tewdles RN

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

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All Content by tewdles

  1. tewdles

    Prescribing narcotics to drug seekers

    tewdles replied to Djuna's topic in Emergency

    My experience is that there are people who abuse substances amongst us... and there are people with chronic pain issues. It is not always easy to determine who is who. When we see "frequent flyers"...
  2. tewdles

    Discharge a patient because they go to er?

    tewdles replied to AtlantaRN's topic in Hospice, Palliative

    Visiting the ED for a medical need that cannot or should not be addressed in the home by the hospice professionals is not an auto reason to DC...it depends what the hospice dx is, what the philosophy...
  3. tewdles

    Oh no they didn't...uniform changes in florida

    tewdles replied to pearljammer's topic in General Nursing

    Children enjoy teddy bear
  4. tewdles

    Not staying on top of pain - confusing orders - myths?

    tewdles replied to Biogirl4's topic in Patient Safety Issues

    It is okay to get people in trouble...especially when they are harming
  5. tewdles

    Career in administration vs management

    tewdles replied to Jan_80's topic in Nurse Management

    Seriously, I am not a fan of nurses who don't like nursing making careers out of nursing management or
  6. tewdles

    Fecal Transplant

    tewdles replied to Mommy_of_3_in_AL..RN's topic in Gastroenterology

    I have a friend currently fighting with CDiff...I am going to get her some info and have her contact her gastro doc.
  7. tewdles

    Signs and symptoms to always be concerned about.

    tewdles replied to HumptyDumpty's topic in Home Health

    what KateRN1
  8. tewdles

    suspension for hostility

    tewdles replied to nightengalegoddess's topic in General Nursing

    I raised my voice not too terribly long ago, not once but several times, to a superior. In my case this behavior was born out of frustration that became anger. Funny thing, when we feel that we can't...
  9. tewdles

    Thinking about leaving hospital nursing, need advice

    tewdles replied to shoegalRN's topic in General Nursing

    Follow your heart and your best judgement. There are plenty of nursing careers that are challenging, fun, meaningful, and rewarding outside of the acute hospital
  10. tewdles

    Free Reign for Hospice Orders?

    tewdles replied to SoCalRN1970's topic in Hospice, Palliative

    What are you to do? Begin looking for another job...it sounds like there is an adversarial relationship between management and field professionals and this is not likely to change unless you get new...
  11. tewdles

    Oh no they didn't...uniform changes in florida

    tewdles replied to pearljammer's topic in General Nursing

    They have the right to require you to wear a particular color of scrubs. They do not have the right to require you purchase from a particular company. The hospital does not own the scrubs that you...
  12. tewdles

    Charting: UTIs

    tewdles replied to nycNurse2b's topic in Geriatric, LTC

    All good suggestions... the question that came immediately to my mind was...WHY? Why so many UTI's? What are the risk factors of your patient population? Use the nursing process to discover if there...
  13. tewdles

    Tricks to get kids to cooperate with treatment

    tewdles replied to JeanettePNP's topic in Pediatric

    hhhmmm... Don't ever ask permission to complete a procedure..."it's time to change your dressing, okay?". Study the growth and development of the age groups you deal with. I often engaged the kids in...
  14. tewdles

    Aspiration risk, Hospice and SNR

    tewdles replied to hospicernsrgr8t's topic in Hospice, Palliative

    In my neck of the woods hospice volunteers are not allowed to feed patients. When is the next care conference for this woman? Can you invite the facility staff to your next IDT meeting where the...
  15. tewdles

    Team Mate working out of scope or practice?

    tewdles replied to SoCalRN1970's topic in Hospice, Palliative

    If I were in your shoes I would have lunch with the MSW and discuss how we would work together as a team. As the case nurse you are responsible for the implementation of the plan of care so it is...
  16. tewdles

    RN Supervisor tips please.

    tewdles replied to NocturneNrse's topic in General Nursing

    Be kind, patient, humble, consistent, compassionate, supportive, and confident. Always follow the rules, they will help you keep order. Model excellence and nurture your staff to strive for excellence...
  17. tewdles

    To experienced nurses...

    tewdles replied to LookForward's topic in General Nursing

    Ultimately you have to discover what blows your hair back...for me it is nursing and I do not regret my decision to become an RN rather than an
  18. tewdles

    Team Mates who toss others under the bus...

    tewdles replied to SoCalRN1970's topic in Hospice, Palliative

    If that is the culture of your workplace you give that credit (or blame) to management. Unless management changes it's style and expectations this will be an unsafe place to work. I would look for a...
  19. tewdles

    Do you as a Hospice Nurse use a pulse oximeter?

    tewdles replied to SoCalRN1970's topic in Hospice, Palliative

    In my neck o the woods we titrate oxygen to comfort, not to pulse oximetry. My experience is that patients with long term resp problems (and their families) are rarely placated with "normal" or "a...
  20. tewdles

    Medicare Meeting

    tewdles replied to sls73's topic in LTC: Directors, Assistant

    I thought the focus of these meetings were supposed to be
  21. tewdles

    Not giving PRN's even though they are ordered?

    tewdles replied to Simply Complicated's topic in Psychiatric

    If, in your professional judgement the patient needs the med then give it. If not, then don't. If you are unsure, collaborate first with your charge nurse and then (if still unsure) with the...
  22. tewdles

    How would you of handled this? Family scenario...

    tewdles replied to SoCalRN1970's topic in Hospice, Palliative

    The DPOA/M gets to decide what the plan of care will include. Make sure that MSW and pastoral care are as involved as possible with this daughter. As a team, discover what other options may be...
  23. tewdles

    Do you as a Hospice Nurse use a pulse oximeter?

    tewdles replied to SoCalRN1970's topic in Hospice, Palliative

    I am not an advocate of measuring pulse ox (in hospice), particularly in the end stage respiratory patient, for the same reasons mentioned above...the patients and the families tend to become fixated...
  24. tewdles

    ED to Hospice

    tewdles replied to UpinawayRN's topic in Hospice, Palliative

    I know RNs who have successfully transitioned from ED to Hospice and even back again. We come from all walks of life and from all nursing specialties. I hope you find your niche in
  25. tewdles

    implantable defibrillators/pacers

    tewdles replied to mc3's topic in Hospice, Palliative

    I have never had a cardiologist refuse to deactivate a defibrillator. Any assertion that it is tantamount to euthanasia in a hospice patient is silly...even from a cardiologist. And you are quite...