tewdles RN

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

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All Content by tewdles

  1. tewdles

    Tell me your experiences with pulmonary fibrosis

    tewdles replied to Vtachy1's topic in Pulmonary

    I find that pulmonary fibrosis patients often have a rapid rate of decline from dx to death. They need LOTs of help with palliating symptoms. Fear, anxiety, depression, and control are often...
  2. tewdles

    Overcoming Apathy

    tewdles replied to EDEduc8R's topic in Nursing Educators, Faculty

    Sounds like a level of corporate compassion fatigue or burnout has hurt your nursing team. I recommend that you continue looking for things to draw them together, to re-ignite their passions for...
  3. tewdles

    Oncology Drug shortage

    tewdles replied to plum94's topic in Oncology

    I just got a partial does of my chemo yesterday because of the shortage. The clinic informed me that they cannot guarantee that they will have all of the agents for my FOLFOX at my next cycle, but...
  4. tewdles

    Has hospice agencies changed so much, we just don't recognize the industry??

    tewdles replied to SoCalRN1970's topic in Hospice, Palliative

    Noey, you have definitely been through the employment ringer over the past months. I has been almost painful to follow it through your posts. Unfortunately, just like with any high stress nursing job,...
  5. tewdles

    Using the FAST scale in Hospice

    tewdles replied to Axelsmomma's topic in Hospice, Palliative

    How about adding another functional assessment tool to the practice to help you qualify the borderline patients? For instance, the Palliative Performance Scale works well for us and may be more...
  6. tewdles

    NRB & COPD your input please

    tewdles replied to crb613's topic in Emergency

    Both CPaP and BiPaP are sometimes useful for palliating symptoms in hospice
  7. tewdles

    Nurses union to University of Michigan: 'no cuts' to benefits

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

    Even not for profit hospice nurses in the AA area make more than 60k...so if you are in a hospital system in Jackson, Howell, or the greater metro Detroit area and don't make similar wages you are...
  8. tewdles

    Explaining post op pain to patients

    tewdles replied to ReginaPhalange's topic in Patient Education

    I also have recently been a post op patient...twice in 30 days...and nobody spoke to me about post op comfort prior to the surgery. Oh wait, we did talk about the use of an epidural in addition to my...
  9. tewdles

    Home Care Home Base

    tewdles replied to CardioTrans's topic in Home Health

    Thanks for that. I don't work in HH or for that company anymore (thank God!) I am not in the habit of purchasing specific equipment to allow reasonable access to charting...that is the...
  10. tewdles

    Nurses union to University of Michigan: 'no cuts' to benefits

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

    My family uses the U of M health system...and has been very happy with the care. It is one of the best medical systems in the world. I, personally, use the other health system in AA and believe that...
  11. tewdles

    Is medical marijuana effective for cancer patients?

    tewdles replied to annacat's topic in Oncology

    My experience with oncologic hospice patients and medical marijuana vs marinol is this... The marijuana is often most effective for them when they use either a vaporizer or consume it. Smoking it...
  12. tewdles

    Staff Splitting

    tewdles replied to KateRN1's topic in Nurse Management

    Sounds to me like your management team needs to have a meeting and establish some ground rules. Your entire office will suffer if this new manager succeeds in dividing the management staff in any...
  13. tewdles

    Non-healing Wounds

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

    "Kennedy" ulcers are not uncommon at end of life, particularly in the very elderly. We are often unable to slow or stop their progression as the patient continues to decline with poor nutrition, poor...
  14. tewdles

    Average doseage of conscious sedation while doing endoscopy's

    tewdles replied to lmbv55's topic in Gastroenterology

    I don't know the usuals for this nursing field and did not read all of the posts... I had a colonoscopy last month for a new cancer dx and received propofol. It worked great and I recovered VERY...
  15. tewdles

    Role of a Hospice RN in the SNF?

    tewdles replied to brenrn06's topic in Hospice, Palliative

    Hospice nurses are partners with the facility nurses in the care of the patients living there. It is imperative that we have good, professional, trust relationships with that staff so that we can...
  16. tewdles

    Home Care Home Base

    tewdles replied to CardioTrans's topic in Home Health

    I found that charting for 6-7 patients everyday on a PDA/phone was killing my wrists and neck...I just need a keyboard and a bigger screen for that much documentation. I did not mind the software...I...
  17. tewdles

    NRB & COPD your input please

    tewdles replied to crb613's topic in Emergency

    COPD patients should be on a palliative medicine service. They will die from their disease unless some co-morbidity or similar kills them in an acute incident. When they have acute failure they often...
  18. tewdles

    documenting

    tewdles replied to LizzieRN0508's topic in Medical-Surgical

    Worked with a nurse who didn't chart the ordered neuro checks through the night, he said he checked the patient regularly. So when the patient was found to have a significant change in LOC toward the...
  19. tewdles

    Morphine and Hospice Patients that are dying

    tewdles replied to suzi0612's topic in Hospice, Palliative

    This is not too high of a dose. It is common to start dosing at 5 mg Q1-4 prn for the opiate naive patient, but it can go up from there. We currently have a patient who is taking 200mg Q2-4 hr for her...
  20. tewdles

    Coached on carrying Narcotics in my pocket...

    tewdles replied to royaso's topic in General Nursing

    You'll be fine. Most of us have made mistakes in our careers...the trick is to learn from them. Use your critical thinking when considering a short
  21. tewdles

    Treating the whole patient?

    tewdles replied to tokmom's topic in General Nursing

    I think stargazer made this point...this is not measurable in it's current form. You CAN treat the whole patient (this is a huge part of what we do in hospice). We look at some of the individual...
  22. tewdles

    Drug Screen Question

    tewdles replied to RHIA, RN's topic in General Nursing

    I am thinking that you have a current Rx for the med and that should cover you. I, personally, am not a supporter of routine drug testing. Good
  23. tewdles

    what would you do!!!!

    tewdles replied to sweetnurse63's topic in General Nursing

    I was actually taught to intubate in my clinical setting for pediatric and neonatal transport. I did learn to intubate adults during ACLS though, actually used it once as a first responder to an...
  24. tewdles

    Morphine and End Of Life

    tewdles replied to MelissaLPN's topic in Geriatric, LTC

    I talk to patients all the time, everyday, who take morphine or dilaudid ATC (sometimes in very large doses). "Once I give you this you will no longer be able to speak..."????? Oh my word, whoever...
  25. tewdles

    what would you do!!!!

    tewdles replied to sweetnurse63's topic in General Nursing

    Back in the day intubation was part of the ACLS training...IF (and that could be a really big IF) I remember correctly. Given that I am an "old grumpy nurse" we might expect that Sometimers disease...