tewdles RN

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

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All Content by tewdles

  1. tewdles

    This can't be right...

    tewdles replied to pinkstudentnurse20's topic in General Nursing

    [ur=http://www.childrenshospital.org/newsroom/Site1339/mainpageS1339P1sublevel583.html]Uninsured more likely to die after
  2. tewdles

    Atropine 1% Eye Drops SL

    tewdles replied to Lexxie's topic in Hospice, Palliative

    You have received some excellent responses... Did you know that any hospice which regularly cares for patients in your facility would likely be happy to provide in-services (often with CEUs) on a...
  3. tewdles

    Caring for a COPD patient

    tewdles replied to Simply Complicated's topic in Pulmonary

    well said
  4. tewdles

    Caring for a COPD patient

    tewdles replied to Simply Complicated's topic in Pulmonary

    poor old guy...he should have probably never been in the hospital in the first place... shoulda been home with his family...comfortable and safe... sigh, musings from an old hospice
  5. tewdles

    hospice question

    tewdles replied to amy1997's topic in Oncology

    Bottom line...hospice patients take what works for them...so if a patient signs up and is on darvocet, or norco, etc and it is effective in controlling their pain we don't necessarily change it. If we...
  6. tewdles

    Hospice help for in-home....

    tewdles replied to karleigh's topic in Hospice, Palliative

    I can't speak to this specific situation, however, I do not always review signs or symptoms of impending death on the admission visit...unless there is evidence that the patient is likely going to die...
  7. tewdles

    Pm care changes to post

    tewdles replied to solacetherapy's topic in Hospice, Palliative

    same topic different thread by same OP? I don't get
  8. tewdles

    Is a 3-day case management course worth it?

    tewdles replied to qtRN's topic in Case Management

    I would agree that most organized nurses can be successful in case management...and don't require an expensive seminar to get started. The dicier question is "will you like it"? good
  9. tewdles

    Call patients the night before or in the morning?

    tewdles replied to tinderbox's topic in Home Health

    I started in home care calling my patients the night before.... but my agency was in the habit of dramatically changing my visits on a daily basis, so I quit that right away...too many unhappy people...
  10. tewdles

    Final Rules on 'Meaningful Use,' Electronic Health Record Standards Released Today

    tewdles replied to rninformatics's topic in Nursing Informatics

    thank you very much for this
  11. tewdles

    No wonder other specialties don't think OR is nursing!

    tewdles replied to PetiteOpRN's topic in Operating Room

    I think you make an excellent point! I trained decades ago...and we observed quite a number and variety of cases. We were encouraged to circulate but it was not a requirement of the rotation. Our...
  12. tewdles

    Field Hospice Nursing vs. Inpatient Unit Hospice Nursing

    tewdles replied to westieluv's topic in Hospice, Palliative

    I do travel to dangerous urban areas... but for the most part field visits at night is reasonably safe. You will find that patient families are interested in you arriving and leaving their home...
  13. tewdles

    Two job offers...accepted both.

    tewdles replied to GhostsWerePeopleToo's topic in Hospice, Palliative

    Welcome to
  14. tewdles

    How do you deal with residents who only want to take a fraction of a med ordered?

    tewdles replied to GLORIAmunchkin72's topic in Patient Medications

    I am not sure why this should be a problem...wanting to take only half of the analgesic dose (which is prn) should be within the rights of the patient. Technically speaking, if the patient wanted to...
  15. tewdles

    Use of morphine and CPAP in hospice patient

    tewdles replied to Elizabeth Hanes's topic in Hospice, Palliative

    Not to nit pick...but the hospice team makes recommendations and the patient or family have "final say"...hospice care is directed by the patient/POA also...hospice works best if the patient/POA...
  16. tewdles

    Funeral Homes

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

    not unreasonable at all to ask a patient upon admission...particularly elderly persons or those in poor
  17. tewdles

    Use of morphine and CPAP in hospice patient

    tewdles replied to Elizabeth Hanes's topic in Hospice, Palliative

    It is important to remember that hospice goals always center on comfort and quality of life. Sometimes folks come to use with opiate therapy which is in need of adjustment...their doses or agents...
  18. tewdles

    Moving to Michigan....

    tewdles replied to kidzrn2002's topic in Michigan Nursing

    no matter what you think about it...they have made tons of money and the company is still churning it out... they are not apparently breaking any laws and the big-wigs have, so far, conducted...
  19. tewdles

    Refusing meds

    tewdles replied to penlight32's topic in Geriatric, LTC

    what a cop out from a
  20. tewdles

    USA Today Article

    tewdles replied to cicatrixx15's topic in General Nursing

    They apparently don't actually know any
  21. tewdles

    Question on Charting and Organization

    tewdles replied to OhioHHRN's topic in Home Health

    you are working for a bad manager...bottom line... I would find another job if I were you....lots of HH agencies needing experienced nurses with new ones cropping up all the time. wun fowest,
  22. tewdles

    ICD 9 coding class

    tewdles replied to spoiled28's topic in Home Health

    my guess would be that they will eventually want the nurses to do that...without additional pay...in addition to their other tasks...so that the owner doesn't have to pay a proper coder... ok I admit,...
  23. tewdles

    Dilaudid via PICC line burns with bolus

    tewdles replied to sas15's topic in Hospice, Palliative

    sounds like your patient may be experiencing both vasodilation and histamine release as result of the bolus...that is probably why the benadryl helps control the symptoms... She is on a pretty hefty...
  24. tewdles

    When is it appropriate to push the button?

    tewdles replied to Used Foley's topic in Hospice, Palliative

    yes, we generally have orders for clinician bolus' which are often substantially larger doses than the PCA dose. We also have standing orders which allow us to calculate the dose which could be...
  25. tewdles

    part time Rn casemanager, full caseload and Lvns in office

    tewdles replied to americanTrain's topic in Hospice, Palliative

    case managing 3 days a week with 13 patients is a lot. My experience is that if you are carrying that load you generally have another nurse, often an LPN, who can assist with visits leaving you to...