tewdles RN

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

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All Content by tewdles

  1. tewdles

    Skin tear in Assisted Living

    tewdles replied to MommaRN86's topic in Geriatric, LTC

    Additionally, the amount of exudate will help you determine the best dressing...some skin tears are really leaky... yes, we need MD orders for wound dressings here in the USA...I know, silly isn't
  2. tewdles

    Nurses as Case Managers Model

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

    Consider the hospice case management model as used in LTC/ALF. That RN will be responsible for 12-25 patients in one or more facilities (depending upon the composition of the team). That...
  3. tewdles

    Imposing compassion?

    tewdles replied to TLDey's topic in Hospice, Palliative

    I will always advocate for bringing families with unrealistic or even inhuman ideals of "comfort care" into the IDT meeting. Certainly, we may not change their minds, but that is the ultimate support...
  4. tewdles

    Indentifying the dementia pt for meds

    tewdles replied to nursinger's topic in Geriatric, LTC

    All of the dementia units I work with use a photograph in the MAR. Some of them are really old photos...like time of admission, but a few take a new photo every
  5. tewdles

    NPO/clear liquid status during labor - evidenced-based?

    tewdles replied to ischialspines's topic in Ob/Gyn

    I thought you asked me if I encourage people to ignore the NPO orders...I thought I answered that. Personally, I am recuperating from my second significant abdominal surgery in 4 weeks and am not very...
  6. tewdles

    Lip care for patient on oxygen

    tewdles replied to MissIt's topic in Hospice, Palliative

    I also occasionally will ask the family to put a bit of the olive oil in the water they dip the toothettes in. Particularly when the patient is actively dying the OO can really help to keep the...
  7. tewdles

    NPO/clear liquid status during labor - evidenced-based?

    tewdles replied to ischialspines's topic in Ob/Gyn

    sweetnepenthe didn't say i was encouraging anything...just having a discussion and voicing another perspective. isn't that what this site is
  8. tewdles

    When should hospice discussion begin?

    tewdles replied to bsnanat2's topic in Hospice, Palliative

    ahhhh leslie...when COPD pts visit their doctors (especially in the last couple years of their lives) they are not well. we will agree to disagree on this, as I think that PCPs or their nurses should...
  9. tewdles

    When should hospice discussion begin?

    tewdles replied to bsnanat2's topic in Hospice, Palliative

    Many times these patients end up in the CCU or the ICU a result of chronic disease states that will ultimately end in death...COPD is an excellent example. Advanced directives, living wills, and...
  10. tewdles

    Need some advice please...

    tewdles replied to arabstarRN's topic in Geriatric, LTC

    I hope you have a good manager, although his/her decision to cut short your orientation doesn't support the concept of "good manager". I will reinforce what others have said. Talk to your manager....
  11. tewdles

    NPO/clear liquid status during labor - evidenced-based?

    tewdles replied to ischialspines's topic in Ob/Gyn

    I believe that we generally deprive laboring women of nutritional and hydration support. Low risk, moderate risk, and high risk labors are generally identified in the OB/GYN visit predelivery. I...
  12. tewdles

    Does this really make me look weak?

    tewdles replied to NanikRN's topic in General Nursing

    Working in hospice I often grow very fond of some of patients and families. It is actually reassuring for family members when the find tears on the cheeks of the staff who have walked this difficult...
  13. tewdles

    Hospital career after hospice nursing

    tewdles replied to mharden's topic in Hospice, Palliative

    While I appreciate leslie's sentiments, I prefer to think that new grads should come to hospice in an inpatient setting first. I think that the field practice can easily overwhelm them with a sense...
  14. tewdles

    How to get a job in management/administration

    tewdles replied to Le-Lee_FNP's topic in Nurse Management

    I recommend that you make certain that your immediate supervisor understands that this is your goal. Make sure that your goal is discussed at your evaluation. This will set you up to be considered...
  15. tewdles

    How to Address a Catholic Priest?

    tewdles replied to westieluv's topic in Medical-Surgical

    I would ask him. The priests that I worked with preferred that co-workers called them by their first names. Most of the patients refer to them as "father son of a gun (or
  16. tewdles

    Hospital career after hospice nursing

    tewdles replied to mharden's topic in Hospice, Palliative

    I know several nurses who have worked their entire careers in hospice. One in particular started as an aide, completed nursing school and obtained her BSN while working as a field nurse, She worked...
  17. tewdles

    End of my rope...

    tewdles replied to DLS_PMHNP's topic in Hospice, Palliative

    Sorry to hear you are feeling discouraged. My agency is NFP, we have intentionally low caseloads. RN Case Managers 0.8-1.0 FTE carry 10-12 patients when working solo. RN CM's working as a team with...
  18. tewdles

    My friend is dying.

    tewdles replied to General E. Speaking, RN's topic in Hospice, Palliative

    You are the perfect friend in this moment...may God bless you as you bless your
  19. tewdles

    Extreme anxiety

    tewdles replied to Vtachy1's topic in Hospice, Palliative

    xanax is a
  20. tewdles

    Is it time to leave hospice??

    tewdles replied to SoCalRN1970's topic in Hospice, Palliative

    Take care of yourself first, then you can care for the broken hearted and dying. Good luck
  21. tewdles

    Prescribing narcotics to drug seekers

    tewdles replied to Djuna's topic in Emergency

    I believe there is room for and have observed the practice of unconditional regard for patients by professional nurses even in the emergency department. I am always saddened by nurses who believe that...
  22. tewdles

    I am so freaking upset!!!!

    tewdles replied to AtlantaRn1's topic in Hospice, Palliative

    It is ALWAYS difficult when a team member drops a ball...lots of splainin and butt kissing to do after that while working to get the pt back into a state of well-being. Perhaps a meeting between...
  23. tewdles

    What equipment you take with you in the home

    tewdles replied to nursenation2's topic in Hospice, Palliative

    Take only what you believe you will need. All supplies stay inside the "clean" area of your bag until you need them. Keep a "common area" in your bag for things used each visit, like scissors,...
  24. tewdles

    Vaccination administration question - Help

    tewdles replied to Irishlass79's topic in General Nursing

    Your co-worker would benefit from an in-service on vaccine
  25. tewdles

    Hospice

    tewdles replied to Blackheartednurse's topic in Hospice, Palliative

    I would recommend you do some research on hospice. That you look at the death and dying statistics of this country. I suggest you read about palliative care and what quality of life means to people...