tnguy31

Hi everyone, I'll keep it short and straight to the point. I work for a post acute rehab facility. 95% of the nurses (RN and LVNs) at the facility is Filipinos. With all due and respects, i think they are great and very good at their jobs. Problem is they speak in there own language even when discussing pt care with each others. I just felt so isolated and felt like i can't blend in at all. Any suggestion or advice would be greatly appreciated.

The pt died last night. I feel so sad. She died peacefully, no pain. @curiousauntie: Thank you for sharing. The family is very worry about leaving the pt feel hungry, they think it's a bit cruel to her. I regretted that I didn't pursue this treatment to relieve her symptoms.

Thank you Capecod, this is so helpful. exactly what im looking for.

The dr. also order NPO till n/v resolve. Patient still has sense of hunger and desire to eat.

@ Idis: I'm thinking about the risk of further dehydrate the patient and possibly perforate tumors in her stomach. What do you think?

Hi nurses, I would love to hear your opinion on this issue. I have an 87 yrs asian female patient with gastric cancer that metastasize to other organs. She was admitted to hospice after having part of her stomach remove. She was doing good for 2 months. Recently, she nauseated and vomited 5-6 times a day, increased the frequency at night, the emesis is coffee ground in small to moderate amount. Pt is on Zofran 4mg dissolve on tongue every 6hr around the clock, reglan 10mg tid 30mins before meals. The meds has no longer effective in controlling her n/v symptoms, it reduced the severity but not very much. Family is extremely anxious, pt looks uncomfortable, visible weight loss, she has no pain, v/s: t 97.4-96.9, pulse 87-94, resp 14-16, o2 >97%, bp 98-118/56-78, BM every day 1-2 times a day. Dr.order protonix po (i forgot the dosage) and NGT intermittent suction. The patient is a very small lady that weight probably less than 80lbs. Do you think NGT is a good idea? Why or why not? The dr. insisted on NGT with pediatric size tube; the DON insisted on not too, so I decide I would ask nurses here. Thank you for your input. Also, I'm giving out the Hospice Quickflip from Corridor Group (2 of them). Have to buy as a package of 4, and realize they're all the same, so I only need one. :)) so just pm me.

Thank you NC29Mom for your input. The pt is a DNR. The family just dont understand the purpose of hospice, and there is miscommunication betweeen the P.A and the family. I already talked to case manager, still waiting on the response

Yes I think so too. Although she is end stage, I don't see her with a prognosis less than 6months. I don't know what the lab for, just CBC and CMP. But I'm checking with the P.A who talks to family. So far, she hasn't respond yet. I have other ES Alzheimer in bad shape physically, but this particular pt is different.

I recently visited a patient with end stage Alzheimer's diagnosis. However, I have problem understanding why she should be in hospice considering her status. The pt is a 93 years old female that walks with walker, most of the time she sits at her sofa and constantly picking the sofa apart ( she is not agitated, it's her habit), awake, very confused. She would talk and lead you to her own world. Bladder and bowel incontinent, vital signs WNL, o2 sat 98% room air, she can feed herself when the meal is ready in front of her. have heart murmur, tricuspid valve disease, lung sounds clear, bowel movement every 2-3 days with daily doses of lactulose. She does need to be reminded of taking food and fluid. Would anyone please explain why this pt should be on hospice? The family also asks about having her lab works done (after the family talked to the Physician assistant, family said P.A. in agreement of having lab done). I explain to them that unless there is sign/symptoms that warrant the need for lab such as UTI or pneumonia; otherwise, we dont do lab work on routine basic since the patient is on hospice and not seeking curative treatment. Do you think my answer is appropriate? Is there a better way to address this question? Thank you so much for you input.

Thank you so much everyone. I started to have doubt at my ability to be a nurse, but your support and encouragement give me confidence.

Hello to all nurses, I have been holding myself back from writing this topic for awhile, but being in this site for a year now, I realize the great support from all of the nurses here. So I'm writing this to vent out my feeling and seek for advice as well. I started as an international student with no background in medical. Didn't understand a word for the first 6 months I was here. For the two years in nursing school, I was full time student with two jobs. Managed to finish school with all B's. Got my license. But my two years gap (being out of field) due to immigration status doesn't look good on my resume at all. So here I am, a new graduate with two-year break, working at a hospice for-profit organization. I basically visits patient and function as both LVN and RN. I had 3 days training, and i was on my own. It's been four months, and I feel frustrated and helpless. I realize I lack of knowledge and nursing skills. I feel like I'm not a good nurse, not a safe one. I constantly seek for information and learn from nurses in this site, but it didn't get any better. The company hires a new DON. She is great. The only problem is she seems to ignore me. Im working full time, and going back to school full time for my BSN. I just felt so lost. I don't know if this is the right profession for me. I don't know what to do. Im wondering if I should change my career? If i should quit this job? Thank you so much for reading. I'm open for all opinions and advices.

Thank you HodgieRN

Hi Tewdles, I'm very new to hospice as well as nursing. I try to find the Corridor handbook that you mention, but nothing related pops up on google. May I ask what is the exact name of the handbook?

Thank you for posting this topic. I found it so helpful.

Congratulations!