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pmabraham BSN, RN

Hospice, Palliative Care

Follower of Jesus • BSN, RN serving others as a Hospice RN Case Manager • Lifelong Learner

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pmabraham has 3 years experience as a BSN, RN and specializes in Hospice, Palliative Care.

Follower of Jesus • BSN, RN serving others as a Hospice RN Case Manager • Lifelong Learner

pmabraham's Latest Activity

  1. pmabraham

    Quotas for visits, mandatory overtime?

    Thankfully the company for whom I work pays their visiting staff hourly vs. salary. Nurses have a form of a quota system and that is 20 points per week where a routine and recert visit is 1 point, an admission visit is several points (I forget the #), and so on. There is no chastisement for being under 20 points. What they look at come raise-time is the overall average of points for the review period.
  2. pmabraham

    Understanding the Risk of Firearms: Suicide vs. Homicide

    The evidence is in the Bill of Rights itself. I'm glad you own a gun and you are teaching your son good information about guns. Yet, keep in mind the 2nd amendment wasn't put into place for hunting but as protection against government tyranny.
  3. pmabraham

    Understanding the Risk of Firearms: Suicide vs. Homicide

    Read https://constitutioncenter.org/images/uploads/news/CNN_Aug_11.pdf
  4. pmabraham

    Understanding the Risk of Firearms: Suicide vs. Homicide

    The 2nd Amendment was written after liberating our nation from tyrants which is the exact intent of the amendment. So that legal citizens who are willing to take up (buy) arms and ammunition and keep those weapons in good order (WELL REGULATED) become the militia at the ready to not only defend their own lives and property but our country from tyrants. And, those rights "SHALL NOT BE INFRINGED!" A lot of people who are either afraid of guns or buying into the liberal media will focus on the words "well regulated" thinking that means laws and regulations; it DOES NOT! See https://constitutioncenter.org/images/uploads/news/CNN_Aug_11.pdf "Well regulated" means being ready, being able to fight, willing to maintain the very arms that are being owned and used. The words "SHALL NOT BE INFRINGED" means just that -- no legal restrictions! Now as it relates to being out in the field, I find cases where I go into the home (I'm a hospice visiting nurse) where there's a sign on the front of the house "Trespassers will be shot; survivors will be shot again" and I smile. I'm not afraid because the issue isn't guns, it's the heart, and I'm happy to be a service to those who respect the 2nd amendment vs. trying to dismantle it and misunderstanding both the words "inalienable" as part of "inalienable rights" and the words, "shall not be infringed."
  5. pmabraham

    Ethical Dilemma: Is it ever ok to mislead a patient?

    Yet without ethics, there lacks compassion and humanity. Now, since you've previously jumped to assumptions vs. assessing, let me be clear I'm not accusing anyone of anything. I'm sharing ethics matter and the patient bill of rights matter.
  6. pmabraham

    Ethical Dilemma: Is it ever ok to mislead a patient?

    Wuzzie, you are assuming in several areas. I was not trying to school anyone. Since you are a seasoned nurse, may I suggest start assessing more than assuming? I work in hospice, so I know what gray is, but gray NEVER take away patient's rights. Now I'll end here, because you come across as having all the answers given your assumptions vs. assessing.
  7. pmabraham

    Ethical Dilemma: Is it ever ok to mislead a patient?

    As I shared, check with the POA... and unless the POA is legally removed as the POA, they are the POA. You are free to read into things, so if you are reading into the responses with a certain tone, that's your choice. I'm just sharing from a neutral perspective as well as one who cares about the patient bill of rights.
  8. pmabraham

    Ethical Dilemma: Is it ever ok to mislead a patient?

    In my comments, I'm referring to the patient's bill of rights which includes the ability to refuse medications and treatments. When it comes to dementia patients, please lookup validation therapy by Naomi Feil. Wuzzle, which is why living wills are very important.
  9. pmabraham

    Ethical Dilemma: Is it ever ok to mislead a patient?

    Then you go to the healthcare POA before you do anything which is unethical. Paternalism/Maternalism in healthcare should always be questioned. Also, nonmaleficence (as an ethic) comes before beneficence for a reason. One can actually cause harm by thinking they know what's best and forgetting the patient and their POA (when the patient cannot make their own decisions) have the final say (not the healthcare provider/worker).
  10. pmabraham

    Social Media and Doxxing - Your Thoughts???

    1: Is it okay to post selfies regarding work situations? This is extremely high risk and very dangerous action to take. Are any patients in the picture? Are any belongings of any patient or coworker in the picture? Are any visitors or other people who may not want their picture taken in the picture? Best case, don't do it. 2: How about the person who reported it? Two wrongs don't make a right. While #1 may show a level of a "stupid" action, given the extremes some organizations go to when receiving a report where the punishment far outweighs the wrong activity, in my opinion, the reporter was in the wrong. 3: Do you know your facility policy? Far too strict.
  11. pmabraham

    Rounds and patient expectations

    "At my facility the ratio is 1 nurse to 19 patients" My wife and I were recently at a rehab unit visiting a relative. Their unit has a ratio of 1 nurse to 5 patients on the worse of days and 1 nurse to 3 patients on the best of days. 1:19.... ouch
  12. Home health and hospice visiting nurses; you drive solo the overwhelming majority of the time. My experience working in hospice, the doctors tend to take your recommendations either Carte Blanche or tweak them.
  13. pmabraham

    Ethical Dilemma: Is it ever ok to mislead a patient?

    Yes, misleading is wrong and paternalism/maternalism (trying to put beneficence before nonmaleficence and patient autonomy) is never a good thing.
  14. pmabraham

    How long for license in different state to go through?

    Sadly, this is going on in our state: https://www.pennlive.com/news/2019/09/pa-nurses-fed-up-with-delays-and-rude-answers-dealing-with-state-licensing-board.html I do recommend calling the board itself.
  15. pmabraham

    Hospice Placement

    As a hospice nurse, I focus on the patient and family in the most holistic manner possible which varies from patient/family to the patient/family. On the pure medical/healthcare side, we focus on managing presenting symptoms. We do not chase after abnormal vitals, labs, etc. Part of the holistic side is learning about the patient and family, what's on their bucket list, and how might we aide in the patient/family achieve those items. There's also working through a lot of education as most families including the patient know little about the dying process. So we teach about disease progression, death and dying, and work with the patient and family to get them all to a place of comfort. Medicare pays for hospice as do a lot of insurances where palliative care typically is out of pocket from my understanding.
  16. pmabraham

    Home care pay

    I would be reporting this to the labor board. This sounds illegal.