ShesanRN

ShesanRN

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All Content by ShesanRN

  1. Mouth sores caused by Roxinol

    Can you tell us more about what the sore looks like? I've not yet seen that caused by Roxanol,
  2. My initial reaction is I'd still prefer to use my own gloved fingers/hand. In some procedures, there is no substitute for the sensory feedback, because of the high perforation risk, as newhospicern...
  3. GIP regulations

    We can take move our GIP patients to a snf we are contracted with for that purpose, but most of ours are cared for in the hospital. We either get the referral from the hospital for one of their...
  4. I agree - I'm not sure how you could've known not to call 911 not having worked in hospice. That's intuitive for most people. In my agency, we knock, sometimes at an alternative entrance, attempt to...
  5. Taking Patients down to the Morgue

    Our patients are in multiple settings, and the ones who pass at the hospital (that is our inpatient setting) do get taken to the morgue, although by hospital staff, not me. I wouldn't mind it, though....
  6. How Much Does a Hospice Nurse Make?

    $28/hour x 40 hours salary for weekend on-call RN in the Chicago-Detroit cradle, logging an average of 35 hours/weekend including travel time, all hours of the day and night. There are times when I...
  7. Hospice symptom management medication list

    Our standard comfort med orders are for sublingual Roxanol, Ativan and atropine drops every 2 hours as needed and Tylenol and phenergan suppositories prn. We adjust and substitute from there with Oxy...
  8. alternatives to morphine

    I haven't used nebulized Dilaudid, but we routinely get orders for Oxycodone IR 20mg/mL (OxyFast) as a substitute for morphine when there's an
  9. Approaching tough subjects with the boss

    I think your boss' responses to you so far have told you where she stands on the issue. I agree with the above poster, and the fact everyone else is looking for an out is a big red flag. The month I...
  10. General rant

    I'm curious, too, as to the details of the situation. Was the patient at home, with family monitoring symptoms? Or was it in a clinical setting? It seems there would be, as others mentioned, more...
  11. How to transfer into hospice

    Your med-surg experience will serve you well, as all the basics like I&Os, ADLs, med management, catheters, wound care, drains and trachs, are all relevant depending on the needs of your...
  12. I want to be a Hospice Nurse

    Like vampiregirl, I was introduced to hospice nursing working in LTC. I loved what I was doing there, and began to especially love the extra time, care and attention I was able to give patients and...
  13. LPN Hospice Nurse

    At our hospice (not inpatient), the LPNs conduct patient visits under the supervision of the RN/case manager (they see the RNs patients and report in to them any condition changes/new orders). When...
  14. PRN--ON CALL

    This sounds like a bad deal all around. Our PRN nurses do not have to participate in the on-call rotation. When a nurse is on call, they make $2/hour beeper time, then hourly rate + mileage "door to...
  15. Care for surviving family

    You may also consider contacting the American Cancer Society to see if they have recommendations for your situation/area. Somtimes even being willing to use the word "cancer," is a needed step in...
  16. I agree with those that encouraged you not to feel put-upon or taken advantage of. The patient benefited most by you giving the suppository then and there, and their needs should come first. If it...
  17. calling all on-call nurses

    I don't have a way to advise you to explain it, except as you have just done to us. You don't really have the option to seek additional employment lest it interfere with your ability to take calls....
  18. Dating a former patient

    I can't see myself ever crossing this boundary; my career means too much to me. There are many more ways to find potential dates that won't put your career at
  19. Hospice Nursing Question

    Sometimes that help means discontinuing medication, other times continuing medication for all the reasons you've mentioned in your posts. The patient's desires and quality of life drives everything we...
  20. Hospice on call setupd

    Our census is hovering around 150 currently. We have two dedicated on-call nurses, one for weekdays 430pm-8am and one for weekends (me!) from Friday 430pm-Monday 8am. Our RNCMs serve as backup to the...
  21. May I ask the circumstances of your case? I'm sure any employer that may give you a chance in the future would want to
  22. Seeking Opinions on End of Life Care

    Everything everyone above said :) plus, if I understand your question correctly, one of the most important steps to promoting ethical clinical practice is communicate, communicate, communicate with...
  23. CHF alzhemiers difficulty

    We've used both Haldol and ABR (ativan-benadryl-reglan) gel as well as AHBR (ativan-haldol-benadryl-reglan) gel topically with patients like these. It is very, very challenging for everyone when the...
  24. I'm supposed to what now?

    Based on what we know, I'm not seeing the nata for the prn dose overnight. The patient sleeps soundly without s/sx dyspnea; the med is given routinely during the day but not at night, and the pt had...
  25. Cut Throat Competition Makes Me Sick

    Sounds like a marketer! Fortunately, I haven't seen ours try to weasel in unqualified patients - they seem to know better, and the nurses always seem to have the last say. The most ours do is try to...