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Have any of you used butter, which when cold molds like a suppository? When a patient is no longer able to swallow, but still requiring larger doses of pain meds, and when IVs are too costly, I use this route. I mix the pain meds such as methadone (f...

Hi Nameste (BTW-I have spent YEARS in India!) I totally relate to you about "hello they are dying....", And as for the glycerine suppositories. Now, that it a GREAT idea! Our hospice is connected to a massive hospital-based center with over 10000...

They work well. The thing is the FDA has not given it its stamp of approval. Methadone is well documented to work rectally. But not in butter--although quite frankly unless they have a allergy to milk I cannot imagine it being any different then "sur...

Story one: I had a patient with some sort of civil war gun by his bed. I requested that his family removed it. I was assured they did, but guess what, he used it on himself. He was a very old man and it was so very horrible for us all and most of all...

I am certified. The test is about 300 bucks if you join the hospice and palliative nsg association....which is about 75 bucks to join...My work place reimbursed me, and they gave me a thousand dollar bonus. But as far as a raise goes: hmmm....I suppo...

When I give a pill or two of course I just use lubrication from a water based thing like lubriderm. But if a patient has 300 or 400 mg of morphine or 40mg plus of methadone (they are horse pills!) which requires administration then I think about an ...

Works really well in some cases. Remember to always have patient take po prior to first nebulized administration. There is a potential for a very bad reaction so if roxanol goes into the lungs death can and has occured. Copd pts really like it. The ...

Golly, when you have to deal with a 3d party such as a nursing home, and the nursing home is trying to look good even though they are negligent of pericare, and dump that on as your responsibility it is quite pathetic. Changing a care plan to increas...

bummer!! so close but too far! hey, sorry about the red. cannot get out of it! you can pass it for sure after all your experience with it first time around. i know what you mean about the strange questions like cord compression. i think we had th...

Your 4 years should provide you with a great knowledge base in order to pass. I can give you this advise: Use the sequel to the core cirruculum test questions book. There are about 400 question, mostly multiple choice. Take the time it takes to do t...

the Febreeze ritual, along with the lab jacket heist is hysterical! It reminds of the breast feeding years when i would drive down to a lonely river bank to "pump". Lord, what we have to do as hospice nurses! And the milk usually curdled. The only th...

it seems like things maybe have changed from this interchange. But actually our mission is to help pts. It is just that in hospice we are helping symptoms and the dying process be gentle loving and meaningful in a good way as possible. By negative c...

Sounds like a linguistic issue. Patients are supposed to be declining; however minimal the decline might be in some cases.The "iffy" patients are the ones that careful attn be paid to negative charting if appropriate. If you focus on the positive the...

RN golfer, your letter is really, really funny! Hospice nurses are such a kick! I just started viewing and interacting on allnurses.com yesterday. it is informative and fun and educational! I totally know what you mean about sucking in and absorbi...

hi, the ratio of po to iv morphine is 3 to 1. Subq should not alter the ratio since it is going directly into the blood stream via tissue and not thru the gut (thus the first pass issue is naught) i have worked with many a cadd pump using s...

i just took the exam yesterday. it was definitely not easy. Your experience is key to passing. the study guide questions is the most helpful way to study because then you can see what you may be weakest in and focus studying those weaker areas. the...

This reply is about 7 months late, but i just saw it! WOW we are about to have the gestapo (i mean joint commission) come. It is a shame your boss believed and embraced Joint Commission. The organization is a guise for "goodness, standards yade...

Morphine is the answer. But you tried to express that there may have been some other factors which were not evidence based which precluded your feeling morphine was what your pt needed. That happens to EVERYONE once in a while. But for this circums...

I hear what you are saying about funerals. After developing some intense and short term meaningful relationships with pts/caregivers, I used to feel I was obligated to go. Its true it feels "right" following thru with the initial grief support by ho...

I just took the exam offered through the american hospice and palliative board (RN) It was a challenge! I was surprised that the results came through the minute I walked out of the examination room. I am writing to ask if anyone else took it on Marc...

Our hospice will not hire a new grad with less than 1 year. I have been a hospice nurse for 12 years. My experience is that without a good year or 2 of full time nursing your skill level may still be a little shaky. A good hospice nurse needs not ...