tewdles RN

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

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All Content by tewdles

  1. tewdles

    Team Meetings & Hospice Nursing Diagnosis

    tewdles replied to LookUp2Sky's topic in Hospice, Palliative

    Geez okie..what are the "case managers" doing
  2. tewdles

    Wisconsin has gutted Medicaid, no mandated ratios!

    tewdles replied to EponaRN's topic in Activism, Healthcare

    Seriously...we are not bankrupting our children's future, we are ignoring it for the financial concerns of grown up people with other agendas. If we do not educate our children or insure that the...
  3. tewdles

    Where do they still practice old-style nursing?

    tewdles replied to Joe NightingMale's topic in General Nursing

    Hospice nursing (depend upon the company) can be very "nursing" friendly. The documentation may be electronic and exhaustive but the expectation is that you spend quality nursing time with the...
  4. tewdles

    Wisconsin has gutted Medicaid, no mandated ratios!

    tewdles replied to EponaRN's topic in Activism, Healthcare

    many people choose not to purchase health insurance because it is too expensive if they do not have an employer which shares the cost... and lots of people have trouble discerning charitable...
  5. tewdles

    Wisconsin has gutted Medicaid, no mandated ratios!

    tewdles replied to EponaRN's topic in Activism, Healthcare

    Comparing use of food stamps or a medicaid health benefit to petty theft is pretty
  6. tewdles

    REAL NURSING?

    tewdles replied to critical thinker's topic in Geriatric, LTC

    Seriously, if you are applying the nursing process to your care of the patient you are a real nurse. The setting you work in primarily determines the type of technical skills you must also develop...
  7. tewdles

    Do you pay more for health care than you get back?

    tewdles replied to starzrn's topic in Activism, Healthcare

    I will tell you from personal experience that it is financially devastating to require catastrophic care in the absence of insurance to pay the bulk of the cost. I give you kudos for taking firm...
  8. tewdles

    Wisconsin has gutted Medicaid, no mandated ratios!

    tewdles replied to EponaRN's topic in Activism, Healthcare

    I love it when we balance budgets on the health and backs of the low and middle class tax payors...being very careful not to over burden our wealthy residents or
  9. tewdles

    Hospice burnout?

    tewdles replied to Brightonrn1's topic in Hospice, Palliative

    You have to re-focus your attentions when you case manage primarily in the facility setting. Med reconciliation becomes a big issue, education of staff rather than family is the norm. Communication...
  10. tewdles

    nurse says, do you want her to be in pain

    tewdles replied to time4meRN's topic in Hospice, Palliative

    Yup, you witnessed a not very good example of hospice nursing
  11. tewdles

    blank signed scripts

    tewdles replied to hospicevet 20's topic in Hospice, Palliative

    No, not making a big deal over nothing... there is nothing legal about this practice and you (and the agency and the MD) would be in trouble if this practice were publicized... It is far better for...
  12. tewdles

    Unlisenced assistive personell replacing nurse positions

    tewdles replied to Italia23's topic in Activism, Healthcare

    Trust me, if there is no nurse in the doctor's office there will be no nursing diagnosis on the chart and the doctor will not "do
  13. tewdles

    advice patient over the phone

    tewdles replied to mumunki's topic in Ob/Gyn

    L&D units have very specific protocols about triaging calls into the unit. You will want to get your answers from the provider or your
  14. tewdles

    why call it diversion?

    tewdles replied to cecilsgirl's topic in Addictions

    "Divert means to draw off to a different course, direction, etc. The appropriate course of a medication would be, of course, from the pharmaceutical loction to the Patient. In this instance, the drug...
  15. tewdles

    Suicide

    tewdles replied to Vtachy1's topic in Hospice, Palliative

    I am not certain it is legal to nullify the DNR against the consent of a mentally competent patient. Having said that, I don't agree with it philosophically either. The patient has a terminal...
  16. tewdles

    Does anyone enjoy being a nurse???

    tewdles replied to Butterfly0328's topic in General Nursing

    I have been practicing nursing for over 30 years in a pretty wide variety of settings. This is my profession of choice and I enjoy it very much. I enjoy it in different ways now than I did earlier...
  17. tewdles

    Hospice Oncall Staffing

    tewdles replied to Rhawnda's topic in Hospice, Palliative

    250+ pts. Dedicated on-call nurses for after 1700, w/e, and holidays. Dedicated telephone triage nurses, we pay a service provider for these
  18. tewdles

    CHPN Exam

    tewdles replied to DLS_PMHNP's topic in Hospice, Palliative

    Did you take a course? I just read the study guide and flew by the seat of my
  19. tewdles

    Family just wants Grandma to die

    tewdles replied to Platypus's topic in General Nursing

    The bottom line is that the family (POA) has apparently determined that the patient should not receive antibiotics and that supportive comfort care will be the basis of the plan of care...including...
  20. tewdles

    In the honeymoon stage?

    tewdles replied to Vtachy1's topic in Hospice, Palliative

    Yes, pace yourself. Practice establishing impeccable boundaries now. I prefer to graduate from the "honeymoon" phase into the "old married coot" phase. You know, the times when you still love your...
  21. tewdles

    Compassion or reality for obese patients?

    tewdles replied to stefanyjoy's topic in General Nursing

    Imagine that your best friend is obese. How would you want him or her treated when in the hospital. How about if it were a first degree relative, perhaps your child...what would you expect the...
  22. tewdles

    how do you chart your prn narcs

    tewdles replied to mozella's topic in Geriatric, LTC

    As others have said, follow the protocol for your facility. Having said that, you should not have to chart it in 2 places. Given that the MAR represents you medication POC, that is where it should...
  23. tewdles

    Discharge From Inpatient Unit With NO Pain Meds???

    tewdles replied to tencat's topic in Hospice, Palliative

    Nope, not normal, just bad discharge planning and transfer of
  24. tewdles

    Lateral Violence

    tewdles replied to SnowShoeRN's topic in General Nursing

    Sending out an email is not going to cure the problem you have on the floor. The management have a problem on their hands and they will have to come up with a much more "hands on" plan to address it....
  25. tewdles

    Sharing prescriptions of non narcotic medications

    tewdles replied to LadyMonteCarlo's topic in General Nursing

    i think that, in general, this is a bad practice...writing prescriptions that physicians sign. having worked in the community and primary care setting, i think that those persons with prescription...