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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. Home Hospice (which from a point of view is very close to home health). You drive solo with the only time management is around is for an annual survey of your skills/practice. When you get good at SBAR's, almost all providers accept your recommendation and often time tell you things like "good job" or "good thinking," or "well thought out" offering encouragement. The families and the patient are often very thankful. As long as you chart in the home, there's minimal work activity outside of work except for a few days before IDG.
  2. pmabraham

    Getting Flack For Not Getting Covid Vaccine

    Margaret Sanger founded Planned Parenthood and has a long history and connection with the KKK, called black people, "weeds," and wanted all blacks wiped off the face of the planet. Bill Gates and his wife support Planned Parenthood and are on record for wanting far less population than we currently have right now.
  3. pmabraham

    Getting Flack For Not Getting Covid Vaccine

    Minimizing? Misinformation? Oh my, what a malarky. I've taken care as many of 40 sickly, geriatric, COVID-19 positive patients per shift when I worked in long-term care from April 2020 to November 2020 and 98% to 99% recovered. The liberal fake news media will not tell you those statistics, but how many infected, how many died, but no percentages. They don't tell you that JUST after the November election they changed the tests so that there's now a 50% drop of infections. They keep spreading the fear. People are being negatively impacted by the vaccine, both with severe side effects and deaths... and within 24 hours of being listed such as on a local ABC web site they get deleted and we are told "nothing to see here," the CDC has not verified any severe side effects or deaths. Yet, I personally know two nurses and a patient greatly impacted (thankfully getting better). Misinformation, my behind.
  4. pmabraham

    Getting Flack For Not Getting Covid Vaccine

    Aysympomatic spread has not been proven.
  5. pmabraham

    Getting Flack For Not Getting Covid Vaccine

    I am educated, thank you. And I'm one of the RN's (along with doctors I know and other nurses I know) refusing these experimental vaccines. We don't know the long-term impact, and will not for some time. My point of view is not based on a lack of education or ignorance. Furthermore, since the vaccine DOES NOT prevent infection or transmission of the virus, please don't bring up it helps with herd immunity which (would matter if the vaccines did prevent transmission). Thank you.
  6. pmabraham

    Getting Flack For Not Getting Covid Vaccine

    A lie is a lie is a lie. Trying to justify the lie just makes the liar a worse person.
  7. pmabraham

    Getting Flack For Not Getting Covid Vaccine

    A liar who uses "the ends justifies the means" logic has no integrity.
  8. pmabraham

    Getting Flack For Not Getting Covid Vaccine

    https://gizmodo.com/Dr-fauci-made-the-coronavirus-pandemic-worse-by-lying-1844050358
  9. pmabraham

    Getting Flack For Not Getting Covid Vaccine

    Oh, you mean the same lying and corrupt without integrity Dr. Fauci who lied to the American public for several months at the start of the Pandemic telling people NOT to wear masks? And then when lying and corrupt Dr. Fauci was pestered enough by reporters about his UNSCIENTIFIC statements and lies that he admitted he was just trying to save masks for healthcare workers... you mean we should trust Dr. Fauci? I would not take a single order from Dr. Fauci if my life depended on it because I have zero trust for a person who lies and then tries to justify the lies when caught vs. apologizing and stopping the bheavior.
  10. pmabraham

    Getting Flack For Not Getting Covid Vaccine

    Curious1997, like the rest of us, you are entitled to your opinion. Thankfully the U.S. Surgeon General is on public record stating NONE of these vaccines should be mandated by anyone. According to Forbes Magazine, PennLive, and various news sources approximately 60% or more of healthcare workers including doctors and nurses are REFUSING the vaccine to the point where if any one of you tries to force the issue, we will take legal action and not work while getting paid (at least in the U.S. where there are laws providing such protection during legal action -- and even if we could not work, would still not be forced). If you think there's a healthcare worker shortage now especially in nursing homes (the one home I worked in prior to going back to hospice would often have one CNA on nights for 150 people, and in the evening one CNA for 50, and I still remember being the house supervisor for 151 patients while being on three separate medication carts caring for 40 COVID-19 positive patients for my shift), force the issue on vaccines that were rushed to market (an extremely recent Medscape article actually states they were rushed to market) and for those of us who know safe vaccines were tested over decades on one million or more people will not be lab rats. There's such a thing as bodily autonomy, and as some who have taken care of a reasonable number of COVID-19 positive patients without ever getting COVID-19 to know there are ways to avoid getting COVID-19 without experimental medications that were not properly tested to know the long-term impacts. So I stand with doctors I know who are refusing these vaccines as well as other nurses!
  11. pmabraham

    Getting Flack For Not Getting Covid Vaccine

  12. pmabraham

    Getting Flack For Not Getting Covid Vaccine

    Thankfully the companies for whom I work are honoring the U.S. Surgeon General's statement that NO one should be mandating the COVID-19 vaccines. One of our coworkers was rushed to the ER via ambulance the evening she got her first dose. Another coworker out of work for over a week due to severe side effects; thankfully both are OK now. A MedTech I know got infected after both doses, and unintentionally infected her husband; both got very sick, were on quarantine for two weeks, and now thankfully better. I've been working with COVID-19 positive (as well as negative) patients since April 2020 without getting COVID-19. For both faith and concerns over the long-term impact of vaccines rushed-to-market and NOT properly tested in terms of the number of test subjects and time frame, I continue to refuse to take the vaccine. Per Forbs, PennLive, and other news sources, I'm not alone; and I'm also not part of the minority.
  13. According to the National Institute on Aging, “Comfort care is an essential part of medical care at the end of life” (National Institute on Aging [NIA], 2017, para. 1). When we talk about comfort, are you aware a person can be uncomfortable without having pain or comfortable while tolerating pain? As a hospice nurse, I want to challenge your practice of asking patients if they are comfortable before you ask if they are having pain as well as for your observational assessment of the patient for comfort/discomfort as well as pain. Why the distinction? If you practice in an area where the patient’s loved ones have concerns about opioids, you may hear such things as “they don’t need morphine, they are not in pain” while the patient is clearly uncomfortable. I was recently in a situation where two other nurses have been seeing a patient who was going through hyper-terminal restlessness where the patient was in severe discomfort, but the family was refusing to use liquid morphine because they associated morphine with pain control vs. comfort control. When the discussion language changed to using the words, “your loved one looks very uncomfortable,” and “being so restless is very discomforting” tied to re-educating the family that opioids at end of life help keep the patient comfortable, the family became eager to provide comfort to their loved ones by learning how to administer liquid morphine. So, when you visit your next patient, do a visual assessment on them: Do they appear comfortable or uncomfortable? What’s their complexion (especially if you have seen them recently for a comparison)? What do their eyes/pupils look like (to help with neurological symptoms)? Are their respirations in a normal rhythm? And then ask them are they comfortable before you ask about their pain. You may then find less resistance when it comes time to discuss opioids for comfort at end of life. References National Institute on Aging. (2017, May 17). Providing Care and Comfort at the End of Life. Retrieved March 28, 2020, from https://www.nia.nih.gov/health/providing-comfort-end-life
  14. pmabraham

    ManorCare York, PA

    Hello: I'm considering an RN Supervisor position. Do any of you currently work at ManorCare or used to that has any advice to share? Thank you.
  15. pmabraham

    Rapid response

    I share this as a current hospice RN case manager. To clarify, a rapid response is not the same as calling a code. And since it can fall into the same lines as respiratory distress if someone is choking to death, a DNR does not prevent someone performing the Heimlich maneuver or similar if the choking is caused by an object which can be expelled. I take care of a number of patients with lung cancer, and from a point of view when families call our 24x7 number with the expectation for a nurse to come out for respiratory distress, it's similar to a rapid response (granted, in our geographic area, nowhere near as fast as anyone would like given rural home environments typically off the beaten path.
  16. pmabraham

    Hospice Related Medication Coverage

    The hard part of accurately answering the questions is the RELATED diagnosis matter just as much as the primary diagnosis. OP, please disclose the related secondary diagnosis for a complete answer.