pmabraham BSN, RN

pmabraham has 6 years experience as a BSN, RN and specializes in Hospice, Palliative Care.

pmabraham's Latest Activity

1. 

   Changing Careers At 42

   pmabraham replied to Zakando Z's topic in Pre-Nursing

   Then there's home health and home hospice where you are not working 12-hour days 😉
2. 

   Changing Careers At 42

   pmabraham replied to Zakando Z's topic in Pre-Nursing

   I went back to school at the age of 50 to become a nurse, got my associate in nursing science, passed my NCLEX-RN boards, then went for my BSN. You can do it if this is your dream.
3. 

   Lowest Dose of Morphine To Cause Death

   pmabraham replied to thisnurse123's topic in General Nursing

   0.25 ml = 5 mg of morphine. The max daily dose of morphine is 1,600 mg. As a hospice nurse, I've had pancreatic cancer patients on 960 mg morphine daily and still talking. Morphine is not a euthanizing agent.
4. 

   Morphine for Hospice Patients: What Nurses Need to Know

   pmabraham replied to KyleStaarmannRN's topic in Education

   The 4 drops of clonazepam DID NOT speed up the dying process
5. 

   Hospice agency shutting down - help!

   pmabraham replied to mslavender1982's topic in Hospice

   As a visiting hospice RN case manager, I don't know how much I would trust cameras in order to be able to properly see the condition of the patient. While vital signs, in my experience, are often not the main factor for me to determine estimated end...
6. 

   Morphine for Hospice Patients: What Nurses Need to Know

   pmabraham replied to KyleStaarmannRN's topic in Education

   It comes from experience and I'm not trying to be snarky. I've articles on medium dot com that go over how to recognize terminal restlessness, when someone is within two weeks or less (does not include sudden death syndrome), etc. but the last time ...
7. 

   Morphine for Hospice Patients: What Nurses Need to Know

   pmabraham replied to KyleStaarmannRN's topic in Education

   Cheyene stokes and Kussmaul are among the common end of life breathing patterns, but nothing you wrote came across as excessive. We are called to use critical judgement and you used yours. Morphine and Ativan are not euthanizing agents; you did the...
8. 

   Morphine for Hospice Patients: What Nurses Need to Know

   pmabraham replied to KyleStaarmannRN's topic in Education

   Let's start off with just a little background of how hospice is supposed to work with families. What I'm sharing is per Medicare guidelines and that means every hospice nurse and provider should be following what I'm about to share but I'll put it ou...
9. 

   Morphine for Hospice Patients: What Nurses Need to Know

   pmabraham replied to KyleStaarmannRN's topic in Education

   It’s frustrating do you have anyone who is a healthcare professional think that hospice uses morphine for euthanasia. Prior to becoming a hospice nurse I worked on the cardiac floor where are they increasingly gave me more and more hospice patients. ...
10. 

    In Hospice are RNCM's Ever Paid Hourly Instead of Salary?

    pmabraham replied to Texasdude's topic in Hospice

    Check https://careers-brightspring.icims.com/jobs/intro?hashed=-626002160 as they own Grane for whom I work as an hourly RN Case Manager.
11. 

    In Hospice are RNCM's Ever Paid Hourly Instead of Salary?

    pmabraham replied to Texasdude's topic in Hospice

    Grane Hospice pays hourly. They are owned by BrightSpring so it is possible other BrightSpring branches for hospice also pay hourly.
12. 

    On-call hospice nurse

    pmabraham replied to lwheatley's topic in Hospice

    "Tuck-ins" are calls or visits to see if the patient is OK, needs supplies, etc. More often they are phone calls but can be a visit if a change in physical location such as nursing home discharged to home or home going to a nursing home (respite or ...
13. 

    On-call hospice nurse

    pmabraham replied to lwheatley's topic in Hospice

    Hi: Tuck-in calls and visits should be doable by LPN/LVN/RN et al as it is just a routine visit or call to check in on the patient. Pre-admission evals typically require a good understanding of LCD's and what makes a patient terminal from a nursin...
14. 

    On-call hospice nurse

    pmabraham replied to lwheatley's topic in Hospice

    "I have been told that I do not have a set number of patients to see, nor will I have a list of "regulars" or appointments. I was hired to be a go-between for families and patients who already have scheduled visits during the day, but feel/know that...
15. 

    On-call hospice nurse

    pmabraham replied to lwheatley's topic in Hospice

    Salary has pros and cons. When I worked for-profit their for-profit took advantage and I worked more hours without the benefit of overtime. On-call can be just phone, phone + PRN visits or phone + PRN visits + scheduled visits. The latter can be h...