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  • Odds and ends

    A few little stories from recent hospice experiences I thought might be amusing.

    Well, that's a little premature . . . .
    A couple of weeks ago, I was working an extra shift doing on call visits for the weekend. I put the address of a patient I was on my way to see into my GPS, since I'd never been there before.

    As I approach my destination, the voice system tells me it's ahead on the left. I start scanning address signs, and see the house I am actually on my way to see, but drive by too fast to make the turn into the drive.

    As I start looking for a place to turn, my GPS says, "Arrived, Destination, Address XX, on the left." I glance out the window to my left.

    It's a cemetery.

    I hope the GPS wasn't trying to tell me something . . .

    In the house??

    I didn't get this call, thank God. The night before my shift, I am listening to our voice mail system taking notes of important patient info, and the visits that need to be made the next day. One nurse notes her patient is very close to dying. If the patient died, whoever had to make the death call was to wash the body and place it in a casket that was already in the home.



    Turns out the family had bought the casket off eBay. It had originally been used at a party. Rumor has it they planned to do the burial in the back yard, but a neighbor objected, so they planned to take the body to some property they owned out in the country.

    Apparently, this is not a new idea.

    I did what you told me!

    This story isn't so amusing. It's more of a CoCW story.

    I make a visit to a facility at the request of the staff there, as they found some new skin break down on one of our patients. There wasn't a nurse on duty at the facility, so I had to make the call to the doctor for wound care orders.

    This particular doctor is a well known asshat who often takes hours to return phone calls from the facilities he covers. This had gotten to be such a problem for us, that we finally got him to give us his personal cell number and parameters for which we could use it, which included new skin break down. Since I couldn't dress the wound without an order, I had no choice but to call.

    He was pissed and went on a rant about how we should always go through the answering service because then there would be documentation of the call, blah, blah, blah.

    Yeah, right. Like this is really about documentation, you jerk. You just want to be able to ditch the calls again.

    A little bit of snark goes a long way

    We've been having problems lately with a nurse who leaves lengthy voice mails requesting visits, gets to the end of her message and doesn't tell us what she actually wants us to do on the weekend. Does she want a phone call follow up? Does she want a visit? What does she want us to do while we're there? An assessment? Wound care? What?

    She had pissed off the entire on call team by leaving a snarky voice mail complaining that I never leave her voice mails to tell her what I did for her patient over the weekend . . . because it was a bald faced lie.

    So I got her back. Yes, I was well and truly snarky.

    She leaves this voice mail about a patient in a facility whom she's concerned that the nursing staff isn't giving pain medications to. She's done this before: she fears the staff won't follow her recommendations (they don't have to) when it comes to giving PRN (as needed) meds. There's a legit concern here; a lot of nurses won't give a PRN med unless the patient asks for it, and many hospice patients can't. They're still in pain though.

    So I see the patient, who is indeed having problems. The nurse on duty recognized this as well. She thought a round the clock order would be more appropriate, and I agreed with her. I suggested she call the facility doctor and get an order to make the med round the clock (when there's a nurse on, she can do this as easily as I can), and she agreed to this.

    I chart the issue and the resolution. Then I have to leave a voicemail on what I did. We have a new policy; voicemails on patients are to be sent to a distribution list to the entire team (all the nurses on a team share the patients, along with social work and chaplains) instead of just the primary nurse.

    Me: Hi, this is Panacea reporting on Patient X, Team C, patient of Nurse S. I visited the patient at Nurse S's request because she was concerned the facility staff was not giving the patient pain medication; she wanted me to check up on this. *I then run down what I just described above.* I really don't know why Nurse S didn't simply call the facility doctor herself on Friday to get a round the clock order.

    Yes, I said that. Because it was a total waste of time to make that visit when she could have resolved the problem herself on Friday by getting the right kind of order. It cost hospice $45 plus mileage to send me out there for this.

    Making a visit to see if the change was effective would have been another matter. But I hate making visits to do work that the primary could have done had she exercised a little initiative and common sense.
    They say that God only gives us what we can handle. Apparently, God thinks I'm a bad ass.

  • #2
    Bravo (about the last story).

    Ive thought about hospice, but in the far future. The cemetary part though......scary. Id have been freaked.

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    • #3
      Quoth Amina516 View Post
      Bravo (about the last story).

      Ive thought about hospice, but in the far future. The cemetary part though......scary. Id have been freaked.
      Honestly, I never thought I'd work for hospice. I took the job because I thought it would be less stressful than the ER, and for the most part it is. I never anticipated I would enjoy it as much as I have.

      And you'd be amazed at how many critical care nurses go into hospice.
      They say that God only gives us what we can handle. Apparently, God thinks I'm a bad ass.

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      • #4
        No, I wouldn't. My mother was a nursing home L. P. N. for most of her career. She hated it badly, but when my grandfather was dying of cancer and moved into a hospice center, she was quite helpful and practically directed his care. She quite enjoyed the work, and almost joined the staff.
        Customers should always be served . . . to the nearest great white.

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        • #5
          Quoth Panacea View Post
          . If the patient died, whoever had to make the death call was to wash the body and place it in a casket that was already in the home.



          Turns out the family had bought the casket off eBay. It had originally been used at a party. Rumor has it they planned to do the burial in the back yard, but a neighbor objected, so they planned to take the body to some property they owned out in the country.

          Apparently, this is not a new idea.
          correct, before the funeral industry got it's start in the early 20th century(though embalming began during the civil war to preserve bodies being shipped long distances from battle), most funerals were held in the deceased's home, the body prepared and dressed by family members, casket made by a family friend-the "modern funeral" with an embalmed body, in a funeral home, with a cemetery, and a fancy casket is relatively new.
          Honestly.... the image of that in my head made me go "AWESOME!"..... and then I remembered I am terribly strange.-Red dazes

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          • #6
            And the casket business is a pretty good racket, too. >_<

            ^-.-^
            Faith is about what you do. It's about aspiring to be better and nobler and kinder than you are. It's about making sacrifices for the good of others. - Dresden

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            • #7
              It amazes me still that you can buy a coffin at costco. Online. and have it shipped.

              And it amazes me that they cost so damn much. A funeral should NOT bankrupt someone. When I go I want to do the Neptune society idea where they just come collect you and feed you to the sharks or whatever.
              https://www.youtube.com/user/HedgeTV
              Great YouTube channel check it out!

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              • #8
                My husband wants a cardboard box.
                Seshat's self-help guide:
                1. Would you rather be right, or get the result you want?
                2. If you're consistently getting results you don't want, change what you do.
                3. Deal with the situation you have now, however it occurred.
                4. Accept the consequences of your decisions.

                "All I want is a pretty girl, a decent meal, and the right to shoot lightning at fools." - Anders, Dragon Age.

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                • #9
                  I want to be planted in a garden, under some fruit trees or some nice roses. *shrugs* May as well do something useful with my corpse instead of putting it in a cemetary to become just another random name.
                  Don't tempt pixies, it never ends well.

                  Avatar created by the lovely Eisa.

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                  • #10
                    I am planning to donate my body for organ harvest, anything that is left can go to a medical school for them to laugh at, then they can feed me to guppies or whatever, I really don't care what they do with my body. I'm not there and won't care.
                    EVE Online: 99% of the time you sit around waiting for something to happen, but that 1% of action is what hooks people like crack, you don't get interviewed by the BBC for a WoW raid.

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                    • #11
                      OT: Every time I read the thread title I think of the doctor with dual specializations: Psychology & Proctology.
                      I am not an a**hole. I am a hemorrhoid. I irritate a**holes!
                      Procrastination: Forward planning to insure there is something to do tomorrow.
                      Derails threads faster than a pocket nuke.

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                      • #12
                        Quoth Seshat View Post
                        My husband wants a cardboard box.
                        Since I'm going to be cremated, me too.

                        Quoth AccountingDrone View Post
                        I am planning to donate my body for organ harvest, anything that is left can go to a medical school for them to laugh at, then they can feed me to guppies or whatever, I really don't care what they do with my body. I'm not there and won't care.
                        Psychologically, the thought of rotting in the ground well and truly disgusts me. Which is why I'm opting for cremation . . . after my organs are harvested and a med school or whatever does what it wants with the rest.

                        Quoth dalesys View Post
                        OT: Every time I read the thread title I think of the doctor with dual specializations: Psychology & Proctology.
                        They say that God only gives us what we can handle. Apparently, God thinks I'm a bad ass.

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                        • #13
                          Quoth Seshat View Post
                          My husband wants a cardboard box.
                          Quoth Panacea View Post
                          Since I'm going to be cremated, me too.
                          My brother worked for some funeral place hauling bodies.

                          Everybody they dealt with for funerary arrangements they required to purchase a proper casket through them. No exceptions. And if you decided to be cremated, then they'd pull the body out, stuff it in a cardboard box and resell the casket.

                          From what I understand, the guy that ran the place had actually been forbidden by the government to have anything to do with anything related to dead people, but every time one of his operations was caught out and shut down, he'd just find some new puppet to run the next place.

                          ^-.-^
                          Faith is about what you do. It's about aspiring to be better and nobler and kinder than you are. It's about making sacrifices for the good of others. - Dresden

                          Comment


                          • #14
                            Quoth Andara Bledin View Post
                            Everybody they dealt with for funerary arrangements they required to purchase a proper casket through them. No exceptions. And if you decided to be cremated, then they'd pull the body out, stuff it in a cardboard box and resell the casket.
                            Agh! That's rat nasty.

                            They should have put that sob in jail.
                            They say that God only gives us what we can handle. Apparently, God thinks I'm a bad ass.

                            Comment


                            • #15
                              Quoth dalesys View Post
                              OT: Every time I read the thread title I think of the doctor with dual specializations: Psychology & Proctology.
                              So I'm guessing that would be the doc to go to if you had a nasty case of rectaloptilitis.

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