flea

lots of folks think we (hospice nurses) come to stay 24 hrs/day instead of intermittently. (especially when we show up on the visit w/ the huge 'nursing bag') Did you read Tuesdays w/ Morrie? At the end, the author noted a 'hospice nurse' posted outside the room. I wrote him and told him that he did hospices a great disservice. Anyway, there is continuous care, usually provided by private duty agency, for health crisis and respite care for caretaker crisis. make it clear that hospice is INTERMITTENT care or you will be overwhelmed and burnt out VERY quickly. suggestions: -personal care home -more RN hospice vss /week (1/week is too little, esp at first) -Agency on Aging referral. they provide respite care in some states -volunteers. they are required under medicare cost savings anyway. -get 02 in on first visit, but no routine pulse ox. explain that hospice goal is too make pt comfortable, not to keep #'s in line. This applies to labs, wts, measuring ankle and abd circumference, I&O's etc. Thinking this through, you realize the pulse ox will drop, wt will drop, ankles will swell etc and this is normal during the last few days of life. If you are monitoring these, the families get VERY anxious. -use the interdiscipliary team. GOOD LUCK!

$50.00 (PRN Hospice)

yes, thanks!! We're switching Mon AM. The pt has intermittent pain, takes 4 BTP doses in 24 hrs, but becomes confused and oversedated when the oxycontin was increased. Hope it goes well, thanks again!!

:rotfl: help! should we start the methadone at the next oxycontin dose time? say- after waking up in the am? any problems with gi distress? may it be inserted rectally, like mscontin?

We also pay per hour. I work PRN @ $21/hr.This is rural Pennsylvania.

i would like to know other hospice nurses experience w/methadone in lung ca. resp depression?? confusion?:angryfire