cowspotzchic

Oh yeah, I had this happen when I was a new grad. I definitely disclosed on my app that I was a new grad- applied to an orthopedic floor. They called, asked some questions, set up the first interview, etc. Then called me back a few days later and retracted my interview stating that I was a new grad. Nowhere on the posting did it say new grads need not apply. I was so mad- I got the call on the bus in nursing school headed back from a congress day. And that was the only job I could find at the time. I feel your pain!!

I dilute everything, if possible, but IV Valium is definitely an exception. if you want to see the crystallization in action- (next time you give some and have some to waste)- take the wasted part and add some saline to it. It immediately becomes cloudy. Definitely don't want to give that to the patient. For admin- I generally unhook the line and push it directly into the saline well. Then reconnect the fluids or flush out. It shouldn't burn that much to my knowledge- I have never had anyone c/o Valium burning. Any questions, I like to call our pharmacy. They're really helpful.

Thank you for all these great answers and personal stories. I have read each one. It helps so much to have others' view and experience. I definitely like the "letting her live and die as she wishes." It is my hope that she will want to stop chemo eventually, but that may be my hope and not hers. I have to remember to let her live her life how she wants it, not how I think she needs to even if I think it may be best for her. I do want to call her onc this coming week- maybe she can just do an after hours phone call with me to discuss a few things. Maybe she can bring up the palliative care talk again too by asking her if she is ready to stop treatment. My mom has another CT scan in July to assess the progress. The onc was telling her last time that the FOLFIRI is basically the last thing there is to try. I talked to my dad though, and I don't think my mom will ever go on hospice because she doesn't want to, and he doesn't want her to either b/c he doesn't know what he would do without her. Like going into hospice makes a difference whether she will die or not... I know there is no way to tell how much time she has left, but I feel like a few months is pretty much spot on. She's sleeping or just lying there with her eyes closed 99 percent of the time, not initiating conversation, eating mostly liquids like applesauce, yogurt or pudding. She's also seeming to be evaluating her life more, talking about what should have been done/ what shouldn't have been done. Just things I think are signs of the process for her. I guess the best words are "que sera, sera"

I would love to be able to speak frankly with Mom, though I am not good at those conversations yet. I would love to get her involved in our local palliative care/ hospice, but I think she thinks that when you bring that up, there's no hope left. Ie- she will give up and die. I want to enjoy her time and not just mentally waste herself away. She is mentally not ready for hospice, and I don't know how to help her get there. See, her mom died the week after she was diagnosed and died in the hospital after 5 weeks of hospital hospice care. I don't think she is going to see hospice the way I see them. When the onc even briefly mentioned the possibility of stopping tx, she just basically went into a puddle on the exam table.... She doesn't really have a close relationship with the onc or her primary. She is the type that only saw the doctor to have me and never went back. She hadn't been to the doc since I was born (I'm 26) and I had to literally take her to get checked out when she got sick. I would love to just sit down and talk to the onc myself by myself, but I don't know- are docs willing to talk to patients' family if they just call them up?? I'd love the onc to "start the conversation" first. Thank you all, I value your answers greatly! Oh the trials and joys of this life!

Hello, I am mostly a lurker here. I need some heart-to-heart advice....and I'm sorry if this gets too long. If it's in the wrong section please move it appropriately. Thanks.... My mom (58 years young) was diagnosed with stage 4 rectal cancer July 2010. She had a diverting colostomy done July 2010- they could not remove the tumor due to close proximity to the aorta. She did 4 months of FOLFOX with Avastin and Xeloda for 6 months, and palliative radiation for pain. She is now in her 2nd month of FOLFIRI due to the previous chemo/rad not working anymore, and I am pretty certain this chemo isn't working either. The tumor is just so far advanced, and all the chemo really will do at this stage is buy a few months. Last month, her onc asked whether she wanted to try another chemo or to stop tx. She asked us all what we thought she should do, we told her it was up to her and she chose to begin more chemo. She is not ready to "give up" and says she just wants to see her grandkids grow up (ages 8, twins 3, and 15 months.) In reality, that is not going to happen. I knew before she was diagnosed what we were going to find out and what the outcome was going to be. Sadly, I have seen so many patients lately get diagnosed with late stage cancer and spend their last few weeks/months on chemo instead of enjoying their time left. (I had a pt last week with new dx stage 4 cancer, it looked pretty obvious to me that he was actively dying, yet he and his family started chemo. He died this week ) I just don't want us to be the ones in denial, but I don't want to kill any hope that she's got. I feel like when she stops tx she will just give up, though I want her to see that she is indeed still living though not treating. Her pain is increasing as the tumor grows. I see her declining physically- she can't get out of bed due to pain do anything except go to the bathroom. She can't shower well, make food for herself, etc. I just want to say to her "Mom, I think it's time to stop chemo." I don't want her to do it just for all of us who will be left behind. The onc has said she thinks she has between 3-5 months left- that was a month ago. I wish the oncs would sit down and talk more realistically about end of life- though I know a lot of pt's aren't ready to hear it. I am her only kid, and no one else in my family is medically savvy- this burden falls to me. And those 4 kids are mine, I work full time nights, and live an hour away from her though I will move in when her time grows shorter. Any advice from those of you who have been there?

if the pt decides the people at bedside are family, i dont ask and dont argue. family is like pain "it is what the pt says it is." no matter what i think about it! :)