tewdles RN

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

Member

  • Content

    3,156

  • Visitors

    33,351

  • Followers

    0

  • Likes

    37

All Content by tewdles

  1. tewdles

    Demanding resident-vent

    tewdles replied to NurseLoveJoy88's topic in Geriatric, LTC

    Thank you heron... I agree that our patients with chronic pain MUST be watchful for the timing of their doses. This is THEIR responsibility first, not the nurses'. To somehow disable the alarm clock...
  2. tewdles

    RN's as Health Coach?

    tewdles replied to jcm1015's topic in General Nursing

    This the role that primary care nurses often fill. Those nurses follow the patient through the spectrum of life and offer education and intervention based upon the nursing process. As physicians...
  3. tewdles

    Ativan...do i hold or give?

    tewdles replied to payang0722's topic in General Nursing

    To be clear... It is appropriate to hold the benzo when the symptom is resolved. It is the job of the hospice to change the orders. The bedside nurse in the LTC should contact the hospice and...
  4. tewdles

    Ativan...do i hold or give?

    tewdles replied to payang0722's topic in General Nursing

    I appreciate facility nurses who call me when they are uncertain about a med or the status of a patient. We are partners in the care and I encourage their use of the nursing process. It is always...
  5. tewdles

    How can your pharmacist help?

    tewdles replied to Rdaily's topic in Home Health

    Even as a home care nurse I often collaborated with the pharmacist that filled the Rx's for my patient. I had no reservation in calling them and asking questions about the meds, spacing, side...
  6. tewdles

    How can your pharmacist help?

    tewdles replied to Rdaily's topic in Home Health

    This is a feature that we enjoy in hospice, the presence of a pharmacist on the interdisciplinary
  7. tewdles

    Day in the life of a hospice nurse

    tewdles replied to FirstYear2005's topic in Hospice, Palliative

    We do not use 485s. Documentation should occur during the visit or directly after...if you are charting at home at night something is not right. It is common to have to phone a physician more than...
  8. tewdles

    off duty nursing?

    tewdles replied to JSlovex2's topic in General Nursing

    I have been first responder to a number of accidents on the road, at the skate park, at the beach, etc. Whether or not you help is completely up to you...I need to help however I can as I would hope...
  9. tewdles

    Management of severe EOL pulmonary edema

    tewdles replied to SurrealMoment's topic in Hospice, Palliative

    Subcutaneous scopolamine stat! then the patch (1-3, Q72hr) and Q4hr Atropine or Levsin (whichever your doc prefers). I totally agree that the best thing you can do is get them as dry as possible. I...
  10. tewdles

    FAST Scale

    tewdles replied to aub123's topic in Hospice, Palliative

    It is true that the FAST scale was developed to stage the progression of Alzheimers victims, however, over time it has become apparent that the form can provide valuable insights into the decline of a...
  11. tewdles

    Tufts nurses vote 70% to authorize strike

    tewdles replied to Chin up's topic in Collective Bargaining, Union

    As the middle class shrinks and the wealthy and corporate interests gain increasing power in the USA, unions will be limited, squeezed, and ultimately broken...just
  12. tewdles

    Do you do venipunctures as a nurse?

    tewdles replied to CassB's topic in General Nursing

    I consider intravenous skills part of the basic skill set for RNs...not expertise necessarily, but certainly basic technical skills. Many RNs may not start IVs or draw blood in the acute care hospital...
  13. tewdles

    Breach of Confidentiality?

    tewdles replied to Double-Helix's topic in General Nursing

    Here is my litmus test; Did I use my position as an RN, employee, health care professional to gain any knowledge (any at all) about this patient's private and protected personal information? In this...
  14. tewdles

    Person-centered approach

    tewdles replied to b0rea1is's topic in Patient Safety Issues

    It is difficult to mix dementia patients in with general population residents with no cognitive impairment because of the safety issues. I believe it is in the dementia patient's best interest to...
  15. tewdles

    Overnight Care for children?

    tewdles replied to LilNurse2b143's topic in General Nursing

    When my dh and I both worked 3rd shift at the hospital our small child slept at the home of a family member who lived near our work. It IS really hard to find good, safe, affordable care for your...
  16. tewdles

    When and where do home health nurses go to a restroom?

    tewdles replied to 50kn's topic in Home Health

    My understanding is that if you are providing episodic rather than shift nursing to patients in their homes you should NOT use the patient bathroom. Most home care and hospice nurses discover the...
  17. tewdles

    What is your Hospice paying for mileage

    tewdles replied to jeannepaul's topic in Hospice, Palliative

    Yikes...I would guess no hospice is paying adequately to cover the expenses when gas is headed toward $5/gal. Can someone in Washington please save us from the greed of corporate
  18. tewdles

    What kind of pt am I?

    tewdles replied to jfpruitt's topic in Emergency

    Everyone has an opinion and you are entitled to yours. Sometimes it is clearly more sophisticated..sometimes it is clearly NOT and is a pure and simple case of yet another nurse who really does not...
  19. tewdles

    Dining room vent.

    tewdles replied to Forever Sunshine's topic in Geriatric, LTC

    Forward the complaints about cold food, etc to administration. Tell the dietician it is not his/her job to decide if your adult patients may watch tv during dinner. Do you work in a prison or in...
  20. tewdles

    In the spirit of recent optimism, what is your true love?

    tewdles replied to canesdukegirl's topic in General Nursing

    Things I love; God, Family, Music, Peace, Love, Nursing. I could throw sex and alcohol in there but that is
  21. tewdles

    Family wants to transport body.

    tewdles replied to Buckyxj's topic in Hospice, Palliative

    Check your local laws...there are more options available to people than they know. The funeral home industry would like if every one were REQUIRED to use their services, but we are not...there are...
  22. tewdles

    Unlisenced assistive personell replacing nurse positions

    tewdles replied to Italia23's topic in Activism, Healthcare

    MAs cannot apply the nursing process to the patients who visit the office. They cannot determine what patients require and what they don't. They are dependent upon the MD for all guidance in...
  23. tewdles

    Medications through an ileostomy?

    tewdles replied to onewithhospiceheart's topic in Hospice, Palliative

    Yup, topical preps are common when folks can no longer tolerate oral meds. It is important to remember that if the person is actively dying they may not have great perfusion and some topicals...
  24. tewdles

    Hospice in Assisted Living Facilities

    tewdles replied to LookUp2Sky's topic in Hospice, Palliative

    ALFs are privately owned businesses and they may "ban" people or organizations from their property. The families have the option to change nurses, change hospices, or to change ALFs. You are stuck....
  25. tewdles

    hospice patient Vs. tracheostomy

    tewdles replied to neurontin's topic in Hospice, Palliative

    If the patient is alert and mentally intact he/she may be able to cough out secretions unassisted by suction, or he/she may be able to suction self. Pulmonary toilet in hospice patients is ALWAYS...