tewdles RN

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

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All Content by tewdles

  1. tewdles

    cervical exams?

    tewdles replied to jennifers's topic in Ob/Gyn

    Remember that in nursing it takes about 6 months before you feel like you are not an idiot...SVEs would fall into that category. Just keep practicing while keeping in mind that the epidural patient...
  2. tewdles

    Source Program and Hospice at the same time???

    tewdles replied to AtlantaRN's topic in Hospice, Palliative

    I am not certain what "source" is, please
  3. tewdles

    Wisconsin has gutted Medicaid, no mandated ratios!

    tewdles replied to EponaRN's topic in Activism, Healthcare

    So...our health care delivery system is too expensive and the best way to control costs is to insure that only those who have insurance or can afford the cost receive the care? And those who have...
  4. tewdles

    "Fighting" Cancer

    tewdles replied to My3GuysinVA's topic in Oncology

    Jess, you cannot let your own grief and struggle with the horrors of cancer to cloud your perception of what cancer victims are experiencing. As a cancer survivor I can tell you that much of the...
  5. tewdles

    Doctors orders

    tewdles replied to new_worker's topic in Geriatric, LTC

    I would notify the family that the patient is painful. I would ask the MD for scheduled AND prn meds. I would clarify the type and severity of pain that the patient is experiencing...perhaps...
  6. tewdles

    Ready to get out of LTC

    tewdles replied to dukesgal's topic in Geriatric, LTC

    You should remain a professional while you are working. You should provide them with proper professional notice. You should participate in an exit interview if you believe that you can do so...
  7. tewdles

    Odyssey/Gentiva -No call returned?

    tewdles replied to Campbell'sSoupCan's topic in Hospice, Palliative

    The largest for profit hospice provider in the midwest does not need to be considerate or professional...their objective is to make
  8. tewdles

    How to inform family that pt is dying?

    tewdles replied to nrq9897's topic in Hospice, Palliative

    The correct verbage will differ from family to family. Signs and symptoms of impending death can sometimes be remarkably discrete. I agree that Gone From My Sight may provide you with some insight...
  9. tewdles

    RN supervisory visit Frequency?

    tewdles replied to new2hospiceRN's topic in Hospice, Palliative

    Most RNs will couple the sup visit with an assessment, just to be efficient...you have to see them at least once every 14 days anyway. Our aide supervisory forms are electronic and are actually a...
  10. tewdles

    Looking for a hospice caseload acuity tool

    tewdles replied to joyfulljen's topic in Hospice, Palliative

    When families are requesting unreasonable nursing visits because they are not able to complete the daily and ongoing care we are VERY direct about the need for either other in-home caregivers or...
  11. tewdles

    Patients dead from infected IV's....

    tewdles replied to MassED's topic in General Nursing

    You always look at TPN with a sepsis
  12. tewdles

    The "nurse in the family" business

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

    Yup, I agree that you are describing a professional RN case management business. I have a friend that has been in this field for 30 years now, self employed and autonomous. She also sub-contracts...
  13. tewdles

    New to Hospice Nursing... a bit overwhelmed! Need advice

    tewdles replied to makua girl's topic in Hospice, Palliative

    I love that we have to clarify that a vaseline ball should be administered rectally...lol Of course, I AM certain that if not specified some poor soul would most definitely try it po and then complain...
  14. tewdles

    morphine sulfate given even though has an "allergy" listed in chart

    tewdles replied to NurseLoveJoy88's topic in General Nursing

    This happens all the time in hospice. The "allergy" needs to be clarified in the chart. The collaboration with the MD, which includes discussion of the "allergy" to morphine must be clearly...
  15. tewdles

    Wisconsin has gutted Medicaid, no mandated ratios!

    tewdles replied to EponaRN's topic in Activism, Healthcare

    Really, you can't argue with people who believe that we (as humans) should get ONLY what we deserve and that there is no obligation on the part of the government to provide for the citizenry anything...
  16. tewdles

    Clinic question

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

    It is not illegal nor improper for an ambulatory clinic or community clinic to be "managed" by a non-nurse...at least in Michigan. It will be challenging for the nursing staff, you, to make sure that...
  17. tewdles

    Comfort kits

    tewdles replied to Mandee's topic in Hospice, Palliative

    Your agency gets to decide which comfort packs they want delivered/used. Our packs never have any HBR supps, some don't have morphine, some have levsin rather than
  18. tewdles

    Team Meetings & Hospice Nursing Diagnosis

    tewdles replied to LookUp2Sky's topic in Hospice, Palliative

    yikes!
  19. tewdles

    RN supervisory visit Frequency?

    tewdles replied to new2hospiceRN's topic in Hospice, Palliative

    Clearly you understand that you cannot supervise the RN and that your company will have some problems if they are surveyed. It is a normal expectation for nurses to complete baths if the nursing...
  20. tewdles

    Where do they still practice old-style nursing?

    tewdles replied to Joe NightingMale's topic in General Nursing

    lol at notion of "lower tech" and "slower paced" nursing...hospice nursing has a different focus and goals but is not necessarily low tech or slow
  21. tewdles

    Curious about HH and Hospice nursing

    tewdles replied to OB RNC's topic in Home Health

    Your lack of general nursing experience may prove difficult for you in the field with a complicated patient...in either home care or
  22. tewdles

    alternatives to nursing

    tewdles replied to Bostonrunner's topic in Hospice, Palliative

    I would recommend that you consider in what ways you might practice nursing that does not involve the acute care hospital setting. You have paid a lot of money for that education and now you have...
  23. tewdles

    Tell me about your continuous infusions

    tewdles replied to ErinS's topic in Hospice, Palliative

    We frequently have continuous infusions...most often Morphine or Dilaudid. We have standing medical orders which allow RNs to titrate pain meds up prior to the collaboration with the MD...but they...
  24. tewdles

    Unstable crazy situation-Help!!!

    tewdles replied to AtlantaRN's topic in Hospice, Palliative

    crazy people down there in Georgia...just
  25. tewdles

    RN supervisory visit Frequency?

    tewdles replied to new2hospiceRN's topic in Hospice, Palliative

    Hospice patients MUST be assessed by an RN at least once every 2 weeks...if they are not your agency is out of compliance with medicare