MimiRN2013

Yeah we get ALOT too :•\ Our problem kinda goes like this... Management puts pressure on marketing and admissions to 'find something' (census driven). They make alot of promises to get people to sign up (physical therapy/rehab provided is a common one, then when we try to get an order its 'no') even if they dont completely understand or are not completely on board with hospice. I even get pts that are full code! How is one accepting of end of life and want hospice care, but they want CPR? Next the RNCM shows up and is the bad guy for breaking down the real deal. Palliative care, comfort measures only, no more diagnostics/aggresive treatment, no more 911/hospital stays, call us to manage sx, edu on disease process and expected decline, lets reduce this huge med/vitamin list, etc. Then the revocations come (or discharges for those who were not approprate to begin with). Then the RNCM gets it for not keeping the pt on/preventing ER visits, even though the pt/family were not fully understanding or accepting to begin with. *sigh* Please dont get me wrong, I do love making a difference and being able to help maximize quality of life at an extremely difficult time. I feel like I dont get to do enough of that because of all the other €r^p.

Thanks for the support/advice all :)

The SW goes thru it too with him, anyone who encounters him gets it. I think EPS is a good idea. However, Im also told we have nothing to report since she is being "cared for". Im thinking this was aslo her lifestyle, she seems comfortable with the activity in the house or she is oblivious. Like i said, even if I am taken off, the next nurse will just go in and have the same done to them. How can this just be stopped? Is the employer allowed to let us work in these conditions?

Basically, without too many terrible details, this is whats going on. The pt lives with her son, who sexually harasses our staff, he is vulgar, rude, creepy, gives graphic detail about his lifestyle, relentless. Its hard to do our jobs. We spend alot of time avoiding and redirecting him. We have talked to him about his behavior, he doesnt think its a problem, I think he even enjoys knowing it makes us extremely uncomfortable. I also think he may be mentally ill, his mood swings are all over the place. Yesterday was a huge falling out with the son on the phone, with what I take as threats involved. He wanted me to come over immediatly "and make things right". He has gone too far. I thought for sure management would finally do what they have to, to get him off our service. Nope. Now I dont know what to feel more sick about... The jerk that may have issues and isnt dealing with a full deck, or the company that doesnt support/protect its nurses? Are they even allowed to send us into this situation? I can probably have the pt reassigned but knowing the company, they will just make my life harder in other ways, and the next nurse will just be traumatized too. I feel a bit hopeless here. Advice? Similar stories and how they were dealt with? Ty

It seems like "protein calorie malnutrition" might be the new "debility"?