Journal Assignment: A Reflection Of My Experience In Nursing

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Journal Assignment #2
As a new nurse, I started working in a local hospice agency located near my house. Among the duties I performed as hospice nurse include calling patients and their families to follow up on their conditions. One of the patients that I needed to check up on regularly was Mrs. L.J., an 82-year-old Lebanese woman residing in a skilled nursing facility (SNF). She had been admitted to the hospice from an oncology medical center and had been a hospice patient for less than a week. Mrs. L.J.’s primary caregiver (PCG) was her younger sister, A.J. Prior to her latest hospitalization, Mrs. L.J. had been living in the SNF for the past four years. The SNF charge nurse explained to the hospice team that Mrs. L.J. was initially admitted to the SNF with the diagnosis of chronic heart failure which had been appropriately managed, controlled, and cared for in the SNF. Mrs. L.J. history and physical from the oncology hospital had indicated that six-months ago, she had been diagnosed with ovarian cancer. During that hospital stay, Mrs. L.J. had a
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Our hospice medical director instructed to resume Mrs. L.J.’s feedings until a meeting at Mrs. L.J.’s SNF was arranged to discuss A.J.’s concerns about her sister’s nutrition and end-of-life (EOL) care. Nonetheless, A.J. refused to resume the GT feedings and/or to participate in the IDT meeting. In addition, she threatened with terminating her sister’s hospice enrollment. As a nurse, I understood that A.J. was the person responsible of making her sister’s EOL care decisions. Yet, Mrs. L.J. had been admitted to hospice with a GT in place and A.J. had agreed to continue her sister’s feeding to provide the necessary nutrition to keep her comfortable and able to function to the extent of her own abilities. I felt troubled by A.J.’s actions and conflicted by her reasons behind the order to reduce Mrs. L.J. normal GT

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