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bananorama LPN

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  1. bananorama

    Was he scared?

    Thanks to all of you for your responses and support. You are so right, I am learning from every experience - even the very real and difficult ones. I think I will do that Katillac, try to send him my thoughts and ask for forgiveness
  2. bananorama

    Was he scared?

    I had a young client who died and I was able to determine when he was having his last breaths. As the family was gathered in the room, I said "these are his last breaths now," so that they could gather around him and support him during those last moments and it sounded like he was crying. After he passed, his wife looked shaken and asked "do you think he was scared?" I didn't know what to say, I just said that he had a lot of love around him and I'm sure that brought him comfort. Now I look back and I feel like I made him cry. He must have heard me say that he was having his last breaths. It was so stupid of me to say that now that I look back on it. It's such an awful feeling. I think he was scared and I feel like I caused it.
  3. bananorama

    New Hospice nurse, all tips welcome!

    I'm also a new nurse but I have worked in Hospice for about 6 months now, so still learning. But here are a few things I've learned in my short time so far: Be mindful that the patient can probably hear everything you are saying during their last days/hours Be sensitive and patient with family that need a lot of teaching Do things slow and always tell the patient what you are doing - it gives them dignity
  4. bananorama

    Family denies that patient is in pain

    Becky, yes I think she holds strong to her spiritual beliefs and although I have been sensitive to this, maybe someone who speaks her language would be more relatable? Maybe she has some trust issues with those who don't share the same faith. I'll talk to the MD about this. The doctor scheduled her HM BID but then the daughter asked to have it changed to PRN. The doctor has asked the nurses to just keep encouraging her to use them. On my last shift I became more assertive with her because the client was clearly in distress and she agreed to give a dose of HM, but then today she blamed me for sedating her. I feel like at this point she is not receptive to any teaching. I guess with some clients you just have to accept that?
  5. bananorama

    Family denies that patient is in pain

    I work as a homecare overnight nurse caring for palliative patients. I am a new nurse, but I have had quite a bit of clinical palliative experience and have worked with this agency for 4 months now. Most of my clients and their families want comfort care and are receptive to EOL teaching. I have one client who is from the middle east and doesn't speak English. She lives with her daughter, no other family is around. I have been with this client for over a week and I clearly see non verbal signs of pain/agitation at times- moaning/grunting, SOB, pulling at sheets, calling out. I have tried to provide teaching to the daughter but she denies that the client is in pain and doesn't want to give her medication. She has HM and Midazolam in the home. When I have given PRN doses of HM she has gotten upset, not wanting the client to be sedated. She tells me "this grunting is normal for her," "she just needs water," "she is just praying" and she wants to be consulted before any PRN's are given. She gets defensive almost when I talk to her about it. I try to explain all while being culturally sensitive that there are clear signs of pain and discomfort, but she is not receptive to teaching AT ALL. She says that in her culture a person's death is preset. Her MD knows that she is reluctant to give pain medications and is supportive of that. But I see a woman who is clearly in the last days of her life and suffering. I do the best I can to reposition her, give mouthcare, hold her hand, but I feel like this isn't always enough. My question is what would you do in this situation? What is the nest way for me to be an advocate in this situation?
  6. I'm a RPN student just about to finish up my last year of school in Ottawa-Algonquin College and I've been really interested in becoming a footcare nurse in hopes of starting my own business. I hoped to take a course when I finish to become certified but there is no such "certification" process according to the Canadian Association of Footcare Nurses of Ontario. Algonquin College has indefinitely stopped their footcare nursing courses. The only courses I can find are through College of Health Studies (onine) and Footcare Kingston which is partly online, however they have a 6 day course/workshop in Ottawa but the total for the program is $3000.00! I feel like it's a bit of a money grab especially when I would have to purchase all of my tools etc and it's not even a certified program. Or is this the average cost to become an educated footcare nurse? I am so confused as to what the best way is to get some education/experience to become a qualified footcare nurse and I need advice from anyone from Ontario who is a footcare nurse. Where did you study? Is it better to shadow a footcare nurse for experience? What is the best route to take in your opinion?

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