TranquilityRN
Tuscumbia, AL
Female, 40
I have been a hospice Registered Nurse for about ten years. Hospice is similar to home health except specializing in care of the terminally ill, dying patient. A hospice nurse provides palliative care for the patient during their last months, weeks, days, or hours so they may pass in the comfort of their home and with their loved ones present. I provide comfort and dignity for the the patient and comfort for the caregiver. Following the peaceful passing of the patient I provide postmortem.
Honestly I have had lots of conversations during the final days but I did have one gentleman was even experiencing the Cheyenne stokes breathing an discoloring of extremities and he was barely able to utter and said, "honey can you please help me" and smiled and I explained I couldn't do anything like that and he Laughed. I had one stubborn little lady patient that was closest to death than I had seen most patients just holding on.....this was third time and just as I said " well you all know how miss M loves to make a monkey out of me?" The patient replies, after being non responsive all day, she said " lil lady you can't predict when I'm gonna die" and winked at me haha she was a funny lady!
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Normally a couple weeks, BUT when the person stops eating and drinking completely usually death occurs within 72 hours. And i discourage IVs when death is inevitable also. Families that are not well educated think the loved one is dehydrated, which they are, but think they are suffering. Once the patient gets to a certain point they do not feel the urge for food and drink. IVs simply prolong the inevitable death that is to occur dragging out the dying process and it makes the brain more aware of pain and discomfort. If a family insist of course we have to do it but we educate educate educate to discourage and allow the body to die a natural death.
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Well sorry to just now answer your question but I have been battling MS and Narcolepsy myself. Honestly it is just a matter of people that are not afraid of death or when they finally get to what is referred to as the acceptance stage and they see death is inevitable. However, my personal opinion, I have noticed that people who have a strong religious lifestyle, regardless of the religion, seem to deal with death in a more positive way, therefore, their families seem to cope with the passing with more ease. Also children for some reason are so resilient and seem to cope with inevitable death with a better perception than most adults. Hope this answers your question.
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Extremely easy to obtain RN jobs. Hospice is a little more difficult, depending on how many companies you have in your area. Also I said in the previous question it is truly a calling. Just any nurse cannot just apply to hospice because they want an RN job and successfully succeed rather the reasons be that they just cannot grasp the concept and philospophy due to nurses being geared towards nurturing and healing and sending a well patient home and with hospice that is never the case. Or the nurse is "simply" not called to do this profession.
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Well both honestly. yIts very easy to get cauht up and become very involved with your patient and their families. It does have a very profound effect on the psyche. It is truly a calling. That is why I am so proud to have been involved in such a profession. I know I am a nurse but all nurses have a calling. You have bad nurses and great nurses. The difference is the ones that truly seek their calling and do THAT as their career are the BETTER nurses per say. Not just anyone can do hospice. The fact that it is a calling, in my opinion, is what makes us resilient and able to rebound and turn sadness into such a profound feeling of gratification for helping your patient and being the support and educator for their loved ones that you do have a sense of fulfillment. It is hard to explain but YES it gets depressing. I had to break from it temporarily after four years of strictly seven on and seven off on call duty. It became hard for me because naturally as a nurse your job is to nurture and heal, thats why most get into the profession anyway. As a hospice provider your not healing and sending a well patient home. You know from the day of admission that you will lose your patient. Our job is to make them comfortable until inevitable death occurs. And as only a oncall RN you are the rescue in the middle of the night, weekend, and holidays, which was so very rewarding but at the same time not many "good calls" or "good visits" occur during those hours. So I missed the daily, weekly visits and bonding with the patients and the families and was only getting to deal with the death part of the process. Very sad at times.
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Google hospice patients alliance
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A number of circumstances warrant the use of morphine. Palliative care providers are trained and certified in the palliative care and again this profession is a calling and you just "know" when the time comes. But when the patient has uncontrolled pain not being relieved by other means of pain control I will occasionally switch to morphine. Also when a patient becomes unable to swallow the sublingual drops of morphine are the most effective pain treatment. Not all hospice patients get morphine that is a misconception. I have had a number of hospice patients that were not in need of morphine but simply sublingual Ativan, Valium etc for terminal agitation related to the changes in the body and lack of oxygen and blood being pumped to the brain as the heart begins to weaken. Also pain patches are effective for those not in severe pain but do require steady pain control. I like this method because SL Morphine is fast acting short lived and doses have to be repeated frequently. This occasionally is stressful for the caregiver too. So with an anxious caregiver I may use other methods. You have to evaluate the situation and it is a holistic approach with the patient being first priority but the caregivers and family being right next in line. You treat the patient and the family is ALWAYS involved in the careplan for the patient. I like to have decisions made while a patient is still alert and oriented and document their wishes and preference for pain control and usually have caregivers present during the discussion so that we have no question of which method to provide. Hope that answers your quesiton. Sorry for the delay I have been dealing with MS. So sorry
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