tgrosz

leslie, i understand what you are saying. it's not as though you quit trying, it's that you know that your trying will often be futile because patients and families are just not willing to accept the inevitable no matter how much prior education/ consultation was done. it's very frustrating, and if you push too hard you come across as being morbidly obsessed.

vivalas makes some astute and interesting observations. not so sure how hospice can intervene in the process other than providing ongoing community education on "the last phase of life" as missit presents. it would seem to me that administrators such as vivalas, case managers, nurses and social workers that work in the hospital, ltac, alf, and ltc facilities are the direct link; but, all too often they get tied up in the business "end of life". also, we live in a death denial society that is more interested on how to extend life rather than to accept "the realization that the human mortality rate is 100%" which vivalas so adeptly points out. maybe the "death panels" as erins mentions or some alternative mandate will need to come to fruition before we may have any serious dialogue. just my thoughts, please add yours

bsnanat2, doesn't look like you got much of a response here but you raise a very good question and your observation with ccu/icu patients is spot on, many would be better served to be sent home with their families with hospice care. how to get there????? come on hospice nurses/administrators, let's toss this around

your concerns are valid, you may want to run not walk out the door asap and not look back. please let us know how you're doing.

it seems to me that your lady is on a whole lot of pain meds for a headache and tummyache unless i've missed something. i also question the patch although i understand in ltc. any chance getting her into a ipu to closely monitor her and get symptoms under control? if not, may suggest getting off the patch and try just using the hydocodone preferably on a prn basis but if you don't trust ltc staff on a schedule basis and see. is she eating? i've not had experience with risperdal for agitation, haldol has worked most of time, and much cheaper. you got your hands full, but you've gotten some good advice here, keep trying, it will come. best wishes?

nice to hear from you again Heron, a wise and thoughtful voice from the past. thanks for interjecting your thoughts, i've been out of the loop a few years and wasn't aware of the changes with IPU, this certainly would change the atmosphere.

DeLana, the fact that you have volunteered for the last 3 months, you find the atmosphere conducive, and the positive feedback you are getting from others would indicate that you may be very successful as an inpatient hospice nurse. your hospital experience, although chaotic and overwhelming, was a good learning experience. apply for the job, i don't think you will have to sell yourself, your actions speak for you. don't get hung up on charting or codes, your compassionate care will get you through. Best wishes!

mharden, suggest you keep trying to get with hospital which is your first choice. although you may gain some technical experience with hospice, it's would be more feel experience. hospice would be more of a career ending than a beginning. best wishes!

take some time if you may to heal. not all hospices are as bad as your odyssey experience, but many are mismanaged and you may find yourself in compromising positions more often than not. unfortunately, hospice has been overrun with greed which has affected the ability to provide the compassionate, competent care that is most needed with this specialty. best wishes!

Vtachy, please give an update on your patient's condition

thank you for sharing, you are a compassionate soul, may you be forever blessed. your friend is heroic, thoughts and prayers are with him and all of you who care for him.

please let us know about your friend

it is a grace from God to be allowed to be in the presence of death

leslie's advice is always useful and spot on. tewdles advice to listen is most important. through listening to both patient and family you will learn to address their needs which will build rapport and trust. not any difference than nursing a non-hospice patient

this post seems to be hijacked by vaseline balls. i understand that if you throw them against the wall, they will stick. anyway, my best advice to makua girl is to visit michael holmes at www.crossingthecreek.com and to read "practical guide to understanding dying process"