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

    RN whos Dad was on Hospice

    tewdles replied to muffin7's topic in Hospice, Palliative

    I am sorry for your loss. Don't assume the oncall nurse who came to care for your father "knew" that he was going to die within 24 hours. She should have notified family of the change in your...
  2. tewdles

    100 year old stroke patient

    tewdles replied to NurseStephRN's topic in General Nursing

    This type of problem will not go away...we have rescinded any portion of health reform which requires MDs to discuss end of life options with patients and families. You know...all that fear about...
  3. tewdles

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

    tewdles replied to Biogirl4's topic in Patient Safety Issues

    Being a patient in a hospital does not mean that you can be assaulted at will by the medical staff. Assault is a crime...even when committed by a physician in the
  4. tewdles

    FOLEY balloon RUPTURE!

    tewdles replied to Miss.HHNurse's topic in Home Health

    Simply because he has had a stroke and is immobile does not necessarily mean that he requires an indwelling catheter. Would he be a candidate for a condom cath? This could potentially save him from...
  5. tewdles

    FOLEY balloon RUPTURE!

    tewdles replied to Miss.HHNurse's topic in Home Health

    If the balloon was ruptured you can determine that when the cath is out. I agree that it is unlikely it would have remained in place had the balloon ruptured. Urine with abnormal color, odor, or...
  6. tewdles

    Accused for having patients best interest at heart

    tewdles replied to DJ-Adia's topic in Pain Management

    Your "director of patient care services" is apparently not directing any actual patient care and clearly isn't providing any service to this patient...what an embarrassment to nursing she is! She is...
  7. tewdles

    What is the hardest thing about your job?

    tewdles replied to Vtachy1's topic in Hospice, Palliative

    I would guess you work for a "for profit" hospice. My recommendation is to look for other employment if the company refuses to acknowledge your important and reasonable boundaries...there are good...
  8. tewdles

    Was I right to decline this? Admission with no consents.

    tewdles replied to SoCalRN1970's topic in Hospice, Palliative

    Ditto...you must have a signed EOB in order to provide any care for the
  9. tewdles

    Question regarding posturing

    tewdles replied to newtress's topic in Hospice, Palliative

    I wouldn't stress over it. People assume a variety of positions when they are dying. In my line of work they are usually in a position known to be comfortable to
  10. tewdles

    Extubation in the home hospice setting

    tewdles replied to Claudia322's topic in Hospice, Palliative

    The EOB was obtained in the hospital in all cases. The patient was transported home with a secure airway (intubated) paid by hospice. There were no insurance issues. Who extubated varied...I did in...
  11. tewdles

    Extubation in the home hospice setting

    tewdles replied to Claudia322's topic in Hospice, Palliative

    I have participated in this process several times. In all cases the patients and families really appreciated it and hospice goals were met. I would do it again with the proper
  12. tewdles

    HELP!! Why is this being done with my 2 week resignation ticking down?

    tewdles replied to SoCalRN1970's topic in Hospice, Palliative

    They cannot refuse admissions and remain profitable. For profit hospices have profit as a high priority...sometimes higher than patient
  13. tewdles

    Hospice nursing...reality check....

    tewdles replied to gorgenurse's topic in Hospice, Palliative

    Your flexibility will depend upon the agency you work for and how well the existing staff work together to care for their patients and each
  14. tewdles

    Admitting patients for the sake of admitting?

    tewdles replied to SoCalRN1970's topic in Hospice, Palliative

    Transfusions are not an uncommon part of the palliative plan of care. Acceptance of DNR status often takes time, education, support, and trust. Some never accept it and that is not a deal breaker...
  15. tewdles

    Nurse: 'I was fired for refusing flu shot'

    tewdles replied to DesertRN2's topic in Disaster Preparation

    This is a heavy handed catholic "faith based" hospital system in my backyard...so
  16. tewdles

    Team Meetings & Hospice Nursing Diagnosis

    tewdles replied to LookUp2Sky's topic in Hospice, Palliative

    Join NHPCO - Search for info on Interdisciplinary Groups. Every thing you need to know is in
  17. tewdles

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

    tewdles replied to Biogirl4's topic in Patient Safety Issues

    You should file a formal complaint with the hospital. It would be in your best interest to consult an attorney to insure that someone is looking out for your best interests. You have every right to...
  18. tewdles

    Admitting patients for the sake of admitting?

    tewdles replied to SoCalRN1970's topic in Hospice, Palliative

    yup...walk away professionally and find an employer whose values reflect your
  19. tewdles

    What do you say to and do for your frightened patient?

    tewdles replied to This Won't Hurt Much's topic in Hospice, Palliative

    I use therapeutic communication to try to discover what she is afraid of...the dying process or death itself. Many people have peace with dying but are afraid of the process...pain, breathing,...
  20. tewdles

    The frustration of the Functionally Dysfunctional... aka family members.

    tewdles replied to SoCalRN1970's topic in Hospice, Palliative

    establish strong boundaries, use your IDT members, and focus on the plan of care... we are not miracle workers and we have no ability to fix families...only to walk with them for a short
  21. tewdles

    Escorted out of the patients home.........

    tewdles replied to AtlantaRN's topic in Hospice, Palliative

    Sounds like your marketers are selling hospice to home care patients. Give the marketing staff some other selling points. They should appreciate insight you can give them about what patients like...
  22. tewdles

    Team Meetings & Hospice Nursing Diagnosis

    tewdles replied to LookUp2Sky's topic in Hospice, Palliative

    As a hospice case manager you should be reviewing the nursing plan of care for you patients in the IDT discussion...you address each problem you have identified for the patient and the progress toward...
  23. tewdles

    LTC to Hospice?

    tewdles replied to Jw1724's topic in Hospice, Palliative

    Not a problem...good
  24. tewdles

    What am I missing here?

    tewdles replied to roser13's topic in General Nursing

    Honestly...my mouth is dry just reading this
  25. tewdles

    What am I missing here?

    tewdles replied to roser13's topic in General Nursing

    MAs are trained to be "doers" for physicians. CNAs are trained to be nurse extenders. They are completely different roles and jobs. Clearly the for-profit model of health care delivery has been...