Posted by: soulshinemoments | September 26, 2013

Shadowing a Hospice Nurse (Day 2)

I shadowed another hospice nurse today at a different facility.  This nurse, P., is someone whom I liked the first time I ever heard her speak. The first time I heard her speak was at a “Team Meeting” back in July.  She was sharing about an obese patient and saying that the patient had a difficult death and a difficult life. Something about the way Nurse P. described the patient with her Irish accent and deep concern in her eyes, made me admire her from the get-go.  Today I got to shadow her.  She is 73 years old, from Ireland, and has been nursing 50 years.

There was, unfortunately, a great deal of tension today between the hospice nurses and the regular facility workers.  It sounds like it has been building up for awhile.  But issues are occurring, for example, where the facility nurses are denying the hospice patients more pain medicine.  One nursing home nurse, in particular, believes because of her cultural background, that pain and suffering are just part of the dying process.  It’s almost as if it is a badge of courage to have pain. Um? That’s wonderful for your culture, but to be hesitant about giving hospice patients from a different culture their pain medicine is infuriating to me (and to our hospice nurses). 

One of the patients today was screaming and yelling and combative.  She hit one of the CNA’s.  She scowled at every person that passed by.  She was the first patient I saw when I arrived at the facility this morning.  One of the other hospice nurses rubbed some ABH medicine on her (for agitation) and once the medicine finally kicked in, she was a different person.  She eventually started smiling, then a little later, singing hymns about Jesus.  She would parrot everything we said to her.

“You have a beautiful smile,” I said to her.
“I have a beautiful smile.” She would say.

Incredible the difference.  The hospice nurse, P., wrote a new order for this patient to receive this anti-agitation medicine regularly.  When she told the LPN who is the one who is extremely hesitant about giving out medications about the new order, the LPN acted irritated at the hospice nurse.

I was thinking today that I am going to try to get a job at a facility that is all hospice patients, if possible, instead of a nursing home.  I have only been to one hospice facility (when my dad was in hospice), but I liked the environment there more than nursing homes.  I liked that there was no one against how much pain medicine to give a patient, that the hospice nurses had more say-so, and that it was more of a peaceful, zen-like environment instead of cold and sterile like a nursing home.

I am about to go to an Elder Care Meeting with my friend, and other intern in my program, so I will cut this short. xo

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