tewdles RN

PICU, NICU, L&D, Public Health, Hospice

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All Content by tewdles

  1. tewdles

    fungating facial wound

    tewdles replied to NC29mom's topic in Hospice, Palliative

    We use lidocaine topically on painful wounds sometimes...or perhaps a topical morphine to the wound edges? Who doesn't hate painful wounds in a hospice patient! So unfair it
  2. tewdles

    Things You Didn't Learn in Nursing School

    tewdles replied to Joe V's topic in General Nursing

    They used to be well prepared. I attended college in MI...we practiced IVs on each other, passed NGs on each other. Those skills were required in order to pass, as were urinary catheter insertion for...
  3. tewdles

    Things You Didn't Learn in Nursing School

    tewdles replied to Joe V's topic in General Nursing

    Things I didn't learn in nursing school... Not every constipated patient has hard poop in their rectum. Hard poop is easier to get out of the rectum. Old women are not easy to catheterize. Old men are...
  4. tewdles

    Moving back to Alaska

    tewdles replied to Soon2BNmay's topic in General Nursing

    Good luck! As you know, Alaska needs more good nurses. And it is a good time to return...someone just turned the lights back
  5. tewdles

    Using PPS rating correctly-chairfast vs. bedfast

    tewdles replied to juniper111's topic in Hospice, Palliative

    The Palliative Performance score is designed to help remove some of the grey areas that are giving you guys
  6. tewdles

    question: can you chart on a pt. being rude?

    tewdles replied to aligar89's topic in General Nursing

    Describe the behavior rather than "diagnosing"
  7. tewdles

    Doctor texting order turned into a nightmare

    tewdles replied to Scotthudson1966's topic in General Nursing

    I havent read all of the posts, my apologies if this has been addressed... How are you protecting the privacy of patients through cell phone text messages??? Texts are NOT secure. IF you are...
  8. tewdles

    Death with Dignity in Hospice Setting

    tewdles replied to cuhome's topic in Hospice, Palliative

    I would like some additional information as well. the agency process sounds unethical as heck...when is it correct to give only partial information to our patients relative to their care and
  9. tewdles

    Difficulty with coworkers

    tewdles replied to MiriamRn's topic in Emergency

    Why leave nursing? It would make more sense to change nursing departments or
  10. tewdles

    Take big paycut and work more hours for possible better job?

    tewdles replied to Genista's topic in Nursing Career

    Many years ago I took a $10/hr pay cut and left the hospital setting for community health. It allowed me to practice in my small home town and I was significantly more available to my small children....
  11. tewdles

    Using PPS rating correctly-chairfast vs. bedfast

    tewdles replied to juniper111's topic in Hospice, Palliative

    PPS=Palliative Performance Score It is more descriptive and prognostic than the Karnovsky in hospice
  12. tewdles

    Keeping Patients Out of Hospitals: A Private-Sector Approach to Health Reform

    tewdles replied to chuckster's topic in Activism, Healthcare

    I tend to agree with you, Chuckster. Professional nurse case management of patients in the community would be less expensive and at least as effective. Patients shouldn't be interacting with RNs...
  13. tewdles

    Continuous subcutaneous infusions

    tewdles replied to tewdles's topic in Hospice, Palliative

    Your experience with these infusions mirrors my early experience with them although we used a different brand (CADD). Currently we don't have that level of pharmacy support and we are trying to...
  14. tewdles

    Ethical Question About Pacemaker

    tewdles replied to Nursingbride12's topic in CCU, Coronary, Cardiac

    I don't know what their experiences are, I only know what I know about end of life as it relates to pacemakers. I know that I work with people at end of life exclusively. I know that I have been doing...
  15. tewdles

    Transportation of presription- narcotic

    tewdles replied to kaitte's topic in Patient Medications

    wow...just wow we transport medications for our hospice patients all the time...nurses, msw's, chaplains, aides, volunteers, office staff, etc. I have requested that the meds be stapled in the...
  16. tewdles

    Transportation of presription- narcotic

    tewdles replied to kaitte's topic in Patient Medications

    So, obviously you were on the clock when this happened...what does your employer say about all of this? Does your agency have a policy that speaks to staff transportation/delivery of medications? It...
  17. tewdles

    SICK of BSN Pedestal

    tewdles replied to DUDERNGUY's topic in Diploma, ADN, BSN

    Sorry, but that is simply not true. I have worked with ADNs in ALL of those areas. One of the best VP of nursing that I ever worked with was an ADN. Fewer than half of the RN staff that I worked with...
  18. tewdles

    no provision for continuous home care

    tewdles replied to nurseebol's topic in Hospice, Palliative

    That is not the norm... The hospice that cared for my mother tends to offer continuous care when they identify that the patient is actively dying...we declined. There are some pretty specific...
  19. tewdles

    Continuous subcutaneous infusions

    tewdles replied to tewdles's topic in Hospice, Palliative

    How do you provide relief for your patients who have refractory symptoms not responsive to oral or transdermal meds? Do you have an inpatient unit that you admit to?
  20. tewdles

    Ethical Question About Pacemaker

    tewdles replied to Nursingbride12's topic in CCU, Coronary, Cardiac

    The evidence simply does not support the concern that the pacemaker will prolong the life of the patient. This would certainly be true for a pacer dependent patient, such as my daughter, but the vast...
  21. tewdles

    Work in Alaska?

    tewdles replied to thatchergirl's topic in General Nursing

    You couldn't pay me enough to live and work in Bethel... It is amazing to me that I have actually survived a winter with -55 temps! As a great lakes person I have been accustomed to cold weather but...
  22. tewdles

    New nice car

    tewdles replied to tinderbox's topic in Home Health

    When I worked in Home Health I drove a company car! In hospice I have preferred to drive used cars that are reliable... and as a previous poster stated...I drive it until it is undriveable. If you...
  23. tewdles

    Ethical Question About Pacemaker

    tewdles replied to Nursingbride12's topic in CCU, Coronary, Cardiac

    Some information addressing defibrillators and pacemakers at EOL.Curbside Consultation: Ethical Considerations of Patients with Pacemakers - August 1, 2008 - American Family Physician # 111 Cardiac...
  24. tewdles

    Ethical Question About Pacemaker

    tewdles replied to Nursingbride12's topic in CCU, Coronary, Cardiac

    Correct...most hospice patients will die without incidence with a fully functional pacemaker in place. If the patient or family want it DCd they may have it DCd and hospice will include it in the POC....
  25. tewdles

    New cna and a hospice agency

    tewdles replied to mysonsmama's topic in Hospice, Palliative

    Welcome to hospice! Love on your patients...listen...be kind and gentle...go slow...laugh with them...look at their photo albums. Your job will be all about helping your patients to enjoy a quality of...