amagicalmind

I feel you. I was a late starter and my husband was -ish- on the whole 2nd child thing. I wanted another and he didn't care but, IF we had another, he wanted it to be soon because he didn't want people to think he was the grandfather LOL. I planned my pregnancy to have my daughter in May, the month my nursing school was supposed to be on break. Which meant I entered nursing school while pregnant (I do not recommend this unless you have a REALLY supportive partner!). You also don't want to take an extended break after the birth and forget what you learned. I would go with getting pregnant around the time you graduate, so you'll have some time to learn your new job before going on maternity leave. Please leave some updates! And well wishes on your next child!

I've been struggling a bit with my company's interpretation of the FAST scale for dementia. As you all know, a patient must be at least a 7A to qualify for a hospice dementia diagnosis. 7A describes as follows: Person speaks 5-6 intelligible words in the course of a day or an intensive interview. I interpret most things quite literally and the word "intelligible" literally means the word is understood by the listener. I have a NH patient who is quite verbal and easily understood, but she makes little sense. She is oriented x 1, repeats herself frequently, will readily tell you "I'm hungry", "They haven't fed me and they better not bill me for it either" (not true btw- she eats all the time) and will answer questions about her family to some extent. Memory is very poor- she calls out frequently for her deceased husband as though he were in the next room when in actuality, she attended his funeral 2-3 yrs ago. REAL conversation is limited but I have trouble classifying her as a 7A. What do you all think?

Working with nursing home residents can be very challenging because of the preconceptions many of the nurses have and also there are variations in how hospices run things, so it's not unusual to encounter the complaint "But that's not how _____Hospice handles that!" or "But ______Hospice pays for that". I've encountered LPNs that refused to give morphine to a dying patient because they were "afraid to give them that last dose" and others that refused to give PRN pain medicine to a nonverbal patient because they could not ask for it. It's a political game to some extent because you are the ambassador for your company while you are there so YOU don't want to do anything to upset them because if the NH stops using your hospice company because of some perceived slight (your fault or just the way your hospice does run things), it's LOTS of $$$$ that will go to another company. If you happen to have several patients at a NH, I recommend you break up your visits so that you are not seeing them all in one day. They like to have a PRESENCE in the NH- let them see your face 2-3 times a week if not more. And good luck with your new job! I know you'll love it!