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"Healing Conversations" by Nance Guilmartin I had the honor of meeting this author at a seminar, and found her extremely helpful. check out her website at http://www.NanceGuilmartin.com You won't be disappointed!

Thanks for all your suggestions! It's always nice to "suggest options" to the docs after hearing from other nurses. Cheryl

Hi all! Any suggestions on how to relieve scrotal edema? Not meant to be a joke. I have 2 guys, one with Pancreatic CA, and pitting edema in his lower extrem. MD has him on a 5 day trial of HCTZ and Spironalactone BIDx's 5 days. Does not want lasix right now. This guy has great discomfort "down below, and I'm not sure what to suggest. My other guy has T Cell lymphoma, with profuse weeping in his lower extrem. His disease is far more advanced, so I'm not sure if I can manage his scrotal edema. My concern with this guy is that his foley insertion site is not visible because of the massive swelling. Both guys have voiced great concern and discomfort, and 80mg of lasix BID has not helped at all with pt #2. Any suggestions or comments?

Your daily bowel movement is about 10:00pm.

LOL. I try not to carry too much in there. I have a bin kept in my car with bandages, foley kis, etc. I usually keep my drug handbook, stethescope cuff, basic bandages, penlight, scissors, gloves and soap.

A 12 pack:idea:

I went into Hospice when my mom's prognosis didn't look good. I feared the unknown. I wanted to be prepared to help my mom have the most comfort in what I thought would be her last year of life. Thankfully, she is doing well, and I found Hospice to be the "Florence Nightingale" of all the areas of nursing I've tried. Good luck with your research.

There is a wonderful story behind it. But long story short, I'm holding a rescued hummingbird. Its my favorite pic. Thanks for inquiring! Cheryl

Interesting and valid points Red.. Thank you!

Hi all.. Just wanted to reply about why I was giving report. I admit, I was totally wrong, and I'm embarrassed, because my supervisor has said many times over, NOT to give report while driving. Granted, the snow did play a factor, I'm sure my reflexes would have responded better had I not been on the phone. This is humbling to bring up on the thread, however, if it stops someone else from doing it, It's worth it!

I just got in my first car accident........While giving report on the phone. I'm ok, it was mild, but Please fellow nurses.. THINK TWICE about doing the same. FYI Cheryl:eek:

Hi, and welcome. I can relate to your story because I too, am new to hospice.(3 months) I recently posted about the heavy focus on recerts, paperwork etc, at the end of my "angry patient" thread. Yesterday, as a matter of fact, I went to my director, and told her how much I loved my job, and let the point be known to please be patient with me because I really like what I'm doing, and want to do well. I was starting to lose focus on my patient goals because of all the "policies and procedures" we are faced with learning. I empathize with you, and understand where you are coming from. With all the stress you are enduring right now, I pray you will be blessed by a patient with whom YOU have made a difference, and places a gentle reminder in your heart that are in the right field. Best of luck

To be honest, I felt I could forsee more goals during my first month of working with hospice. Ya know when I was "shadowing" people. I know I have it in me to make up a great unique careplan for my patients, but lately, its been difficult, because in the past 2 months, I've had to learn so many things about pain management, company policies, AND use of a laptop. It seems so hard to keep up with recerts, updating care plans, orienting home health aids, communicating with other members on the interdiciplinary team, etc., its easy to get off focus. (This is only my 3rd month as a hospice nurse) Don't get me wrong, I LOVE IT. It was just nice to have read your post, and what others wrote. It helped me to sort of "re-focus" if you know what I mean.:) I recommended this website to several employees today. It has definately had a positive impact on my job. Thanks! I hope I can inspire someone out there as well.

Don't ever resonsider your dream of becoming a nurse! This was a learning experience for you. If you think real hard, I bet you can think of 3 positive pieces of knowledge you gained by this experience. I had a similar experience watching my first C-Section. Made me sick. (And at least the woman had some pain med.) But it was just the whole "man handling" and poor bedside manner that got to me. I recently started working as a Hospice Nurse. All I can say is: I found my calling. You should check out the hospice thread. I bet you will truly be moved. And possibly even consider it in the future. Best of luck!!!!

CCCC has an excellent Nursing Program. I graduated in 1993. My nursing career in now in Hospice. Best of Luck.

I am sorry for the loss of your relative. Hearing comments like yours, melts my heart, and only encourages me to be the best hospice nurse I can be. Peace to you and your family..... Cheryl

Wow! That's pretty deep. I like the fact that it is one of your goals. I never thought of it that way. Interesting......

Hello, Just got a call from a friend who was asking advice and not knowing what to say, I'm trying here. She had breast implant surgery 20 years ago, and now is having complicationss. She needs to have the implants removed, and her doctor told her she would need to be out of work for 2-3 weeks. She works in the "Corporate office world" and is struggling on what to tell her co workers as to the reason she will be out of work. She obviously does not want to state the real reason, and when I suggested to simply say "Its personal" (none of your business in other words) she said it wouldn't fly. What other common surgery would justify a response for her? Please help!!

You guys are incredible! Thank you so much! We hospice nurses are definately on the same wavelength. Looking forward to signing on this website again.

I have often thought to myself: Now THIS is what I went to nursing school for! I to, have also felt it to be an honor to take care of patients at this time of their lives. As sad as the situation may be, you, as their hospice nurse, can have such an impact on your patient's (and their families) remaining time together. I think the best quality a nurse can carry, is reading nonverbal cues, and acting on them. When I arrive to a patients' house, I don't run in and wash my hands and set up my bag. I learn so much about how to plan my approach just looking at them; discretely watching their family members expression when I ask my patient how the night went, taking a mental note of how much eye contact is made, etc. As a hospice nurse, you are gifted in noticing things like this. PLUS, you have the opportunity to actually spend this kind of time with them. Not everyone can be a hospice nurse. I think the majority of hospice nurses feel a certain connection of respect for one another. For example, I was so happy to view the responses to my "angry patient" thread. It was like a sudden burst of: YEAH, I knew you guys would understand! I know I'm rambling a bit. I love hospice, and I love continuously trying to be better and better every day. I say GO FOR IT!!

Hi, I have only been a Hospice Nurse for a few months. I absolutely love it, and feel this is where I belong. My question? I'm having a hard time knowing what to say to a man in his early 60's who is experiencing a huge amount of anger and frustration, which is understandably so. I usually feel pretty comfortable, asking patients about their feelings, and allowing them to express themselves. This gentleman, however, has started to refuse all meds exept for his morphine, and is extremely restless(not due to respiratory distress). When I brought up Ativan, he threw his hands up, and his wife looked at me, like I shouldn't push the issue, so I respected that, and told him so as well. I'm wondering how others handle angry patients, and what might help bring him more at peace with his situation. He has periods of confusion but alert enough to have input in his care. I know this must be a common challange for hospice nurses, but I haven't had to deal with this level of anger yet. I already have a social worker involved. Any suggestions would greatly be appreciated. BTW, This website ROCKS! I have learned so much in reading threads this past week.