tewdles RN

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

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All Content by tewdles

  1. tewdles

    Hospice Nursing question

    tewdles replied to RNDialysis80's topic in Hospice, Palliative

    I am so sorry about your experience. I agree, there seems to be a disconnect in our health care continuum which makes it difficult for many medical providers and their teams to be straightforward...
  2. tewdles

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

    tewdles replied to rn4ever?'s topic in General Nursing

    If you are ever deposed you will benefit from having the names and titles of any health professional with whom you collaborated. Any supervisor who claims that naming a professional who contributed...
  3. tewdles

    From Golden Child to Worst Employee: What The?????

    tewdles replied to tencat's topic in General Nursing

    tencat, this is a very difficult situation for you, obviously. The fact that you were held in high esteem prior to your leave suggests to me that you were a highly productive team player...clearly...
  4. tewdles

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

    tewdles replied to JenRN22's topic in Home Health

    Charting in the home is the best practice for both HH and Hospice nurses...however it is NOT always possible. For instance...I care for a sweet little ol' man who lives by himself...he is deaf and...
  5. tewdles

    Dirty little secrets to managing LTC

    tewdles replied to Kashia's topic in Geriatric, LTC

    starletRN...hang in there...it will get better, you will get faster and will develop scary skills in prioritization. Tip, schedule patient teaching for yourself if you can...rather than catching it...
  6. tewdles

    Reimbursement/billing question

    tewdles replied to Spidey's mom's topic in Hospice, Palliative

    You are correct that hospice is reimbursed on a "per diem" basis...that is, a daily "flat rate" is paid for each patient who has elected the hospice benefit (medicare). So NO procedure or treatment...
  7. tewdles

    Gaining weight in homehealth

    tewdles replied to chenoaspirit's topic in Home Health

    The drive thru food is really a big baddie in this line of work...that and soda pop or other high calorie drinks (any of us like "foo foo" coffee drinks with whipped cream on top?). I have a...
  8. tewdles

    Handling the ones that are constant fall risks

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

    Sometimes the bias of LTC administrators amazes me. MWs are clearly not for everyone, but they are the "bees knees" for many elderly and confused patients who desire to be up and active but are not...
  9. tewdles

    Adoptive mom brings in pumped breastmilk to feed baby: what are your thoughts?

    tewdles replied to redbeads's topic in Ob/Gyn

    tsk tsk...rules and regulations, based in fear, impeding the good care of newborns. tsk tsk...requiring blood tests for HIV in order to deliver a baby...that is why we utilize standard precautions......
  10. tewdles

    Reimbursement/billing question

    tewdles replied to Spidey's mom's topic in Hospice, Palliative

    I would imagine that the PICC placement expense could be covered under the insurance policy if the placement is required/recommended for a diagnosis which is different from the hospice diagnosis. So,...
  11. tewdles

    Weekend Hospice Nurse

    tewdles replied to abbeyscottage's topic in Hospice, Palliative

    I may be wrong, but I think there are labor laws which prohibit employers from requiring staff to work more than 16 hours continuously. Regardless, it is not safe to drive a vehicle with that level...
  12. tewdles

    Hospice Nursing question

    tewdles replied to RNDialysis80's topic in Hospice, Palliative

    I do allow the family to have a voice in how often a nurse visits...and sometimes we have to negotiate. There have been occasions where daily visits have been requested and are scheduled...but if in...
  13. tewdles

    Patient doesn't know he's terminal

    tewdles replied to AmericanChai's topic in General Nursing

    NN, I think you make valid points. I do, however, think that not all families are acting in the best interest of the patient when they make these and other choices about hospice care. Check that...I...
  14. tewdles

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

    tewdles replied to JenRN22's topic in Home Health

    I completely agree that you have to do your homework. In my experience, too many home health agencies are smitten with the money they can make and forget that they also have an obligation to their...
  15. tewdles

    Best vehicle to use for visits????

    tewdles replied to JenRN22's topic in Home Health

    you absolutely have to balance reliability with fuel efficiency...you cannot make money for your family if your vehicle won't start or breaks down...likewise, you clearly don't want to spend more on...
  16. tewdles

    Hospice Nursing question

    tewdles replied to RNDialysis80's topic in Hospice, Palliative

    No, I don't always use that language. I do talk to them about their diagnosis, I ask them what the doctor told them about their condition and prognosis. I often tell them (in some fashion) the...
  17. tewdles

    Dirty little secrets to managing LTC

    tewdles replied to Kashia's topic in Geriatric, LTC

    That same financial reasoning crosses the health care spectrum. Nurses are generally viewed as a necessary but expensive
  18. tewdles

    Family member in room at night

    tewdles replied to cicatrixx15's topic in General Nursing

    I think family should stay...when possible... of course there are good and bad actors, but, I think patients benefit from having someone with
  19. tewdles

    Dirty little secrets to managing LTC

    tewdles replied to Kashia's topic in Geriatric, LTC

    I would love it if LTCs would hire more
  20. tewdles

    Patient doesn't know he's terminal

    tewdles replied to AmericanChai's topic in General Nursing

    perhaps you assumed too much from my post?... please note that I have clearly indicated that nurses faced with these situations need to investigate as thoroughly as possible and document... I provided...
  21. tewdles

    Lessons learned from a fatal medication error:-- reflections for CRNA epidural order

    tewdles replied to NRSKarenRN's topic in Certified Registered Nurse Anesthetist, CRNA

    excellent...thanks for the
  22. tewdles

    Ideas from nurses who've been around awhile!

    tewdles replied to vtgirl's topic in General Nursing

    I remember putting maalox on decubs and blowing oxygen from the wall over/on
  23. tewdles

    Have you ever felt unsafe while in HH?

    tewdles replied to Poi Dog's topic in Home Health

    yes I felt unsafe from time to time in HH... unsafe because of the patients, or their families, or their animals, or other individuals in the vicinity... I live in a state with CCW laws and I took...
  24. tewdles

    Dirty little secrets to managing LTC

    tewdles replied to Kashia's topic in Geriatric, LTC

    I am sorry that over half of a given nursing job is nothing more than passing medications...most of us did not go to nursing school to spend the majority of the day passing routine, long term
  25. tewdles

    Dirty little secrets to managing LTC

    tewdles replied to Kashia's topic in Geriatric, LTC

    I don't wonk in LTC, but I did want to comment that part of what an RN does is delegate tasks to others in order to provide care for the group of people. While we cannot replace a nurse with a med...