tewdles RN

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

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All Content by tewdles

  1. tewdles

    Methadone Maintenance

    tewdles replied to KADRN's topic in Addictions

    It is true that you have much to learn. Please consider that the long term care patient who is experiencing pain is unlikely to become "addicted" to this medication. They will develop "tolerance" but...
  2. tewdles

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

    tewdles replied to AtlantaRN's topic in Hospice, Palliative

    My manager would call them and speak about the language and interpersonal expectations of the hospice. Heck, I would be speaking with them about that...life is too short to tolerate
  3. tewdles

    Horizon Homecare MobileCare-GPS TRACKING

    tewdles replied to RN1263's topic in Home Health

    charting on a PDA will be brutal and takes a toll over time. they can and will track you using the GPS feature...if not at first they will eventually. good
  4. tewdles

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

    tewdles replied to AtlantaRN's topic in Hospice, Palliative

    Those admission visits are flipping annoying as all get out...especially when being done on OT...which is how I do them. I completely understand the pressure out marketing people have...and thank god...
  5. tewdles

    Sex in a LTC...is this ok?

    tewdles replied to AKAnurse4's topic in General Nursing

    us old folks have needs too... your ltc is their home so, I suppose "neighborly" activities are generally
  6. tewdles

    What does a community health nurse do?

    tewdles replied to omavirgie's topic in Public, Community Health

    Good luck to
  7. tewdles

    A interesting teaching method...

    tewdles replied to LuckyinKY's topic in General Nursing

    My husband thought it was...inspiring...I am feeling a bit choked up just
  8. tewdles

    Sad to leave LTC but not sure what to do?

    tewdles replied to pn2rn08's topic in Home Health

    I am glad that you have found another home in LTC. It is important that we work where our passion
  9. tewdles

    What does a community health nurse do?

    tewdles replied to omavirgie's topic in Public, Community Health

    I can tell you what my experience was... I worked for a community health network. This organization served the uninsured, under-insured, and the migrant hispanic agricultural worker communities. We...
  10. tewdles

    Really Tired of Fighting Hospice Ignorance......

    tewdles replied to tencat's topic in Hospice, Palliative

    I am fortunate to work in a hospice that routinely has students of all disciplines educating with our staff. We benefit in a couple ways from having U of M, EMU, MSU, etc students of medicine,...
  11. tewdles

    Pain management protocol

    tewdles replied to ErinS's topic in Hospice, Palliative

    We go slow because so many of our new patients are opioid naive, and we create too many side effects. If the patient warrants it we bang, bang, bang the doses...BUT...that is a VERY individualized...
  12. tewdles

    Legitimate Pain or no?

    tewdles replied to MiaNursingStudent's topic in General Nursing

    I think you did fine. I believe your assessment that your patient was in pain and required better pain relief. I think you followed your chain of command. Frankly, I am a bit dissappointed in the...
  13. tewdles

    Pain management protocol

    tewdles replied to ErinS's topic in Hospice, Palliative

    We have protocols. We have standing orders. We use whatever the patient needs to be comfortable...nothing is dismissed without careful consideration. We start low and go slow. Our medical directors...
  14. tewdles

    Start as a case manager...huh?

    tewdles replied to shynurse's topic in General Nursing

    It is a nursing specialty that takes advantage of our well rounded knowledge of all of the disciplines and advocacy for the whole person. It is not a specialty that requires expertise in the bedside...
  15. tewdles

    Deep Suctioning: Should We Do It At End of Life?

    tewdles replied to tencat's topic in Hospice, Palliative

    so...the flippin physician is an idiot who doesn't understand end of life care...that explains
  16. tewdles

    Too Many Hats, Not enough heads

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

    for profit hospice is most definitely not my cup of tea either... good
  17. tewdles

    Terminal agitation

    tewdles replied to river19's topic in Hospice, Palliative

    Did you discuss this in the IDT following death? That is part of the reason a brief case review occurs with the bereavement report...so that some of the clinical successes and failures can be...
  18. tewdles

    What I really think of nursing

    tewdles replied to jmeng's topic in General Nursing

    Clearly nursing is not or you...or you are burned out. Either way it is probably time for you to move on. So, I appreciate your post and your honesty but many nurses do not have that experience or...
  19. tewdles

    How much per mile??

    tewdles replied to septvirgo03's topic in Home Health

    I know they are not required...but my experience is with 4 different agencies in 2 states and they all paid whatever the IRS rate
  20. tewdles

    documenting burns

    tewdles replied to cruzcontrol's topic in School

    My experience has taught me that you were correct to report....was likely a cigarette burn but, dependent upon age of child, may have been self inflicted. Some kids growing up in abusive homes...
  21. tewdles

    Managing pain question- best advice

    tewdles replied to compassionRN's topic in Orthopedic

    With pain 10/10 you want to give a fast acting opiate to get control NOW. Then you want to give the oral routine med to provide the longer term relief...just like the doc said... Of course your unit...
  22. tewdles

    How much per mile??

    tewdles replied to septvirgo03's topic in Home Health

    Your agency should pay, minimally, whatever the current IRS rate
  23. tewdles

    No dogs allowed in room

    tewdles replied to Blackcat99's topic in Private Duty

    I think your hospice office has some boundary issues. They may not tell a family member when they can and can not leave their own home. They cannot tell you how you may and may not get to work. They...
  24. tewdles

    OIN and fluids

    tewdles replied to ErinS's topic in Hospice, Palliative

    We do not give fluids to prevent side effects but we do give it occasionally to palliate unpleasant
  25. tewdles

    This may sound dumb, but a hospice is the last place a patient goes...

    tewdles replied to Spikey9001's topic in Hospice, Palliative

    It is very likely that the hospice case nurse was coordinating all of the plan of care in the hospital, and the floor/unit nurses were facilitating the orders of the hospice team. If we are cleared...