tewdles RN

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

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All Content by tewdles

  1. tewdles

    In need of some feedback

    tewdles replied to Hospice Nurse LPN's topic in Hospice, Palliative

    ok...I have to admit that I am a bit confused. You are quite certain that the patient is taking the meds and they are not being diverted? If so, why are you advocating for a lock box? You did not say...
  2. tewdles

    Mistake??

    tewdles replied to xoemmylouox's topic in General Nursing

    have you considered
  3. tewdles

    Charting blood draws in an office

    tewdles replied to Stacy in North Texas's topic in Ambulatory Care, Clinic

    When I worked in an office setting I always charted blood draws...something simple, who, where, what, and how
  4. tewdles

    Finding your own coverage

    tewdles replied to heron's topic in Hospice, Palliative

    Sounds like crummy management, IMHO. Is management thinking that if you cannot find coverage then you may not be allowed your earned time off? Please refer to your employee handbook...any...
  5. tewdles

    Appropriate for Hospice?

    tewdles replied to lesrn2005's topic in Hospice, Palliative

    That is part of our job, Sterling, to educate the public one family, one person at a
  6. tewdles

    Pain Follow-up

    tewdles replied to tewdles's topic in Hospice, Palliative

    I remember the days of reviewing paper charts for quality and performance purposes. It is much easier in the digital
  7. tewdles

    Clinical Nurses

    tewdles replied to Destiny12's topic in General Nursing

    I have a passion for nursing...the niche has changed periodically. You can't know if this is a new area of interest for you until you try
  8. tewdles

    Pain Follow-up

    tewdles replied to tewdles's topic in Hospice, Palliative

    hospicetex...do you use an electronic chart? do you have as specific pain follow up document within your electronic record? If no, then where do you doc your pain follow up? yes, alternative methods...
  9. tewdles

    Procedure when family or pt does not answer phone or door.....

    tewdles replied to AtlantaRN's topic in Hospice, Palliative

    These are difficult situations...and similar things happen rather routinely in field hospice work. Just yesterday I received calls from the volunteer, the HHA, and the supervisor because one of my...
  10. tewdles

    Appropriate for Hospice?

    tewdles replied to lesrn2005's topic in Hospice, Palliative

    So the kicker is this...you don't envision him dying "soon" but what does that mean? Do you think that he will likely live more than 6 months? It requires the opinion of 2 physicians that the...
  11. tewdles

    Charting Time of Death

    tewdles replied to SouthernLPN2RN's topic in Geriatric, LTC

    I am in Michigan, in home hospice... I believe that LPNs may verify and pronounce death in some settings in this state. The hospice agencies I have worked for only use RNs for pronouncement of death....
  12. tewdles

    No Bowel Movement in Three Weeks

    tewdles replied to RN1981's topic in Hospice, Palliative

    what a crappy situation... I typically use a combo of senna and colace routinely for patients with opioids in the POC. In the event that this plan is ineffective I add another agent...usually MOM or...
  13. tewdles

    How many patients are you "expected" to see in an 8 hour day?

    tewdles replied to 4eversail's topic in Hospice, Palliative

    I visit up to 6 patients daily...all of my case load is currently in private residences (no facility patients). I do 99% of my documentation at time of visit or directly after. I document on the POC...
  14. tewdles

    No Colostomy Output X7 days....stomach cancer

    tewdles replied to AtlantaRN's topic in Hospice, Palliative

    Is he a candidate for a gentle "enema" or other stoma
  15. tewdles

    Do you include co-workers' names when charting? How do you chart?

    tewdles replied to rn4ever?'s topic in General Nursing

    Make sure you choose a nursing specialty from the bottom of that list posted here if you want to live like "you'll probably never, ever go to court in your lifetime". I have worked in a couple of...
  16. tewdles

    Quality/ Performance Improvement

    tewdles replied to caeRn's topic in General Nursing

    Perhaps there is some history you are unaware
  17. tewdles

    Current ADN student interested in Hospice Nursing

    tewdles replied to runninfool1009's topic in Hospice, Palliative

    Most agencies in Michigan employ a healthy mix of LPN, ADN, BSN, etc nurses. We have areas which are adjacent to universities and they tend to have a higher concentration of well educated nurses. I...
  18. tewdles

    hospice and personal struggle

    tewdles replied to akRN68's topic in Hospice, Palliative

    Definitely not alone....my mom died from COPD in July 2008. I took a week off and returned to work only to have my very first visit be a death call for a woman of similar age, also from COPD. The...
  19. tewdles

    Do you include co-workers' names when charting? How do you chart?

    tewdles replied to rn4ever?'s topic in General Nursing

    At the risk of offending you I will suggest that these are dangerous ideas to promote related to nursing documentation. You must document so as to make YOUR job easier as the professional witness,...
  20. tewdles

    To return to home health or to stay put in hospital??

    tewdles replied to JenRN22's topic in Home Health

    If I know I am just going down the block to chart I do not clock out of the visit... If I am running to another home I close the visit and go back to it later... Mostly I want to do the best job I can...
  21. tewdles

    Handling the ones that are constant fall risks

    tewdles replied to Kitty Hawk's topic in Geriatric, LTC

    I wounder when the next routine Case/Care Conference is scheduled? Wouldn't that be the perfect venue to have all of the interested parties meet...admin, professional,
  22. tewdles

    How long can port-a-cath go without flushing

    tewdles replied to fakemusician's topic in Oncology

    Standard of care is flush Q 4wks. Deviation from that should include MD order for frequency, to
  23. tewdles

    I LOVE Community Health

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

    I also worked in a community health network which had 5 health centers in 4 counties serving migrant agricultural workers as well as the poor, uninsured and underinsured residents in the area. It was...
  24. tewdles

    Hitting The Wall

    tewdles replied to indianahope's topic in Hospice, Palliative

    whew indiana...been there, done that, and I had the shirt (but burnt it in the fireplace for warmth when out of work). It sounds like your team is overdue for a meeting to problem solve your staffing...
  25. tewdles

    LPN, thinking of starting out as volunteer in Hospice

    tewdles replied to iwanna's topic in Hospice, Palliative

    I do not think that volunteering will give you a great deal of insight into the role and function of the case nurse or visit nurse... You could, however, contact a hospice which is hiring and inquire...