tewdles RN

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

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All Content by tewdles

  1. tewdles

    How many patients do you see each day?

    tewdles replied to Vtachy1's topic in Hospice, Palliative

    Please talk with your management about this. You will burn out (develop compassion fatigue) if you are not able to care for yourself with this workload. Unless those 17 patients are residing in...
  2. tewdles

    Careplanning for Comorbidities?????HELP?????

    tewdles replied to AtlantaRN's topic in Hospice, Palliative

    interesting... so we just admitted a pt with a co-morb of htn, well controlled and asymptomatic. we did not include that in the poc. whispera, I have worked for several hospices and we were never...
  3. tewdles

    Taking the time to educate the families

    tewdles replied to jeannepaul's topic in Hospice, Palliative

    We use a caregiver handbook that has lots of useful information for families in caring for loved ones with declining functional status. The handbook identifies typical problems and outlines...
  4. tewdles

    Pain management: CA pt mets to bone and '20%of kidney function left'

    tewdles replied to coogabooga's topic in Hospice, Palliative

    my original post never showed up... I also agree that gabapentine might be a good option and that a steroid may help. Is the patient a candidate for palliative radiation for the bone
  5. tewdles

    IV certification / wound vacs / PCAs common?

    tewdles replied to amarilla's topic in Hospice, Palliative

    wound vacs are more the territory of home care...too expensive as a general rule for hospice...and our focus is more on stabilizing and comfort otherwise, hospice patients can be complicated train...
  6. tewdles

    Is this legal?

    tewdles replied to missladyrn's topic in General Nursing

    Sounds like the hospital has a bad policy that was poorly executed. Seriously?, the NM and educater searched your locker, with others present, told them what was going on, and you heard about it...
  7. tewdles

    Warning: Rant enclosed

    tewdles replied to JZ_RN's topic in General Nursing

    This is part of the reason that I love hospice...the physician is a member of the team, not the
  8. tewdles

    Got my license in WA with simple possession of marijuana

    tewdles replied to Saab93's topic in Licensure: Criminal History

    marijuana laws are
  9. tewdles

    Have you ever cried when a Pt died

    tewdles replied to Topaz7's topic in Hospice, Palliative

    Some of us shed a tear and some of us don't. If your eyes fill with tears, know that it is okay...but check yourself and your emotions as it is important not to reverse roles with the family. We...
  10. tewdles

    Chronically late patients...

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

    I am not recommending zingers for your tardy patients. I would recommend that you discover how the chronic tardiness impacts your workflow and then submit a proposal to remedy the impact. If your docs...
  11. tewdles

    Taking off your Nurse's Cap

    tewdles replied to GinaDecorRN's topic in Hospice, Palliative

    I agree that the MSW presumed something and then admonished rather than observe and then ask. As a hospice professional I will apologize for that behavior even though I am certain that you know it...
  12. tewdles

    How would you react to a corrective resignation letter?

    tewdles replied to EarthwormRN's topic in Nursing Career

    I am guessing that your resigned employee did not feel confident that there would be an exit interview but felt strongly that management should know the reasons anyway. I would read it with interest...
  13. tewdles

    Are nurses forced to assist abortions?

    tewdles replied to lookingintoRN's topic in Activism, Healthcare

    It's easy...don't work in areas where that might be an issue. Or, request a different assignment. Or select an employer that does not provide that service. Or, consider why this is an issue for you...
  14. tewdles

    What's the difference between a graduate nurse and an experienced nurse?

    tewdles replied to Joe V's topic in Nursing Humor

    A graduate nurse cries when the doctor yells at them. An experienced nurse waits til the rant is over, asks the doc if they are better now, and proceeds to obtain the needed medical
  15. tewdles

    It shouldn't have happened this way....

    tewdles replied to nerdtonurse?'s topic in Hospice, Palliative

    or for that matter, what difference does the O2 sat
  16. tewdles

    Does the board of nursing over ride union?

    tewdles replied to determined2doit's topic in Collective Bargaining, Union

    why don't you pose this question to your state board of nursing? Here's a hint, from who does the nurse obtain a license to practice as a
  17. tewdles

    help please! morphine side effects!

    tewdles replied to missnurse2012's topic in Patient Medications

    The hospice agencies may be prescribing morphine in ml rather than mg but it is a dangerous practice and should not be encouraged. There is a big difference between writing medication instructions for...
  18. tewdles

    help please! morphine side effects!

    tewdles replied to missnurse2012's topic in Patient Medications

    I imagine that all of us nurses know that this is a "bad practice" setting the scene for serious medication errors. I am surprised that your nursing or facility management does not put a stop to it...
  19. tewdles

    help please! morphine side effects!

    tewdles replied to missnurse2012's topic in Patient Medications

    As others have intimated, the "mistake" was actually the providers, for writing an improper medication
  20. tewdles

    Hospice and Ventilators? Need input please

    tewdles replied to ovnerati's topic in Hospice, Palliative

    In my opinion, the ventilator for a COPD patient is aggressive treatment. The COPD can be considered a co-morbidity, however, E/S COPDers often have heart failure secondary to their pulmonary disease...
  21. tewdles

    "Starving to death"

    tewdles replied to Vtachy1's topic in Hospice, Palliative

    One thing that is helpful sometimes is to ask the family if they have ever had a loved pet die of "natural causes". If they have, they are often aware of the social withdrawal and disinterest in food...
  22. tewdles

    Nursing Home Blues

    tewdles replied to circularstaircase's topic in Geriatric, LTC

    Stand firm on your precepting/mentoring needs. At the same time know that it is normal to have little confidence when you start a new job. Definitely stay out of the gossip arena. Do not get...
  23. tewdles

    I BELIEVE

    tewdles replied to GitanoRN's topic in Spirituality, Religion

    I believe that even men can be squishy emotional
  24. tewdles

    Things I noticed as a patient...

    tewdles replied to theantichick's topic in General Nursing

    I am a firm believer in addressing infection control issues IN THE MOMENT when in the hospital as a patient or visitor. For instance, when my dh was hospitalized I made the unit aware immediately...
  25. tewdles

    "Starving to death"

    tewdles replied to Vtachy1's topic in Hospice, Palliative

    It sounds like you did fine. These are hard questions for hospice professionals and the family asking are occasionally not wanting to hear what we must tell them. If your agency does not have printed...