tlmhospice

I worked with several LPNs in hospice and am one myself. We did everything the RNs did and simply had an RN sign off on everything. Is this legal? I don't know. That is just one of the reasons I am no longer working there! Tonia

That depends on what stage the patient is in at the time. Is he/she actively dying? Is this tx aggressive, or is it pallative? Number one priority in hospice is comfort and pain management. Tonia

We use the Scope patches some, but mostly we use the Scope gel that one of our compounding Rx makes for us. It seems to work better, but it needs to be applied at least every 4 hours. Sometimes if it is really bad, we will use them together. But at that point, it is more for the families' comfort than the pt. It can get quite frightening for the family to hear it and even after educating them, it continues to upset them. It kinda goes in one ear and out the other. I can't judge as I know if my loved one was passing I would be the same way! T

You are very smart to think this through and wanting to gain more of the clinical nursing skills that are very sparce in hospice nursing. When I quit my job to stay at home with the kids, they had me train a newly graduated nurse that had been working with our company as an aide for years. I really discouraged that idea, but she was insistent she wouldn't have a problem. What happened (as I suspected this would) is she had a great deal of knowledge on how to take care of her pts through her nurses aid experience along with "book knowlegde" from just graduating. However, she lacked the confidence within herself to make judgement calls which snowballed for her and absolutely crushed her image as a nurse. I would listen to your instincts and take a job elsewhere to gain experience until you are comfortable coming back into a field where you make most of the decisions yourself. Best of luck! T

My husband's grandmother, which is 90 y/o, has been relatively healthy living a very independant life on her own in Pittsburg. Suddenly, yesterday we get a call that she is having a bx of a mass in her bladder. From what we got from the family, which is always limited at best, it was indeed maligment, only on the surface of her bladder, mostly removed, and are now going to try a "bladder flush". Does anybody know what this is referring to? And why are they blaming this ONLY on smoking? Is there some new link that I am not aware of? Cancer does run rampid in family with both of her daughters with Breast Ca, my mother in law's so aggressive it only took 8 months before she passed with aggressive treatment. I am on the hospice end of it and know about Ca itself, but not treatment as we only deal with the end stages of it focusing on palliative care, not treatment. Any answers would be appreciated as we feel left in the dark with so little info to go on. tlm:confused:

Wow, after reading some of the posts on here, I find myself sounding impatient and almost disrespectful to you OBers by us wanting induction. Sorry for that!! Unfortunately, the situation on this end is a bit more complicated than just wanting induction for convience. Ok, a little bit of instant gratification I suppose! My friend is giving her baby up for adoption, and the birth parents are in from out of state, but that really is only a minor consideration. Her doctor has never once taken a fundal height on her, has absolutely refused to answer any further questions, and I quote, "You are only allowed 3 questions per visit with me," and in general, I don't feel he has taken care of her. I understand what was said about the dates, but that is one thing this dr INSISTS that he is right on the head about. It really blew me away when he didn't check her cervix for progress last time. Maybe I am way behind on the times here!!! Afterall, I only went from OB to hospice!! :roll She went on to the hospital today and is now again on her way home. I look forward to seeing her tonight at TaeKwonDo class (instructor's wife, not student until after baby:p ) to shed some new light on her whole situation thanks to reading on here. Thanks to all, as I had almost forgotten how understaffed and overworked us nurses are!!:imbar Thanks for the vent as well!!:kiss tlm

I am a former OB nurse (like 10 years ago) and have questions. I have a friend who is 39 weeks, dilated to 4 the last time her dr checked her (last week), and is continuing to have steady contractions today q 5 min. She has been sent home time after time due to her dr refusal to do anything for her even with hx of pitocin needed. She recently had her weekly visit with this dr and he didn't even check her cervix for progress. She has no SROM, but the baby seemed to engage over the last 2 days. Is it normal now for moms to get sent home at this point? What could the hesitation be with her doc? He is quite an a**, terrible bedside manner, but I dont want to believe he is just that stubborn about AROM. Any answers would be appreciated!! TLM