28 February 2023

how to be a hospice nurse


What is hospice to you? 
What is death? 


Most cultures have some 
Ideas and norms for death and dying. 


In TV Land aka Hollywood,
It’s seldom as simple as this.
 
Death is a process. Not an event. 

Most of us try to not think about it. 


In simplest terms, Hospice
Is a program that Nursing offers
Where the focus goes from CURE
To CARE. When no cure can be had,
It’s time to focus on palliative care. 
No heroics. No CPR. No machines. 
Oxygen is ok. It’s for comfort. 


Hospice is generally when a person
Has only 6 months to live. 
Some groups say 2 years. 

Hospice and Palliative care
Are finally emerging as a
Loving, acceptable option. 
I would want it - no hesitation!


Once upon a time, very few people 
have heard of hospice. 
Now just about everyone knows someone
Who is on hospice care. 

And yes. Roll up a fat one- 
Whatever you like. This is your time. 
And no one should take it from you. 
All rules are out. All consequences- gone. 


Many people plop their hospital bed
Right in the living room or den. 
Better for visitors. 
More room. Many machines. 
More centrally located. 

Homeless people are eligible for care 
if your Social Worker can make it happen. 


Kids of all ages can access hospice. 
Everyone in the bed! Pile up!
Even Doggo, if you find it comforting. 


I love the Monks and Nuns. 
I’ve had many Buddhist cases. 
Very beautiful process.
 Much respect for the dying. 
Beautiful chanting. Such a privilege 
To witness and support. 


This is the Bardo Blanket
That covers the dying Buddhist. 
To help assure success 
In the Next Life. 
No touching the body until 
a certain amount of time has passed. 
Just the Nurse’s stethoscope 
touches the chest 
to listen for heart beats-
 by law we listen for 2 to 5 minutes.


Canada has passed a law
MAID 
Medical Assistant In Dying. 
A person takes a heavy dose of medication 
(By their own hand)
To make them comfortable 
While they end their own life. 
It’s medically supervised. 

This is a Swedish “Death Pod.”
The actual name is a Sarca Pod. 
The dying person must be fully awake
Fully aware, and must touch the buttons
With no help. Not assisted suicide. 
Just death with dignity. 
There is also a “Live” button
If the person changes their mind. 


American society is not quite ready for this. 
Maybe because of  Kevorkian? 
Maybe because we value life?
(Do we really?) 
The Death Penalty makes people
Assoiciate death with punishment. 

Grace & Frankie had this storyline. 
An old friend had a terminal condition. 
And rather than go through the suffering,
She chose euthanasia. 

I had a friend in real life who did this. 
I was mixed about it, at first. 
Now, I’m OK. 


Some people think we are ferried 
To our new destination. 


Elizabeth K├╝bler-Ross 
And her body of grief work. 
She reported she was visited 
By patients who had just died! 


But what do we really know? 
Probably very little. 


In the movie Zorbo, an old lady died,
And the townspeople raided her place
Even as she was taking her last breath. 
It’s funny because it’s true! 
People really do this. 


Hospice is the best, most humble
And honest form of Nursing. 
Anything goes. 
And we’ll be right by your side. 


And yes. There is even a 
Hospice for babies. 


Hospice is a promise. 
We help dying people maintain 
Dignity and autonomy. 


We can’t control much. 
But we can control pain. 
There is virtually no limit 
To the amount of Morphine 
(Part of the comfort pack) 
A dying person can have. 
They can have as much as they need. 
The rules change for Hospice. 


Side note: Hospice Nurses handle
Such vast amounts of narcotics. 
We must pass monthly background checks
And on-demand drug screening. 
(They hand you the cup. You pee.)
Hospice Nurses are typically 
Squeaky Clean. 




Thank you for reading!
 I hope this helps. 
As you might be able to tell,
I love Hospice the most. 

Death be not proud…
John Donne and the Holy Sonnets 
Have you seen the movie “Wit”?
Here’s a nice takeaway. 
Please enjoy. Mascara alert!

it is well


Morning sky is pretty 
People will be petty. 
My new motto.  LOL. 


Be a Nurse, they said. 
It will be fun, they said! 


Air Quality sucked today. 
Pun intended. 


Mask up. No exceptions. 


These ended up in my cart. 
So I ate them. 
I’m really impressed. Good crunch. 
Great taste. 18 grams of Protein. 
This and protein shakes x2. 


I still like the Kratom
I take them once a day. 
In local stores, it’s $1 a gram. 
I found a place online that sells 
Loose powder 250grams/ $27. 
So 10 cents a gram. 
A standard dose os 1/2 gram for me. 


Has it been year? 
Time flies when you’re 
In a Global Pandemic Crisis 

I had to rest my knee. 
I stepped on a power cord, slipped,
Almost fell. 
Time for new power cords. 


I took an Advil 
And by gosh by golly,
I slept! I didn’t wake up at all. 
No even to go to the little nurses room. 

Trying to gain traction here…
My up-and-coming 2nd blog…. 
You know how comments can be! 
Someone asked me if I have teeth. 
So yes. Yes I do have teeth. 
My own teeth; my mother gave them 
to me as a keepsake when I was born! 
I’ve not lost any- except that one tooth
Jumped out of my mouth during COVID. 


27 February 2023

how to be a geriatric nurse


Unfortunately this was the scene
Like 30 years ago. And today. 


Folks sitting in wheelchairs 
All around the Nurses Station
Or lining the hallways. 
Waiting for meals. Or Bingo. 


Nursing plods along 
And change is often slow. 
Big changes take a generation. 


We all get old. 
Why is this field so neglected? 
I promise you- most Nurses hate this -
And Nursing Homes are the
 Bane of our existence. 


Slight improvement from the 1950s 


People are living longer. 
(Sometimes) 
With improvements to life. 
(Sometimes)


What have we created? 
Definitely room for improvement. 
Many Nurses will start their career here- 
At a LTC Long Term Care Facility. 
I know I did for sure. 
They pay more than Home Heath. 


So so so many meds. 
In order to be eligible to live 
In a “Nursing Home”
Now referred to as Nursing Care Centers 
Or ReHab.  Or Assisted Living…
To qualify, a person needs to 
have a medical need. Like a diagnosis,
Or multi medications. 
Some need. Nursing always 
addresses a need. Why are we there? 
What are we doing for the patient? 


Group Homes are also nice. 
Usually Private Pay, though. 

Sad fact is that most places are 
Sadly understaffed. 
And regulated to death. 


For example:
I worked in one such place 
That used the wrong fasteners 
For the hand rails- in the hallway. 
The State closed them down
like they had the plague. 
BUT the rails had already been up 
Literally for decades. 
Suddenly they focus on that
Instead of the bigger picture. 


In a standard Skilled Nursing Facility 
Aka Long Term Care Center, 
Each Nurse has a corridor 
Or part of a hallway to cover. 
A Nurse can have up to 30 patients 
In this warehouse of human souls. 
There little time for care. 
This is the Charge Nurse. 
S/he has several CNAs
(Certified Nurse Aide) working. 
They’ll take the vital signs,
Do the bathing, personal care,
[Nurses call this ADLs-
Activities of Daily Living]
And help with meals. 


The Nurse will pass meds,
Usually 2 times a shift. 
Give insulin, oversee care,
And wound care … etc.  

You can probably guess- I’m a fan of 
Reforming the whole system. 
It’s sadly broken. 


Now it’s our turn to take care 
Of our parents. 
They call it a Sandwich. 
You’re smack dab on between
Raising your own kids - and 
“Raising” your parents…
That is, tending to their needs. 


I can’t imagine this life for me. 
Or anyone I love.
But it’s great if you have no other options. 
Some residents have rich fulfilling 
Friendships and receive good care. 


Some fancy LTCs require $100,000
Non Refundable Deposit- 
Just to be on the list. 
$1000 a week is starting cost. 
On the low end. 
Anything for Dad, eh? 
Especially if it’s his money! 

Private pay Nursing will charge 
$1000 a day for 24 hours care. 
That’s not what the nurse gets paid. 
By the way.  Drats. 


This is why we preach prevention. 
Being strong and healthy. 
I’m not rich. But I’m healthy. 
And that’s infinitely better! 


The expectation 
VS the Reality of aging. 

Into this mix of Adult Diapers, 
(It’s a no-no to say diaper. 
We say “Briefs;” Babies wear diapers.)
Chronic illness, loneliness and heartbreak 
God sends His Nurses. 
Most Nurses don’t last long in what
can be truly deplorable conditions. 

I’m ready for reform! 
A new kind of place for mom.