johnys

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1. ESRD, stopping dialysis

   johnys replied to 84RN's topic in Hospice

   It would depend to a large degree on what, if any, renal function they have left. If zero, then can plan on a short Hospice stay. There is always the unexpected...had one lovely 93 yr old lady come off dialysis, slipped into a coma on day 5, and unfo...

2. rescue meds...or not.

   johnys replied to johnys's topic in Hospice

   Much thanks for all your insights. Post-script: pt was sent out to local ED, received IV morphine and ativan, and when meds were finally in place at SNF he went back; died next morning, peacefully. Honestly, I was out of my mind with anguish that I, ...

3. rescue meds...or not.

   johnys replied to johnys's topic in Hospice

   FLArn, thanks for your response. Yes, the doc had faxed signed written scripts to the pharmacy. I confimed that from the nursing home. The staff nurse followed up with the pharmacy to see when the meds might be delivered. We had the confirmation we n...

4. rescue meds...or not.

   johnys posted a topic in Hospice

   So, this is one part question, one part unloading, and 4 parts heartache. It is long, and I apologize for that. I am an admissions hospice rn. What I experienced with two patients on back-to-back days is making me question what I am doing. Both cases...

5. Hurrying death?

   johnys replied to lalalulu's topic in Safety

   "Yes, when I worked in hospice we did use highly concentrated liquid forms of morphine and sublingual ativan on our patients who were actively dying. Most of them did not have veins that could support IV access. Besides, why cause a dying patient mor...