melsch

melsch

Hospice Palliative Care

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All Content by melsch

  1. Advice on creepy doctors?

    melsch replied to carterr's topic in Patient, Colleague Relations

    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...

  2. consientious nursing

    melsch replied to emmie santos's topic in General Nursing

    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...

  3. Patients who die right after the family leaves the room.

    melsch replied to nitenite's topic in Hospice, Palliative

    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...

  4. Inpatient center patient load

    melsch replied to hospicernva's topic in Hospice, Palliative

  5. I don't know how you nurses deal with death

    melsch replied to Poochiewoochie's topic in Patient, Colleague Relations

    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...

  6. Night shift and daylight savings....

    melsch replied to mappers's topic in General Nursing

    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

  7. Allergic to Morphine Sulfate but on Hospice Care

    melsch replied to payang0722's topic in Hospice, Palliative

    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...

  8. Mandatory Flu Vaccines- How do you feel?

    melsch replied to Snowbird17's topic in Disaster Preparation

    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...

  9. Bowel regimen

    melsch replied to cmanurse2004's topic in Hospice, Palliative

    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...

  10. Sympathy strike...would you do it??

    melsch replied to notachargenurse's topic in Collective Bargaining, Union

    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...

  11. is this a nursing trick you would use?

    melsch replied to onthejourney's topic in General Nursing

    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...

  12. inpatient hospice nurse/pt ratio

    melsch replied to clite's topic in Hospice, Palliative

    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,...

  13. Any techniques for cleaning feces off of a patient?

    melsch replied to Nerd5000's topic in General Nursing

    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

  14. Hypothetical Ethical Issue

    melsch replied to Pepper The Cat's topic in General Nursing

    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...

  15. Alberta Casual in lieu of benefits rate

    melsch replied to Stephanita's topic in International Nursing

    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...

  16. Alberta Casual in lieu of benefits rate

    melsch replied to Stephanita's topic in International Nursing

    There is a list of current contracts on the Union website. I think it would be dependant on the contract for the workplace that you were hired at. Look for the information on casual workers....

  17. What is your response to lay people?

    melsch replied to Vtachy1's topic in Hospice, Palliative

    It is a question I seem to get a lot. People think that our job must be really sad. I alway say it is the most rewarding job I have ever had. It is sad for family members, but for me death is a...

  18. Patient falls: What works to prevent them?

    melsch replied to UPSBossman's topic in General Nursing

    As Leslie said make sure their basic needs are met -toileting, exercise etc. We have extra low beds that we use and keep them at the lowest level. We also have crash mats that we put on the floor -...

  19. Reapply a Fentanyl Patch?

    melsch replied to wifeandmomoftwo's topic in Patient Medications

    I wouldn't put it back on either - I would have wasted it and put a new one on and changed the schedule to reflect this. I would be worried about how well it was being absorbed once it had been...

  20. Management of severe EOL pulmonary edema

    melsch replied to SurrealMoment's topic in Hospice, Palliative

    I am in an inpatient setting as well, so my experience my differ as well. We use SC morphine or dilaudid for pain and to ease the dyspnea symptoms. We use Atropine SC q1h as well, but find that it...

  21. Medications through an ileostomy?

    melsch replied to onewithhospiceheart's topic in Hospice, Palliative

    Our protocol is also to use ativan 1-2mg sl q4h round the clock when our patients are no longer able to take their antiseizure medications orally. Mix it in a little bit (1/2 cc or less) of water in...

  22. Night shift and Sleeping

    melsch replied to jaznia15's topic in General Nursing

    Actually I think on a 12 hour shift it is two 30 min unpaid meal breaks and 2 15 minute paid coffee breaks and on an 8 hour shift it is 1 30 minute meal break and 2 15 minute coffee breaks - and on...

  23. Night shift and Sleeping

    melsch replied to jaznia15's topic in General Nursing

    I work nights and we nap on our breaks (not when we are supposed to be working) We do always know where each other is and go and get each other if needed. Our manager is aware and doesn't care so...

  24. Differences between Canadian and USA nursing?

    melsch replied to Cinquefoil's topic in General Nursing

    I just had to go back to this question - I think we are more secure with our licenses in Canada. I have every right to question and refuse a Dr's order if I am uncomfortable with it. I need to follow...

  25. Courses for palliative care/hospice nursing in Canada

    melsch replied to frozenyogurt's topic in Hospice, Palliative

    Hi frozenyogurt, I am not sure what part of the country you are from, but I know that out west there is not much in the way of formal Hospice/Palliative courses. The Victoria Hospice puts on a...