nhelkhound

Holy crap!!

God bless you for your loving heart.

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 pain, and had diarrhea for 48hours. The Dr yelled at...

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

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 repositioning attempts (some had been repositioning against ...

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 medsurg. Been an RN for 6 years and love it. You will fin...

RUN AWAY.

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 this stimulates breathing she may have had a blockag...

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 pushed out from the inside!

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 death that he may not be able to communicate with ...

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 me. And of course everyone wanted their pills at e...

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 health on track before you're able to safely re-ente...

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 ER visits IF he did not inform hospice of the visit...

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 PCP.

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 decide if the aspiration risk should or can be diminish...

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 seen a case firsthand. Difficult to even find a neuro...

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 not be administering any meds, and that although s...

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

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

: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 Patient does not currently meet hospice eligibility ...

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 present with NYHA Class 4 and/or ejection fraction

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 THEM!

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

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, particularly with brain CA or mets.

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