skd1019

I'm not in the UK, but this thread touched a nerve. Not all change is for the better....... I work in a free-standing inpatient hospice unit. The facility and grounds are truly beautiful, and it is obvious that thousands of dollars have been poured into the place to make it as home-like, peaceful and inviting as possible. Up until Jan. 04 we were required to wear white pants, but our shirts/jackets could be any soft/muted, pastel, or floral pattern (just nothing glaringly bright/dark.) Imagine the uproar when we were casually informed that as of the end of the month we had to wear ALL WHITE!!! Uproar, may not be a strong enough word to describe the reaction...I kept expecting a riot to break out. :angryfire It seems that "the-powers-that-be" (we all know the type...those who are pathetically far removed from the pulse of nursing, yet wield the power to really mix things up!) wanted "our patients and families to be able to clearly differentiate the nurse from the nursing assistants", and also stated that they "really like the crisp look of a nurse in white." The home-like atmosphere is now a bit sterile, and the morale of the staff has taken a dive. (We fought against this tooth-and-nail, many firing off heart-felt letters to administration opposing the change.) Are we way off base, or has anyone heard anything more ridiculous??

I also think that it is wonderful that you are considering hospice work. I graduated from nursing school in Dec. 2002, and have been working in a free-standing inpatient hospice unit for almost 2 years now. I guess I was an "experiment" of sorts, because I was the first new grad ever hired. My manager openly and readily admits that hiring a new grad was a risk...but one that she has never regretted. Since you are just starting out, I'd like to share a few things I learned while in school. Keep an open mind, and don't be surprised if you find several types of nursing that you enjoy (and some that they couldn't PAY you enough to do!) I was fortunate enough to know in my heart that hospice nursing was my calling. My dream at the start of school was to work on a Mother/Baby unit...maybe even become a lactation consultant. (I certainly went to the opposite end of the spectrum, didn't I?) EVERYONE, EVERYONE, EVERYONE will tell you that "you need at least a year on Med/Surg" before going into ___________(anything/everything). If you are still interested in hospice work, and aren't fortunate enough to have an inpatient unit nearby, ABSOLUTELY do the year (at least) in Med/Surg!! A new grad is not equipped with the skills needed for home care!! If you have an inpatient unit...GO FOR IT!!! The same goes for most other fields of nursing. If you know where your calling is, and the education/support needed to learn the job is made available to you, follow your heart! Getting through nursing school is time-consuming, scary, intimidating, frustrating, exciting, wonderful, rewarding. While in the middle of it, it seems that school will never end. When they hand you that hard-earned degree, the time will have seemed to fly by. You will have packed more knowledge into your brain than you ever dreamed possible, you will have made friends that will be friends forever, and you will have experiences that will stay with you a lifetime. Enjoy your time in school! It's OKAY if you walk down that graduation aisle totally confused about where you want to work/what kind of nursing you want to do. You might even take a position that ends up being the wrong fit for you. Don't be afraid to change. You will have worked too hard to earn that RN after your name to end up not liking the kind of nursing you're doing. Try something else! Be assurred that most everyone eventually lands where they are meant to be. Best of luck to you!

Just last month I sent a patient out to a local hospital to have a catheter implanted for paracentesis. It is a type of dialysis catheter, although the record I received from the O.R. (outpatient surgery) when my patient returned didn't give a specific name (simply referred to it as a "65cm pig-tail dialysis catheter") It is a simple tube with a clamp near the end, and a small cap at the tip. Every other day we attach a foley bag, and allow it to drain for 1 hour. It is very simple to use. I should also mention that we had a bit of difficulty finding a surgeon to do the procedure. However, being able to spare the patient from having to be tapped Q6days was well worth the effort. Hope this helps.

I work in a 40-bed inpatient hospice setting, and our ongoing "bath wars" have me frazzled. Our nursing assistants complain constantly that the NA's on other shifts don't do their fair share of patient baths. (The current policy is that day shift NA's do odd-numbered rooms, evening NA's do even-numbered, night NA's bathe patients who are LOC 4.) However, fingers still point at other shifts, and a lot of grumbling goes on. Shift RN's are also now reporting that the NA's are so relentlessly focused on cranking out their required baths, they are glaringly unavailable to help with the unscheduled tasks that come up each day (answering call lights, feeding patients, helping to the bathroom, etc.) My opinion is that most hospice patients do not need a full shower/bath daily. (Special circumstances aside.) My initial idea is to make the general rule that all patients get the basics (hands/face/peri/underarms) daily on each shift. The shift RN can then delegate to the NA which of his/her patients need a full bath. Any other ideas/comments? Help me end the "Bath Wars" once and for all!!