tewdles RN

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

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All Content by tewdles

  1. tewdles

    a video to share: what I leaRNed

    tewdles replied to rn-jane's topic in General Nursing

    Brilliant!
  2. tewdles

    Nursing and critical thinking

    tewdles replied to LouisVRN's topic in General Nursing

    yup...you must complete the necessary paper trail which will result in her either being nurtured and grown into a safe nurse or her separation from your employer...I know...she screws up and you get...
  3. tewdles

    infants receiving Ztrack injection in butt. Horrible reaction, was this done right?

    tewdles replied to catnipjones's topic in Pediatric

    gluteal IM injections are not the site of choice for that age population...Z-track or not...and the medication was likely
  4. tewdles

    HELP!! What about what the PATIENT WANTS?????

    tewdles replied to AtlantaRN's topic in Hospice, Palliative

    thanks for the update...sounds like a very sad
  5. tewdles

    HELP!! What about what the PATIENT WANTS?????

    tewdles replied to AtlantaRN's topic in Hospice, Palliative

    I would speak to this patient...tell her that the doctor ordered a hospice evaluation and confess to her that you are there to discover what she thinks and feels and to give her information. I would...
  6. tewdles

    Overworked hospice nurse

    tewdles replied to momorn's topic in Hospice, Palliative

    momorn...sounds like a miserable job, honestly. I think I would also be looking to change the situation. just out of curiosity...do you work for a for profit or not for profit
  7. tewdles

    Which Hospice companies are Good to work for?

    tewdles replied to Raine08's topic in Hospice, Palliative

    I have been on record again and again stating that I think that field hospice nursing is a very difficult place/position for new grads. Inpatient units, however, are a totally different animal and I...
  8. tewdles

    Overworked hospice nurse

    tewdles replied to momorn's topic in Hospice, Palliative

    6 months is a short time to have a 25 patient caseload! However, an RN/LPN/MSW/CP team should be able to comfortably manage 25 patients. The fact that you are working so many hours says several...
  9. tewdles

    Alzheimers Diagnosis questions regarding items covered....

    tewdles replied to AtlantaRN's topic in Hospice, Palliative

    Aricept is not an appropriate drug for end stage alzheimers dementia...if the patient is appropriate for hospice with a dementia dx then the MD should be recommending DC of that med, because it is no...
  10. tewdles

    New to Hospice, Not to Nursing, have many questions

    tewdles replied to rlloyd227's topic in Hospice, Palliative

    You are absolutely correct that your manager sucks at her job. There is no room in hospice to work for poor managers...the combination is lethal and any good nurse (or MSW, or chaplain, etc) will...
  11. tewdles

    Do all hospice patients now have IV's?

    tewdles replied to Blackcat99's topic in Hospice, Palliative

    When I worked for a hospice which did not run an IPU, I frequently started and cared for IV patients in the field. Now I work for a hospice which also operates a good sized IPU...so IVs in the field...
  12. tewdles

    Hospice RN carrying medications in their car

    tewdles replied to 10 year nurse's topic in Hospice, Palliative

    It is always a good idea to check the pharmacy laws in your state...your pharmacist is likely conversant with the laws and can help you
  13. tewdles

    Use of morphine for tachypnea

    tewdles replied to Menji's topic in General Nursing

    palliation of symptoms is different from treatment of disease...you participated in the palliative care of your
  14. tewdles

    Question about morphine

    tewdles replied to pharmgirl's topic in Emergency

    Thank you for stepping forward to provide the needed care for this guy... Keep this in mind...even people who have NO opiates on board may have significant bradypnea at end of life... Even those...
  15. tewdles

    Revocation of hospice service?

    tewdles replied to mschelee's topic in Hospice, Palliative

    Just for the record...when an emergency kit is delivered to the patient, that kit is signed out for that patient specifically...it is as much theirs as the other meds provided by hospice. After the...
  16. tewdles

    Uninsured patients

    tewdles replied to 15isto2's topic in General Nursing

    overall the only ones who benefit from a single payer, not for profit health care system are those who will not be bankrupted by forays into the system....could be you, or you, or even
  17. tewdles

    suspended until further notice

    tewdles replied to gettingbsn2msn's topic in General Nursing

    ok...from a management perspective I would say this... If this is a rule, but abuse is rampant, then the employer likely does not "value" the rule highly... So, they would likely use this infraction...
  18. tewdles

    Can 2 ml of fluid be administered in deltoid muscle?

    tewdles replied to Blackheartednurse's topic in General Nursing

    I completely agree leslie...that is my preferred site really for any IM
  19. tewdles

    Did you ever see a patient taking two laxative at the same time

    tewdles replied to Blackheartednurse's topic in General Nursing

    MiraLAX must have some pretty dang good marketing going on because everyone seems to start with it...start, geez. Of course, we generally try to get our patient's onto a program which achieves good...
  20. tewdles

    Wasting controlled substances

    tewdles replied to onewithhospiceheart's topic in Hospice, Palliative

    They quickly get into the water table, little
  21. tewdles

    If there are no jobs in Nursing then where are the Jobs ??

    tewdles replied to Back2Nursing09's topic in General Nursing

    un and underemployment in Michigan is 20.4%...that surely includes many
  22. tewdles

    Did you ever see a patient taking two laxative at the same time

    tewdles replied to Blackheartednurse's topic in General Nursing

    standard practice in
  23. tewdles

    Wasting controlled substances

    tewdles replied to onewithhospiceheart's topic in Hospice, Palliative

    There may be pharmacy laws or similar in your state or region...so ask your pharmacist for the legals. The standard is to mix meds in used coffee grounds, kitty litter with liquid, or similar...closed...
  24. tewdles

    On-Call position

    tewdles replied to AmandaCRN's topic in Hospice, Palliative

    I have not done it personally but have worked with nurses who very much enjoyed that sort of arrangement for reasons similar to your
  25. tewdles

    Uninsured patients

    tewdles replied to 15isto2's topic in General Nursing

    It is important to remember that the ED represents only a piece of what "health care"