tewdles RN

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

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All Content by tewdles

  1. tewdles

    Siblings sharing a room

    tewdles replied to CapeCodMermaid's topic in LTC: Directors, Assistant

    I dunno... At the risk of sounding odd, my brother and I have a very close relationship. When we see each other we hug, hold hands, and a kiss full on the lips wouldn't be out of the ordinary. That...
  2. tewdles

    Why are new nurses treated poorly?

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

    Yup...there are mean nurses, therapists, social workers, doctors, pharmacists, etc, etc. College education doesn't magically change a meanie into a nice
  3. tewdles

    How Would You Rate Your Pain????

    tewdles replied to tnbutterfly - Mary's topic in General Nursing

    First...we shouldn't use the FLACC for adults, use the PAINAD instead. The pain scale works because it allows the patient to give their perspective of the pain, which is the most important part. If...
  4. tewdles

    interview in a clinic HELP!!

    tewdles replied to MarisaMc's topic in Ambulatory Care, Clinic

    You didn't say what type of docs practice in that setting... I worked in that environment with dual certified internists and pediatricians. Our patient population, therefore, spanned the age groups....
  5. tewdles

    BSN as entry into practice; why we decided against it.

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

    Again, I don't believe that the evidence supports the thought that a BSN is necessary for a nurse to be able to provide competent and effective bedside nursing. I do believe that higher educational...
  6. tewdles

    Home based RN business

    tewdles replied to DavinaRN's topic in Nurse Entrepreneurs, Innovators

    Professional nursing case management... I believe that these type of businesses will help to improve health outcomes in the
  7. tewdles

    What is hospice?

    tewdles replied to eflr's topic in Hospice, Palliative

    It sounds like your dad is in an inpatient hospice setting? It seems more like you are wondering if this hospice is practicing appropriately rather than what hospice "is". As the case manager to...
  8. tewdles

    Radical Management Strategy

    tewdles replied to oldenurselady's topic in Nurse Management

    In hospice we are honest with our patients from the start. We let them know if they are at the distant edge of our service area because it will impact our ability to get there quickly...requiring...
  9. tewdles

    Sending MD pictures of wounds on cell phone?

    tewdles replied to maddock26's topic in Wound, Ostomy, Continence

    You may be able to photograph the wound, but the photo should not be texted to a provider with patient identifiers as that would violate HIPAA. Texts are typically not secure forms of
  10. tewdles

    I need help processing my first hospice patient experience.

    tewdles replied to pkateRN's topic in Hospice, Palliative

    If your patient has rhonchi and and pulmonary congestion you can ask for atropine 1% gtts and transdermal
  11. tewdles

    Always wanted to be a Hospice Nurse

    tewdles replied to beatrice1's topic in Hospice, Palliative

    Most hospice nursing jobs are RN positions, do not require certification or BSN, but DO require experience for field positions. There are lots of resources for self education in the basics of...
  12. tewdles

    I need help processing my first hospice patient experience.

    tewdles replied to pkateRN's topic in Hospice, Palliative

    Because you are practicing in a palliative inpatient unit you can do things a bit differently, more cautiously so that YOU are comfortable as well. That is important. In the absence of agitation or...
  13. tewdles

    BSN as entry into practice; why we decided against it.

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

    I have commented before that we have decades of evidence that demonstrates clearly that a BSN is not required to be a competent and effective bedside nurse. Should professionals continue their...
  14. tewdles

    Medical Marijuana and Hospice Patients

    tewdles replied to StNeotser's topic in Hospice, Palliative

    Because it is not regulated in that fashion we cannot quantify in a typical fashion. I agree with your doc that we shouldn't worry much, there is not report of anyone dying because they smoked or ate...
  15. tewdles

    Read this email my NM sent to all the nurses.

    tewdles replied to GummibearsRN's topic in General Nursing

    If I wasn't behaving in that manner I wouldn't be concerned about myself but I might be glad to note that the manager is sick of
  16. tewdles

    How do you handle perceptions from other coworkers?

    tewdles replied to NoblePath's topic in Hospice, Palliative

    Ask your hospice for some professional information for staff. Decline to stick around for abuse of ignorant physicians. Invite outraged physicians to interact with your medical director so that they...
  17. tewdles

    RN rounding for Doctors?

    tewdles replied to traumasurgRN's topic in MICU, SICU

    no...different role, different
  18. tewdles

    Read this email my NM sent to all the nurses.

    tewdles replied to GummibearsRN's topic in General Nursing

    No intent to punish the other workers...also no intent to allow people to work and get paid when they are not following the
  19. tewdles

    Read this email my NM sent to all the nurses.

    tewdles replied to GummibearsRN's topic in General Nursing

    It's easy to be an armchair critic...or manager. It may not have been impressively eloquent but it conveyed her meaning...she means business and is fed up with the embarrassingly unprofessional...
  20. tewdles

    RN rounding for Doctors?

    tewdles replied to traumasurgRN's topic in MICU, SICU

    Most of the cases I am familiar with the nurses have standing orders and algorythms for their guidance that have been developed by the MD. Therefore, they are following MD orders when they implement...
  21. tewdles

    meds for actively dying

    tewdles replied to pnhopeful's topic in Hospice, Palliative

    Use the PAINAD to assess the obtunded patient for comfort. Moaning, groaning, grimacing are all evidence of discomfort. If the patient was uncomfortable when alert, we will assume that they are locked...
  22. tewdles

    meds for actively dying

    tewdles replied to pnhopeful's topic in Hospice, Palliative

    Depends upon the symptom constellation and needs of the patient. Each POC is individualized so you may not see that type of
  23. tewdles

    I Think I Want to be Done with Hospice

    tewdles replied to dialysisnurseLC's topic in Hospice, Palliative

    Agree that if the death of patients in general is distressing to you hospice is likely not a good fit at this time in your
  24. tewdles

    Want to gift my aides for Christmas

    tewdles replied to MarcyRN's topic in Hospice, Palliative

    I agree with Ruby, something personal is nicest and generally well
  25. tewdles

    Part time weekend Hospice job in addition to regular job... Am I crazy?

    tewdles replied to nurseart's topic in Hospice, Palliative

    I think that sounds like a well thought out plan. Don't worry about whether or not you have a "heart" for hospice nursing. I have come across a number of nurses who really had hospice "hearts" but...