melsch

You are in Canada, get your union rep involved right away. They are your best protection. Don't worry about losing your job, labour laws will protect you, but document everything and try not to go to a meeting with management without your Union rep. Remember the doctor is an employee of the hospital/health authority and has no say in your employment no matter how long he has been around. His behaviour is deplorable and he needs to be called on it.

I am not sure what you mean by intellectual disabled, but I work in a palliative inpatient unit and from 7 am to 11 pm we have 1 RN, 1 LPN, and 1 Care Aide for 12 patients. From11 pm to 7 am we have 1 RN and 1 LPN for the same patients. This is very doable, and safe. Rarely have we had to have extra staff for 1:1 etc. We are not overstuffed, but I feel it is just about the right ratios.

Often patients wait until they are alone to die. I have even encouraged family to leave for an hour or so if a patient seems to be hanging on for some reason to see if possibly it is just that they want to be alone, with the reassurance that I will call if there is a drastic change, or the patient passes. Families who are ready and wishing for peace for their loved ones are usually open to the suggestion. Families also know their loved one and if it is their personality that they might want to be alone they sometimes come up with the idea on their own.

I work in hospice and I think your perspective changes when you deal with death on a regular basis. I don't see death as a bad or awful thing for the patient, I see death as something normal that everyone must go through, and my job is to make it as comfortable and dignified as possible. I am rarely sad when a patient dies, but if it is my family member or a friend it is totally different. I am sad because I will miss them, or if their death was caused by an accident or crime, I might be angry or devastated by what the person might have experienced, but my patients are expected to die so there is different feelings when they pass. I am sorry your Mom's death was not as nice as you were hoping, my patients whose lungs fill up at end of life like that are the hardest on everyone as you feel so helpless. Be assured that your Mom probably wasn't aware of the fluid by that point and it is harder for you to watch, than for her to experience.

We used to do that, but now we get paid for the hours worked. It is much better and no one gets short changed as it never worked out fairly.

The pt was probably dying anyway, and didn't die from an allergic reaction, but we always use a lower dose of dilaudid rather than morphine if they say they have an allergy to morphine. If the patient is still able to take meds orally we sometimes get them on oxycodone, but usually it is just a direct switch to dilaudid. We find lots of people say they are allergic but when asked what their reaction is they say it makes them nauseous or sleepy, which are expected side effects and not allergies, but if the pt can't say we would err on the side if caution and use something else.

My employer mandated we get the shot this year, or wear a mask at all times from December until march. I figured it would be easier to get the shot than have a mask on at all times. I got the shot yesterday and thankfully I have sick time because I had to call in for last night and tonight so far, we will see about tomorrow. Within a couple of hours I started feeling hot then cold, then just really tired. Really I feel like I have the flu, and I am guessing that my body figures that I do and is trying to fight it. I am feeling so lousy right now I am wondering if wearing a mask would be easier. It has reminded me why I haven't had the shot for about ten years.

This is our protocol: Has there been a BM within the last 48 hours? If yes give two sennosides 8.5mg at hs. If NO, give two sennosides 8.5mg twice a day. If BM within 24 hours continue and monitor if no advance to: Increase sennosides 8.5 mg tid and add lactulose 15-30 ml BID for more rapid effect. If BM within 24 hours contiune or lower sennoside dose. If no BM advance to: Nurse to assess for impaction - if no impaction give bisacodyl supp or fleet enema. If BM within 24 hours return to previous dosing, in order to aim for BMs q 3 days. Of course nursing judgment re individual patients, PPS level, and intake, come into play as to how aggressive we are with using the bowel protocol.

Where I live nurses are considered an essential service which means we are not allowed to reduce our numbers below what is considered enough staff to look after the patients. What we have done is work to rule, which means we only do essential jobs - no extra paperwork, no house keeping jobs, no overtime etc. Management can do those jobs until our contract is settled. If another union goes on strike we still have to show up to work, but anyone who is not considered essential (as determined by our union) doesn't cross the picket line, and everyone who is at work refuses to do the work that would be done by the other union.

We do this as well. And if a patient has a gown on we sometimes place the top sheet under the gown, next to the patient. Don't tie it or it could be a restraint. It doesn't always keep them from taking off their pad - but it slows them down a bit.

I am in a stand alone inpatient hospice. We have a mix of end of life, respite, and symptom management patients. We have two 12 bed units. Day and evening shifts have an RN, LPN, and a care aide, for each side and on nights there is an RN for each side and a LPN on one side and a care aide on the other.

I have to agree with the shaving cream suggestion. It really works. Put some on your cloth and start cleaning. Once the fecesis all soft just wipe it off and give the a rinse with clear water.

I asked myself the same question as I work in hospice and wondered what I would do if he was in our facility. We did have a man who raped and murdered a young girl a while ago and I just looked at it as he was just another body and someone had to look after him. He was mostly unresponsive by the time he was my patient though. I don't know if I could have looked after Olsen though - this man was evil and there is no way anyone in Canada doesn't know who he was or what he did. I would have hoped that they kept him fairly sedated so he couldn't harass the staff and to make it easier to look after him. I don't think I could have done it otherwise.

I work in BC, but it seems our collective agreements are similar. I don't believe you qualify for any health benefits, but you would get paid out your vacation pay. The Royal Alex falls under the provincial collective agreement. http://www.una.ab.ca/collectiveagreements/pdf/UNA%20AHS%202010_2013.pdf Amend Article 17 to read: 17.02 (a) Casual Employees shall be paid, in addition to their Basic Rate of Pay, a sum equal to: (i) 6% of their regular earnings during the 1st employment year; (ii) 8% of their regular earnings during the 2nd to 9th employment years; (iii) 10% of their regular earnings during the 10th to 19th employment years; (iv) 12% of their regular earnings during the 20th to 24th employment years; (v) 12.4% of their regular earnings during the 25th and subsequent employment years; in lieu of vacations with pay; (b) Casual Employees shall receive payment in lieu of vacations with pay to which they are entitled following each pay period.