kate0x

Pennsylvania 21.00/hour skilled geriatric nursing LPN 3 years full time 3-11 shift no shift differential charge nurse (non management position)

This is news to me! We always send residents out to try and commit them and they always send them back saying they can't with a dementia diagnosis. Maybe we just have some dumb hospitals around here. :) haha

I personally would have given the morphine. If the patient is actively dying, why not? You can't really know for sure whether they are in pain or not. I am very PRO morphine at a time like this. HOWEVER, you definitely have rights and should never do what you are not comfortable doing as a nurse. Try to use your own judgment, and certainly only do what you are ethically comfortable doing, but don't get in the way of a hospice nurse doing what she and the patient/patient's family wish to have done.

In Pennsylvania, when you send a resident out to a psych facility or even to the ER to have them 302 committed, they will not keep them if there is a dementia diagnosis. Doing so is actually illegal. We've run into this problem quite a few times at my facililty. Honestly, all you can do is keep PRN antipsych meds on hand and dole them out as you need to. I know it feels bad to do it, but when you factor in that you don't usually have time to spend 1 on 1 redirecting because you have other patients to attend to, it really seems like it becomes the only option. *And ALWAYS, ALWAYS document as thoroughly as you can. This will make it almost impossible for an MD to deny you PRN meds! Good luck!

I have 25 residents at my job and I can get a 3-11 med pass (just as heavy as day shift) done in 1 hr depending on the night (:

could not agree with you more egglady.

I agree with this so much. LPNs don't rush through a med pass by choice, they have to! Also, it becomes second nature as you learn your residents and their meds.