Question re: snowed

[-Midget-]

Firstly, I'd like to thank all the Hospice/LTC nurses, for the fabolus, loving, work they do. All the ones I have encountered have been a true inspiration to me. After I get done with school, I am considering maybe doing some Hospice/LTC work, since it seems that nurses have the ability to spend much more time with their patients. I know I have a ways to go before I get to work, but I am just taking this time to of course, do my work for my pre-reqs, and explore the wide variety of oppurtunities for nurses! So, what background is important to work in a hopsice, or LTC facility? What about Skilled Nursing? Or is that the same?

My grandpa and I have just placed my grandma in a nursing home recently, and she is recieving hospice care, but doing well. All the people I've met through this process have been very supportive, and very willing to educate me about their jobs!

So the other day, the DON was telling the staff about my grandma, and about how she might become agitated. So, they would be given her PRN Antivan. However, she said she didn't want her to be snowed. I asked her what she meant, and she explained. But she was busy, so I didn't want to take much of her time. So, what exactly does it mean when a pt is snowed?

[lesrn2005]

My 1st thought would be "overly sedated". Unable to fxn due to "too much". Anyone else?

[CoffeeRTC, BSN, RN]

Yes....that is what snowed means. I'm sure the hospice nurses here will be able to give you great info on the line between snowed and medicated for comfort.

[leslie :-D]

i'm glad you're pleased with the care your grandmother is receiving.

often, elderly need adjusted doses in meds because of their decreased kidney and liver function. if a 40 yo pt is receiving 1mg ativan, an 80 yo might only need .25-.50mg. typically doctors like to 'start low, go slow'. with that in mind, i don't know why there would be a concern of your grandmother getting snowed. you should feel free to discuss any questions you have with the hospice nurse. i wish you well.

leslie

[-Midget-]

Thanks for the answers, everyone! Leslie, I am very pleased, and in fact, inspired by the care she is recieving. :) I do feel free to ask her any questions, and I do...but I find I understand stuff best when I get explanations from a few people! :) What clinical experience is best to get before moving to a hospice or long term care environment?

That makes since how an older person would process the medication differnet than a younger person. Not having taken any nursing courses, yet, that didn't not come to my mind. :) Thanks for pointing that out.

[leslie :-D]

What clinical experience is best to get before moving to a hospice or long term care environment?

if you want to work with our elderly in ltc, you could probably get a job out of nsg school. i would expect a reasonable orientation. keep in mind that our elderly are living longer; and the acuity level is much higher in a skilled nsg facility, than it was yrs ago. it's important to realize that the elderly population comes with their own unique set of health concerns.

if you want to work hospice, it's highly preferable to have a med-surg background. if you work in hospice home health, you are alone and don't have the usual set of resources you would find in a hospital or other facility. you work independently and your assessment skills need to be top notch. it's also very helpful to know the implications of not only the disease process that is terminal, but multi-system organ failure as the body shuts down. they also have inpatient care facilities (hospice houses); and often you'll be going directly to a hospital or ltc facility. but for the most part, you work alone which commands a comprehensive knowledge base of pathophysiology, the symptoms of any failing system, the steps of dying and impeccable communication skills in talking with your pts, their families.

but nothing is written in stone. there's always someone willing to hire a nurse who might not have the desired experience but does have the enthusiasm to be the best there is. :balloons:

leslie

[-Midget-]

Excelent information - thank you! :) I don't know where I want to start, or what direction my career in nursing will take, I'm just exploring all my options - and there are a ton to explore! It seems (correct me if I'm wrong) that Hopsice and LTC sort of combine case management and handson care? Is this true?