nhelkhound

nhelkhound

hospice, home care, LTC

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All Content by nhelkhound

  1. So disgusted

    nhelkhound replied to MomRN0913's topic in Hospice, Palliative

    Holy

  2. The hardest thing

    nhelkhound replied to tayloramaRN2be's topic in Geriatric, LTC

    God bless you for your loving

  3. Can a physician deny an order to transport from LTC?

    nhelkhound replied to anangelsmommy's topic in General Nursing

    I once had a physician refuse to give me an order to transfer his Pt to ER after the Pt had fallen on the floor in the bathroom, had a large hematoma on his head, was complaining of acute abdominal...

  4. So who do nurses marry or have as civil partners???

    nhelkhound replied to snoopy29's topic in General Nursing

    The man I adore and I met in church when I was 14. He's an IT

  5. The right to refuse has so many interpretations

    nhelkhound replied to Alnitak7's topic in General Nursing

    I had a hospice patient living in an ALF. Pt was bedbound, on scheduled morphine. Facility policy was repostion Q2 hr, Pt consistently refused in spite of education. I directed LNAs to stop...

  6. Cry for help: I don't think I can do this.

    nhelkhound replied to -MissTake-'s topic in General Students

    It will get better. During nursing school I was on the Dean's list every semester, and most of my clinical instructors disliked me. I dreaded clinicals. Mean nasty instructors. Never worked in...

  7. new grad/ltc

    nhelkhound replied to pink2004's topic in Geriatric, LTC

    RUN

  8. Question about breathing at end of life

    nhelkhound replied to Spotty44's topic in Hospice, Palliative

    I have never seen apnea only during sleep at the end of life, but I'm always surprised by the things I haven't seen (yet)! I would try repositioning this Pt when she exhibits apnea during sleep; if...

  9. drug diversion

    nhelkhound replied to onangelswings's topic in Hospice, Palliative

    I had a case where the Pt's daughter told me that someone had broken into their apartment and stolen her morphine. Even showed me where the thief had entered; only problem was that the screen was...

  10. Non Hospice RN

    nhelkhound replied to RNERHOUSESUPOR's topic in Hospice, Palliative

    I'm sorry that your father is so ill. My opinion is that if you can you should go to your father as soon as possible and spend as much time as you can with him now. Don't wait until he is so close to...

  11. Evening Med Pass Question

    nhelkhound replied to westieluv's topic in Geriatric, LTC

    This was the same at every LTC facility that I have worked at, a heavy pass between 4and 5P and another heavy pass between 7 and 9P. I was also exhausted. I had between 25 and 40 patients. Just shoot...

  12. Rusty skills/burned some bridges. what to do?

    nhelkhound replied to SunnyPupRN's topic in General Nursing

    Sorry to hear of your misfortunes. I recommend that you stay away from nursing. Are you able to collect disability? You really need to secure health benefits (possible thru disability) and get your...

  13. Discharge a patient because they go to er?

    nhelkhound replied to AtlantaRN's topic in Hospice, Palliative

    As far as I know, this would not be grounds to discharge. A patient has the right to seek medical care. In this instance the patient will be held financially responsible for charges incurred d/t the...

  14. Whose patient is this???? assistance please

    nhelkhound replied to AtlantaRN's topic in Hospice, Palliative

    What a mess. I hate this type of situation. Clearly the scope of services was not clearly discussed and/or understood by the Patient/family. I like the idea of tossing the ball to the

  15. Aspiration risk, Hospice and SNR

    nhelkhound replied to hospicernsrgr8t's topic in Hospice, Palliative

    Let's keep in mind the goals and desires of the Patient, who is saying she's hungry and wants to eat. The aspiration risk should be explained to her and her family and they should be the ones to...

  16. Aspiration risk, Hospice and SNR

    nhelkhound replied to hospicernsrgr8t's topic in Hospice, Palliative

    Challenging. First is the unique needs of a Huntington's patient. My very dear friend (like a sister) had early onset Huntington's. This is quite rare and most med/nursing professionals have never...

  17. Team Mate working out of scope or practice?

    nhelkhound replied to SoCalRN1970's topic in Hospice, Palliative

    Let's see, a SW administering and educating about drugs. Not a good idea. Definitely out of her "scope of practice". If this happened with my SW I would arrange a sit-down, inform her that she should...

  18. How would you of handled this? Family scenario...

    nhelkhound replied to SoCalRN1970's topic in Hospice, Palliative

    The daughter doesn't want to use the morphine because of increased somnolence? How about adding a little Ritalin or

  19. Do you as a Hospice Nurse use a pulse oximeter?

    nhelkhound replied to SoCalRN1970's topic in Hospice, Palliative

    I feel that the use of a pulse oximeter in Hospice may be a moot point, but Medicare conditions of participation wants to

  20. Admission without evaluation

    nhelkhound posted a topic in Hospice, Palliative

    :coollook:A few of these have happened to me recently and I'm trying to figure out why. My company tells me to admit Mr/Ms So and So. Out I go to do the admit. I come to discover that the potential...

  21. Admission without evaluation

    nhelkhound replied to nhelkhound's topic in Hospice, Palliative

    I agree with the point that the problem lies with referral sources and/or person obtaining the consents. Medicare has tightened up the criteria for hospice eligibility, e.g. End-Stage Cardiac must...

  22. How does one avoid burn out??

    nhelkhound replied to SoCalRN1970's topic in Hospice, Palliative

    Learn to say no. "Can you handle this 4P admission? Since you're nearby, swing by a see So and So...etc". Hospice will eat you up if you let it. Set your boundries and STICK TO

  23. Was I right to decline this? Admission with no consents.

    nhelkhound replied to SoCalRN1970's topic in Hospice, Palliative

    I NEVER deal with a patient without legally executed consents. It's my

  24. Question regarding posturing

    nhelkhound replied to newtress's topic in Hospice, Palliative

    Clinically speaking, posturing is due to brain damage. Acute brain damage can manifest as posturing, but at the end of life in a known disease trajectory it would be unlikely, but possible,...

  25. Who else loves their job

    nhelkhound replied to johnny depp23's topic in General Nursing

    I also love my work as a Hospice RN. I do not, however, like dealing with computer