melsch

melsch

Hospice Palliative Care

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All Content by melsch

  1. What is the best unit to work in and why?

    melsch replied to wnb4's topic in General Nursing

    Any unit that is led by a great manager. I love the unit I am on now, but a lot has to do with having a manager who supports her staff and encourages everyone to support each other. She is a great...

  2. What are the top 5 medications YOU administer daily?

    melsch replied to northmississippi's topic in Patient Medications

    I work in Hospice - so it is Dilaudid, Nozinan, Morphine, Atropine, and

  3. What is "burnout" and how do you cope?

    melsch replied to nunnurse1's topic in Health, Stress Management

    I was burnt out three years ago, working part time on a medical/oncology/stroke unit. It was really heavy and although the team worked pretty well together the manager wouldn't back us or help us at...

  4. ~Sigh~ Nothing like an unexpected death....

    melsch replied to Virgo_RN's topic in General Nursing

    To the OP know you did everything you could have. The best gift you can give a dying patient (at least one who has lived their life and has decided that they do not want any more heroics) is to be...

  5. What's Your Best Nursing Ghost Story?

    melsch replied to steffck's topic in General Nursing

    I have a new one, and if my co workers read this they will know who I am as we have been comparing stories. A few of us have had unexplained experiences over the past few months on one wing of our...

  6. Night Shift Pros and Cons

    melsch replied to Kaychell's topic in General Nursing

    I am currently working straight nights (11pm to 7am) and I love it. I have kids who are in school and I only work part time so that may help. My DH works mon-fri durring the day and has weekends...

  7. A letter to my Patient

    melsch replied to gentlegiver's topic in General Nursing

    To the OP, thank you for posting this. I am a night nurse in hospice and I know exactly how you are feeling. It is such an honor to take care of our patients. The fears and pains always seem so...

  8. Nurses, Clients and Power

    melsch replied to Anxious Patient's topic in General Nursing

    GEPDAR, I suggest you take that up with the hospital system, without personally blaming any of the nurses. It is not the nurses fault your insurance will only pay for a certain number of nursing...

  9. what can I read about dealing with death and family of the dying

    melsch replied to Grnrn's topic in Hospice, Palliative

    I will second Final Gifts. That is a great book, and one of the few non nursing books on death I have actually

  10. Duragesic patches

    melsch replied to leonurse's topic in General Nursing

    We have been told not to use tegaderm because the skin warms up under the tegaderm and increases the rate the medication is absorbed. I am told this is a manufactor recomendation. We use paper tape...

  11. IV's for Hospice

    melsch replied to Turtle in scrubs's topic in Hospice, Palliative

    I work in an inpatient hospice and we rarely have IV's. Pain mess are all given orally, sc, or transdermally. The only thing I can recall using an IV for is pamidronate infusion, and once finished...

  12. Charting by exception

    melsch replied to sharann's topic in General Nursing

    Where I work we have charted by exception for over 15 years. We have tick sheets for the usual assessment and then a narritive area to write any unusual findings. When I was in acute care I felt...

  13. Mouth moisterizer homemade for end-of-life patients...

    melsch replied to ERMindy's topic in General Nursing

    We have mouth spray available, but mostly just use toothettes dipped in water, and Vaseline or the pts own lipbalm on their lips. We find most of the patents don't actually like the minty taste of...

  14. M.R.S.A or mersa?

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

    Interesting observation. I use the letters M.R.S.A. and I am

  15. To flush or not to flush...advice please.

    melsch replied to lovingtheunloved's topic in General Nursing

    Flush IV lines as per your policy, the OP was asking about SQ lines which really should not have more than 2.5 mls inserted per line as it displaces too much tissue and can cause pain and inflammation...

  16. To flush or not to flush...advice please.

    melsch replied to lovingtheunloved's topic in General Nursing

    I did a quick search to see if I could come up with any manufacture recommendations or policies for intermittent subcutaneous injection sites (not IV). Most of the policies I saw were similar,...

  17. To flush or not to flush...advice please.

    melsch replied to lovingtheunloved's topic in General Nursing

    We do prime the line with the medication first, and then leave the line primed for the next dose. As we do not mix the drugs within the lines we can do this. For example, if I am giving 2 mg of...

  18. To flush or not to flush...advice please.

    melsch replied to lovingtheunloved's topic in General Nursing

    I am not sure what your policy is, but where I work we use a different sc line for each medication (yes some patients have up to 4 or 5 lines in place, well marked of course) and we do not flush...

  19. Hospice Care Question

    melsch replied to tri-rn's topic in Hospice, Palliative

    Dyspnea is such a common symptom in our dying patients. In our inpatient hospice we can't put O2 on without a dr order, but we find turning on a fan works just as well. I have been told it isn't the...

  20. Physician Abbreviation - Can't Read This One

    melsch replied to KristinWW's topic in General Nursing

    Definitely ask the dr for clarification before you finalize the form but could it mean ml (milliliter) T (total) C (count or calculation) ? I was just thinking about the in and out (I&O) totals...

  21. Showing up to work SICK

    melsch replied to CaLLaCoDe's topic in General Nursing

    Please call in sick if you are. I just had to cover for an RN who came in sick on a night shift and was sent home by the infection control doctor because she had c-diff. Because she came in and...

  22. Do you like team nursing?

    melsch replied to RN1263's topic in Medical-Surgical

    Our hospital does mostly team nursing on all the floors except the critical care areas. I love it. Our floor is one of the heaviest in the building and we have 8 patients with 1 RN and 1 LPN and the...

  23. Thank you's - memorable ones you've received?

    melsch replied to Liddle Noodnik's topic in Patient, Colleague Relations

    I got the best one this week. I had had a horrible day on Monday and was at the point of wondering if this job was really worth it if all I could do was run from one thing to another and feel like I...

  24. Palm TX or Palm T5?

    melsch replied to mjpa28's topic in General Nursing

    I have a TX and love it, BUT, get the extended warranty. I got mine as a replacement for my Sony Clie, (on extended warranty), when it kept dying on me, and now I am having problems with the...

  25. feces odor in student

    melsch replied to ALoucas's topic in General Nursing

    I would definitly suspect encopresis as this child is showing all the signs. My almost 8 year old son is struggling with this and he never notices when he smells. I would do some research on this...