I fill out a missed punch slip with the reason I had to ...