she wants to go again

renerian, BSN, RN · Feb 1, 2004

Is this person looking for aggressive care as in revoking her hospice benefit?

I am sorry I did not see your other post.

renerian

mittels · Feb 1, 2004

She was coded on Saturday at the hospital sent back to her assisted living home. On Monday she enrolled in hospice. I told the hospice nurse she wanted to go and I think she totally ignored me. I also informed her social worker.

chris_at_lucas_RN, RN · Feb 1, 2004

I think you owe it to your patient to advocate for her.

First, document what she said and when she said it, and document that the info was relayed to the hospice nurse (and name him/her).

Next, let your mgr know what the situation is. If nothing else, this is damage control. You might mention that--in case they get all over you about MYOB, etc.

If nothing happens and your patient still wants to go to the hospital, and the family is there, I would have a conversation that didn't happen (tell them up front you are talking person to person and not as a nurse employed by that facility and that you will deny having said what you are going to say, should it come up later--make sure you are away from any staff, etc.). Tell the family what their options are as far as advocating for their family member.

Hospice is voluntary. And not like the military when you "volunteer" and then can't get out til your hitch is up.

This is the last couple of days or so of your patient's *life.*

Imagine if it were you--and you were helpless, like she is, to get what you wanted or needed.

Then do the right thing.

Good luck, and keep us posted!~

Dave ARNP · Feb 1, 2004

Put her in the ambulance and get her on her way.

Talk to the charge nurse, the ADON, the DON or God if you have to.

Dave

aimeee, BSN, RN · Feb 1, 2004

Sounds like she is truly not ready for comfort measures only...

I'm just curious...what is the family's reaction to this?

fab4fan · Feb 1, 2004

I agree with aimeee...this pt is not ready for hospice. Some people never are, and that's OK.

It's not up to the hospice nurse to decide how a pt dies. If the pt changes her mind, then she should be able to go to the hospital, period.

jerseyRN · Feb 15, 2004

It's not my place to tell anybody they can't go to the hospital, but sometimes people want to go because they believe the hospital will save them. I'm not sure from these posts what the patient and family know, and what the patient expects the hospital will do for her.

And you're right. Hospice isn't for everybody, and it's the nurse's job first and foremost to listen to the patient.

chris_at_lucas_RN, RN · Mar 9, 2004

Mittels, what did you decide to do with your patient, and how did that work out?