nosonew

Luckily, No. We do document where, how long, miles, etc, but have never been questioned. I totally depends on the traffic, weather, etc.

Okay... new hospice nurse (RN since 93 however) and having difficulty transitioning from curative to palliative care. (imagine that!) Pain control: What do you most commonly use? Do you ever fear using too much Roxanol? How do you explain the difference between Roxanol and Morphine Sulfate? Our Medical Director tells me they are TOTALLY different drugs. Yet they are both MS, so I do not understand this. Yes, I know Roxanol is stronger... but that isn't what he meant. Bowel regime: What do you do when you get a patient (new admit) and apparently he/she hasn't had a bm in 7-10 days? (eek!) Is unable to tell you.. and facility he has been at "hasn't paid attention?" (eek!) What would you have done? Ordered? Skin Care: What products do you use most frequently for skincare and decubs? Last but not least... (boohoo) HOW do I get supplies that I would LIKE to use, but aren't on in stock (perhaps expensive)??? And I work for a non-profit... (eek!) Help!

Actually, I was a bit more concerned about what she might do to the oncologist than to herself. However, UPDATE... spoke with her at length today. She sounds better and she and I do get along very well. She told me our bereavement counselor "sucked" and if he would "quit beating around the bush and just state it like it is they MAY have gotten somewhere". She is open to suggestions and she and I are going to get together next week for lunch to talk about her feelings. We need to talk about her mother (on hospice also) as she has some medical issues and daughter is POA. So... I think we are on the right track right now.. and I am going to keep in close contact as I can. I am NOT going to contact the sons at this time. At least not without her permission, which I plan to ask her next week for. She did actually tell me on the phone today that she is still "angry as hell" but doesn't feel like killing anyone anymore as that won't bring her husband back. (whew). I think her anger stage is moving forward...and onward we go. Thanks for the advice ladies!

Her husband died after a very short battle with cancer. The oncologist told them due to his liver function that chemo would kill him, but he did do radiation. However, the cancer spread and within 3 months he died. They were just about to retire and travel. Now, the wife is very angry, making threats against the oncologist, stating he didn't give them the option to do chemo and it was their right to choose. She has called the oncologist and written him letters. She talked to our bereavement counselor once, then told him he should look at a different line of work. She refuses to see a therapist. Is it appropriate to call her grown sons and voice my concerns without giving out all of the info? I am really concerned about her and also just found out her youngest son was just diagnosed with cancer. And her mother is dying. I don't think she can take anymore. What to do???? I am taking care of her mother and I also took care of her husband during his last weeks, so I have met the sons.

We pay for all meds associated with their hospice dx. Including any comfort care items (ie: bowel, bladder, depression, pain, etc. of course) The thrift shop is in a rented building on our main street. They take donations, have volunteers that come in M-W to go thru the items, price, etc. It is open Thu-Fri-Sat. It is all based on donated items and volunteers. All monies go to help with hospice expenses. I think they opened it because so many families lived out of town and didn't know what to do with the clothing, nik-naks, recipe books, crafts, Xmas items, etc... Occas. they get furniture. Lots of kitchen things. Luckily, we nurses can use it for our patients needs as well. If a client with no money has a broken crock pot or coffee pot... we can go in there and get one for free. There is also a volunteer who checks everything electrical for frayed cords, if it works, etc.

We currently have 58 patients. We live in a rural community and cover many counties. Luckily, we do have many donations and many/most of our clients do memorials to our hospice which helps make payroll (that is paid after paying medical bills of course!) and we also opened a hospice thrift shop with all donated items and that money is also used to pay for things patients need but are not covered. I love love love my job... I wish I could win the lottery and donate half of it and work for free. Honestly. Until last year, I have been told this hospice paid for all medications for all clients. They are still sad they can't keep doing that, but medications are just too expensive.

So more or less it depends on the Hospice Organization itself? The hospice I work for is non profit and allows this... yet I have a friend across the US that can not find a hospice to help with her 80 yoa MIL who has terminal ca but needs palliative radiation. I have encouraged her to speak to other hospice organizations in her area. Thanks!

And still be considered a hospice patient? I am wondering because those can both be done for comfort care, to keep the size of the tumor from growing, thus allowing increased comfort. I am new to hospice nursing and confused! Help!

Honestly, my biggest stressor in 7 years with dialysis are the critical issues you deal with. No, they do NOT happen often, however, they do happen. Strokes, seizures, anaphylaxis, etc. I have been extremely lucky in that I have never actually had a full code in my 7 years, and generally I was the only nurse working (small unit). However, when you have the periods of time with a patient who is ill, and you know "something could happen at any time" it is stressful during their entire run. I personally loved MedSurg too... the busy aspect and seeing all of the different medical issues. But, I think dialysis is my one true love. I just don't do it anymore.

My first 3 months were a nightmare. Large unit, hateful staff, none of whom had ever heard of teamwork. When I went to a smaller unit, it was soo much better. Honestly, if I had stayed at the larger unit, I would have ended up quitting. I worked in dialysis 7 years and loved it. It was unprofessional of those nurses to speak to you in front of the patient, AND I know the Althin machines take a long time to learn (which is what I have always used). Best wishes...

I was pregnant twice in my 7 years. I didn't have any issues with pregnancy and working, although I ended up on bedrest (I was 35 and 37 during each pg). So, I was off work a bit longer than normal, but other gals I worked with had no issues. Personally, do NOT tell them you are pregnant. If you are beginning to show, just wear maternity clothes. They should be able to figure that part out. Also, beware, this is not a sit down job of any kind. You work your butt off! Good luck!

After 12 years clinical experience, I decided to do what I love best... teach. I love teaching patients, families and staff. So, I took a position with our local college and now have the full time job of developing an ON LINE Out of Practice RN Review Class. It is an 8 credit hour course with 180 hours of clinicals (preceptored). I need to have my syllabus and outline developed by February 1. I would like to have the texts picked out and in my hands prior to Christmas. Any suggestions on texts that cover literally everything? Any other suggestions? THANKS!!!

I recently quit Davita after 7 years but they pay both PTO and EIL (Extended Illness Leave). Don't know who you work for... but I personally wouldn't be happy... sounds like someone is giving you false info.

Deigo... I just emailed my local college DON about open positions... she put me to work right away! Most of these jobs are word of mouth, rarely advertised! Of course, I knew her... perhaps you could go in person... Babs... I would have LOVED working with you.I worked for Davita... great company as a whole, sucky admin in my facility. I am loving my new job... patients still call me at home to chat... (small town :) ) however, I am trying to gently cut ties for THEIR well-being... and mine I suppose. Hugs to all of you working your tails off! I do still wake up at 4am as I did every mon-wed-fri for 7 years.. hoping that quits soon! Noso...

At our unit we had a 2K or 1K bath.. nothing else. If below a 5.0 K we did a 2 bath...if over 5K we did a 1 bath. All we could do. Also, I titrated versus patient telling me what he or she was eating.. summers, lots of 1.0, winters, 2.0 due to veggie consumption.