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jammycakesRN's Latest Activity

  1. jammycakesRN

    Charity wound vac option

    There's also a fairly new SNAP Vac that's disposable you might check into. Not sure about charity availability.
  2. jammycakesRN

    Medihoney as debrider?

    Many of our patients use medihoney in place of santyl. They aren't the same, but similar & medihoney is much more affordable for our patients.
  3. jammycakesRN

    New to HBOT...

    Look at Healogics. They have HBO units all over the states, might come in handy if you transfer often
  4. jammycakesRN

    Tired HH nurse

    I'm tired of working 10-12 hrs/day for 8 hrs of pay. I never have time to get it all done & they just keep piling it on! At this point I think I'd work anywhere that I can go home to my family at a normal hour & actually have a life!
  5. jammycakesRN

    Patient refusing Hospice

    Yeah, that's not even close to being the case. I went to every supervisor I had AND consulted with our sister hospice company. My supervisors told me that we could not provide the "hospice care" he required BECAUSE we have a sister hospice company & they needed to be referred to hospice. I was in no way " blowing her off".
  6. jammycakesRN

    Wound Care

    We use unna boots frequently & they work well for most of our patients. Clean well with cleanser, apply unna boot wrap toes to 1" below knees, then Kerlix wrap, then coban wrap. Change 2-3 times a week.
  7. jammycakesRN

    Patient refusing Hospice

    He passed tonight. Maybe he can finally get some rest.
  8. jammycakesRN

    Do hospice nurses usually get benefits?

    The home health agency I work for has all benefits and pays more than the hospital. I know our hospice dept also offers benefits, but not sure what they pay.
  9. jammycakesRN

    Patient refusing Hospice

    I'm not really a fan of sticking around per se. But, seriously, if I tell him I won't ever see him again once he chooses hospice...he will NOT choose hospice. I discussed it with my director & she was okay with it. I don't think there will be much time for too many visits.
  10. jammycakesRN

    Patient refusing Hospice

    Ok. Here's an update. He has agreed to have hospice come talk to him tomorrow. I hope he will agree to let them help him. He said he wasn't going to like it if I wasn't going to be his nurse. His wife agreed & I explained that they can't have home care & hospice, but if they want me to, i would continue to visit them on my own time. I don't want them to feel like I'm abandoning them & I don't want him to refuse hospice just so I'll keep coming. Physically he continues to decline. I'm not familiar with the timeline of these kinds of things, but last week I noticed his teeth look like they're thinning or something, they almost look transparent on the edges. His skin around his eyes look really dark & his temples are very sunk in. Earlier this week he began to not be able to control his bladder. Today he seemed very confused and wasn't able to answer questions correctly. Do any of you experienced hospice nurses know about how long he has, based on those signs? It breaks my heart to see him go thru this, but I'm going to continue to be there for them.
  11. jammycakesRN

    Patient refusing Hospice

    This was the reason for my original post. I'm not a hospice nurse & don't really know the info she needs for end of life care or about available resources. For me, in the home health field, calling in Hospice IS our "end of life resource" for our patients. I make the referral & viola' I'm done. And an awesome hospice nurse takes over to do a wonderful job. At the visit today the wife provided a new DNR order. At least I'm not going to have to break his ribs with CPR.
  12. jammycakesRN

    Patient refusing Hospice

    I don't think I'm trying to force him to be on hospice, it's just that I know his wife is struggling & I do not have the resources (or know what resources) she needs that are available. I know she needs more help than I can provide. I am only there for an hour every other day. That's a lot of hours she is there alone with him. She is doing a great job at caring for him, but she has admitted that she doesn't know what to do when he passes. I told her she can call me, BUT he doesn't have a DNR order, so I have to consider him a full code & send him to the hospital and possibly even do chest compressions. He probably weighs less than 100 pounds now & the last time I tried to send him to the hospital, he refused. I'm just so out of my zone here, I have no idea what to do. I DID make a hospice referral, that's who he refused. His wife told me that he has already admitted to her that he doesn't have much time left, I just can't figure out why he doesnt want her to have some assistance.
  13. jammycakesRN

    Patient refusing Hospice

    No. Just me! He got so upset that she won't even discuss any other disciplines.
  14. jammycakesRN

    Patient refusing Hospice

    I have been a home care nurse for the past two years, prior to that I worked in the clinic setting. I am not, nor ever have been a hospice nurse. In my area, we come in and help the patient on a temporary basis until they are back on their feet. During the certification time for this patient he has steadily had a decline in health. I mentioned hospice to his wife several months ago and she was not receptive at all. He continues to get worse and now is pretty much bed bound. Last week his wife began asking me for details about end of life. I explained to her that this is not my area of expertise & asked again about hospice. She declined. This week she finally said she was ready because she had questions & needed help. When she mentioned it to him, he was adamant that he was NOT going on hospice. What do I do? I don't have a clue how to help her with end of life situations. I feel bad for them, but I can't force him to accept hospice. I won't leave them stranded, but I honestly feel I am way out of my comfort zone here. JammycakesRN