tewdles RN

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

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All Content by tewdles

  1. tewdles

    I need help processing my first hospice patient experience.

    tewdles replied to pkateRN's topic in Hospice, Palliative

    We use anticholinergics for pulmonary congestion/secretions at EOL...we like to prevent the "death rattle" when we can as it is very upsetting for the family and potentially uncomfortable for the...
  2. tewdles

    Critical Thinking: you have it or you don't. Agree or disagree?

    tewdles replied to LTCnurse11's topic in Nursing Professionalism

    Critical thinking is what we learn and then practice to make habit. Good nurses develop this skill early and hone it over time. We have probably all worked with nurses who have poorly developed...
  3. tewdles

    Giving up

    tewdles replied to MommyandRN's topic in Nursing Career

    Of course most hospitals could use more nurses...more nursing hours per patient = lower rates of complication and readmission. Too bad most administrators can't see past their own paycheck to...
  4. tewdles

    How to get into palliative care consulting within a hospital

    tewdles replied to roma4204's topic in Hospice, Palliative

    You need expertise in palliation of symptoms. The palliative certifications are generally recommended after practice in the area for 2000 hours or so. Many palliative programs use APNs for inpatient...
  5. tewdles

    nurse coming to work drunk

    tewdles replied to nickola's topic in Patient, Colleague Relations

    I think that it is true that one could not say for certain that the nurse was drunk...but it can be said with certainty that she was not able to carry out her professional duties and should not have...
  6. tewdles

    New LPN Seeking Info On How To Become Hospice Nurse

    tewdles replied to nowdistracted's topic in Hospice, Palliative

    In a previous hospice position, I worked regularly with LPNs who were "teamed" with RN CMs for delivery of care. These teams often managed the care of up to 20+ patients who often resided primarily...
  7. tewdles

    Degree Without the Major Imprinted On It?

    tewdles replied to Denroc72's topic in Indiana State University

    Yup, different Universities do it differently. I have had employers ask for a copy of my degree as well as transcripts...even though I have decades of nursing
  8. tewdles

    Good nurse vs bad nurse

    tewdles replied to PankaD89's topic in Geriatric, LTC

    You've been working PRN since August? The old rule of thumb is that it takes 6 months in a new nursing job to feel like you are not dangerous...that is typically in a FT position. It sounds like you...
  9. tewdles

    RN to MD

    tewdles replied to kalevra's topic in General Nursing

    Yup...happens all the time. I have worked with MDs and DOs who started as CNAs, EMTs, RNs, LPNs, RTTs, Police, Chaplains, teachers, etc. The nurse to MD transition makes good sense in my
  10. tewdles

    nurse coming to work drunk

    tewdles replied to nickola's topic in Patient, Colleague Relations

    It seems that the facts are: 1. The nurse presented for work when unable to complete her duties secondary to illness (the cause of that illness or inability to work is not really relevant to you as...
  11. tewdles

    Does anyone carry a Care Kit/emergency meds?

    tewdles replied to NativeNewEnglandah's topic in Hospice, Palliative

    It sounds like perhaps you are using a mail order hospice pharmacy and have comfort kits present in your office for admits. Will your agency let you take an extra kit with you for the unexpected...
  12. tewdles

    Sign on bonuses

    tewdles replied to Yuvonne's topic in General Nursing

    Some hospitals offer bonuses because they are located in parts of the country where there really is not a glut of competent
  13. tewdles

    Morphine neurotoxicity

    tewdles replied to aphillipi's topic in Hospice, Palliative

    nah...in hospice we wouldn't check the labs...but it is appropriate to switch opiate to eliminate the noxious
  14. tewdles

    Using PPS Palliative Performance Scale

    tewdles replied to military spouse's topic in Hospice, Palliative

    Our job as nurses, is to take the info from the various tools and paint the picture of the "whole" patient for the team. Without the tools the picture becomes too narrative and subjective. We have to...
  15. tewdles

    Who actually likes nursing??

    tewdles replied to mmcnabb3's topic in General Nursing

    I have been practicing nursing for more than 30 years and I enjoy it thoroughly. I have not always enjoyed every nursing position I have held, nor have I cared for every employer. But nursing has been...
  16. tewdles

    Using PPS Palliative Performance Scale

    tewdles replied to military spouse's topic in Hospice, Palliative

    The person who had evaluated earlier either hadn't been properly trained in the use of the tool...OR...the patient improved significantly in one
  17. tewdles

    Using PPS Palliative Performance Scale

    tewdles replied to military spouse's topic in Hospice, Palliative

    The problem with scoring patients that way is that it then becomes difficult to document their actual decline. Good
  18. tewdles

    What is nursing really about?

    tewdles replied to Starkrav's topic in Nursing Career

    Hospice, Home
  19. tewdles

    Using PPS Palliative Performance Scale

    tewdles replied to military spouse's topic in Hospice, Palliative

    Are you confusing the FAST with the PPS? The FAST has a level 7c which describes the ambulatory ability of the patient and is used in determining how severe the dementia may be. It is the "Functional...
  20. tewdles

    fungating facial wound

    tewdles replied to NC29mom's topic in Hospice, Palliative

    We often put lidocaine on the painful wound
  21. tewdles

    Salary for assistant nurse manager/clinical supervisor

    tewdles replied to misswoosie's topic in Nurse Management

    seems low to
  22. tewdles

    Nurse managers-Do you think tattoos look professional?

    tewdles replied to Blackcat99's topic in Nurse Management

    As a nurse manager I am concerned with the professional skills of the individual I am interviewing. I uphold corporate policy regarding professional appearance. The tatoos of a prospective staff...
  23. tewdles

    never been screamed at like this before :(

    tewdles replied to mmc51264's topic in First Year After Licensure

    Like water off a ducks
  24. tewdles

    Do you think psychiatric care is inadequate in the US?

    tewdles replied to MusicEMT's topic in Activism, Healthcare

    I have been a nurse long enough that I remember when the funding for mental health care dried up decades ago. Regional and state mental health facilities were closed and the residents were put out of...
  25. tewdles

    Should Healthcare Be Funded As A Basic Human Right?

    tewdles replied to jayp's topic in Activism, Healthcare

    Are you advocating starting governmental programs other than medicaid and welfare to help people get back on their feet? You do realize that the greatest $$ abuse of medicaid and medicare occurs not...