teamrn

I'm a newbie, so please be gentle! What is the difference between a femoral sheath and femoral line? Thought the sheath was an anatomical entity NOT to be removed. Or is the reference to removing a femoral sheath, actually the removal of the plastic sheath of the cannula in the femoral vein? Something to do w/ IABP? Isn't a femoral line, a central one; though not to be relied on for PCWP Isn'a a femoral sheath, part of a patient's anatomy? I'm stumped and need this info; can someone explain in BABY TERMS and gently? Thanks in advance and where can I go for procedure? It's kind of obvious I don't work in ICU, but am intrigued. Can someone help out a fellow RN? team

I used to work as a case managing RN in hospice. We used no official 'term' for this well known 'rattle' when death was near; rather, we'd explain to the family that the patient wasn't experiencing suffering as long as his oxygenation status was not compromised. If O2 was compromised, we ordered O2, and a scopolamine patch also helped dry the secretions, so family members were not as distressed. Respirations at this time were also often irregular, and I found that teaching the family the meaning behind all this, worked more than the agonal/ cheynes-stokes terms. But I brought them out if they were necessary. :mad:

Sam, I've been a hospice nurse for @ 9 years now, and in as much as I don't have a complete knowledge of the bereavement process in my memory and at my fingertips, I feel it is necessary for me to understand that there IS a bereavement process, and its basic concepts. (The details, I leave to LCSWs, chaplains, and bereavement counselors). Hospice is a team approach to care, and the bereavement care is a very important part of that care. Annie

I've worked as a hospice nurse for the past 9 years, and do I LOVE it. Yes, there are the ups and the downs, like in any job, but there have been a few days while I'm driving from house to house, when I've pinched myself, and said (to myself!)"Ican't believe that I 'm paid to enjoy what I do." Granted, not paid that much, but I get to do the teaching that I love, pain and symptom managemant that I feel is so necessary and often overlooked. I work with such an incredible team of CNAs, social workers, volunteers and chaplains, and I also have the opportunity to be of support to the patients and families who are experiencing one of the most difficult times that can be faced. I am able to be a part of that, and love it.

Well, finally national attention that quasi met my 'approval'. However, the statement that the shortage of nurses exists NOT because of salary issues, but because of image portrayed, irritated me. Yes the image thing is so very true, and when I ran the example by my husband he agreed. But, the reporter dismissed the salary issue as a non-concern w/ a quick comment, something like, after all, new grads make $40K. Unfortunately, they max out rather quickly, the responsibility for that $40K is pretty hefty, the image is poor as agreed. Wish more had been made of the interview w/ the NURSE who discussed what she felt the general public's perception of nursing is. 20 years after I started in nursing I'm making more than when I started, but w/ inflation in there, cost of living, etc, I don't believe there's much reason for this baby-boomer to stick around; except, she LOVES what she does! Let's keep those letters and calls going to Washington and the mnm org, and to anyone who'll listen. I think we've got attention.

I worked permanent nights for @ 6 years, rotating days/nights for @ 4 years. The weight thing was not a problem, but I think it was because I didn't need to go home and sleep(no kids, no husband at the time). I went home, changed my clothes, went to the Y, or to the lake swimming or biking or did something active. Didn't go to sleep until noonish most days. As far as food at work being tempting, the candy machines were in another building, so I limited myself to the snack(s) that I brought w/ me. Every now and then, there was patient-provided food; guess I just indulged on those RARE occasions! Good luck.

I work in hospice care and a good nurse-patient relationship is mandatory. In hospice we address the family/significant others as the unit of care, and they become my patients. Its necessary that I MAKE the time to develop therapeutic relationships w/ them, as when I've established them, my teaching effectiveness increases. Someone mentioned the ATT language line. It has been really helpful at some times, but there are certain phrases, nuances that DON'T translate. Other emotions are international, and patients can tell if you have a vested interest in their care, or are 'just going through the motions'. Please use any and all means of communicationg at your disposal, but never forget the power of human touch. I don't remember nursing school spending adequate time on communication, but it seems to be an innate quality/skill that is found in caregivers, and it can be honed.

In my hospice we use pumps for medication administration (usually MSO4) if there is no oral route, and enteral or transdermal routes are ineffective. Yes, the cost is there, but if we feel the quality of life will be enhanced, and the family is willing/able to learn pump administration under the guidance of the case manager, we'll make a 'go' of it and have had alot of success.