http://allnurses.com Where Hospice Nurses come together and share their knowledge and understanding with other Hospice Nursing Professionals. Hospice nurses perform many traditional nursing duties such as observing, assessing, and recording symptoms, and they still work closely with physicians, administer medications, and provide emotional support. Hospice nurses have a particularly tough job because, from the outset, they know that the patient for whom they are caring is terminally ill. en Sat, 21 Nov 2009 01:05:44 GMT vBulletin 60 http://img.an-file.info/misc/rss.jpg http://allnurses.com http://allnurses.com/hospice-nursing/continuous-care-440024-new.html Thu, 19 Nov 2009 21:26:56 GMT Very curious about medicare's criteria for "continuous care." I was under the impression that it had to be a "skilled nursing" activity every 15 minutes. Could anyone clarify or explain what exactly they require? thanks as always...;) ]]> Hospice Nursing saribeth http://allnurses.com/hospice-nursing/continuous-care-440024.html http://allnurses.com/hospice-nursing/lpn-student-want-439658-new.html Tue, 17 Nov 2009 22:52:51 GMT I am planning on beggining an LPN program in January and want to work with Hospice patients and... I am planning on beggining an LPN program in January and want to work with Hospice patients and families. I cared for my Mother who had Infammatory Breast Cancer and this was our first experience with Hospice care and the wonderful nurses and social worker who helped us so my mom could be at home and we could participate in those last weeks of life with her. I was so amazed at the experiences we had during that time. Im sure many of you have your own amazing stories. I felt called at that time to go into Hospice care as a nurse after some grieving time,my mom was only 57 when she died so it was pretty shocking for me. Any advice on how to get into Hospice care and how I should go about it. I have spent a lot of my own time reading books by other nurses in Hospice care and of course Elisabeth Kubler Ross. Any help would be so appreciated... Thank You ]]> Hospice Nursing kleah http://allnurses.com/hospice-nursing/lpn-student-want-439658.html http://allnurses.com/hospice-nursing/how-long-feel-439328-new.html Mon, 16 Nov 2009 03:47:39 GMT Hello all of you hard working Hospice nurses. I have been involved in hospice (very happily, I... Hello all of you hard working Hospice nurses. I have been involved in hospice (very happily, I might add) for over six years. I just took a new job that utilizes the SunCoast electronic software. Now....please remember that I am an old school nurse who is accustomed to paper charting. I can see how this new format can potentially be beneficial (and anyway....we will all have to adapt, right).. I have completed class......and was hoping to get some personal experience stories and opinions on how others have adapted. I appreciate you all.......we are in prehaps the most noble nursing area around. Robert ]]> Hospice Nursing RKMARK http://allnurses.com/hospice-nursing/how-long-feel-439328.html http://allnurses.com/hospice-nursing/transportation-narcotics-other-439275-new.html Sun, 15 Nov 2009 22:13:16 GMT I have a question and maybe someone can help - a hospice social worker was asked by her agency to... I have a question and maybe someone can help - a hospice social worker was asked by her agency to transport controlled substances from the pharmacy to a pt. home; and on another occasion, compazine from the pharmacy to a pt. home. These were on-call after hour visits and the on-call nurse was unavailable. The social worker is decidedly uncomfortable with this, and I wonder if, as well as poor practice, that this was outside the law? Can someone help?:eek:

Thanks. ]]> Hospice Nursing susanerl http://allnurses.com/hospice-nursing/transportation-narcotics-other-439275.html http://allnurses.com/hospice-nursing/ativan-439038-new.html Sat, 14 Nov 2009 15:00:20 GMT Can IV Ativan ever be used down a PEG tube if that is all one has on hand? Thankyou for any help. Can IV Ativan ever be used down a PEG tube if that is all one has on hand?
Thankyou for any help. ]]> Hospice Nursing mollie http://allnurses.com/hospice-nursing/ativan-439038.html http://allnurses.com/hospice-nursing/share-your-best-438990-new.html Sat, 14 Nov 2009 04:54:29 GMT Hi all!

I'm relatively new to Hospice nursing and I am eager to learn what tips and tricks related to patient care and comfort you have gained over the years. Are there any that you would be willing to share with us all? Anything and everything is welcome: from good remedies to alleviate constipation to care when patients are actively dying.

Thanks in advance!:spin: ]]> Hospice Nursing RachelRN25 http://allnurses.com/hospice-nursing/share-your-best-438990.html http://allnurses.com/hospice-nursing/pt-load-case-438927-new.html Fri, 13 Nov 2009 22:36:14 GMT Case managers - tell me, how many patients are you managing on any given week? How many visits do... Case managers - tell me, how many patients are you managing on any given week? How many visits do you do in an average week? Does your hospice have a separate admissions nurse? :paw: ]]> Hospice Nursing holiday2525 http://allnurses.com/hospice-nursing/pt-load-case-438927.html http://allnurses.com/hospice-nursing/voluntarily-refusing-food-438547-new.html Thu, 12 Nov 2009 01:01:00 GMT I am doing my bioethics paper on this, and wondered what you hospice nurses' experiences were with this, and how you felt about it. ]]> Hospice Nursing 4treasures http://allnurses.com/hospice-nursing/voluntarily-refusing-food-438547.html http://allnurses.com/hospice-nursing/idg-meeting-question-438510-new.html Wed, 11 Nov 2009 21:49:38 GMT I am having trouble with a few of my Alzheimer's pt's at IDG meetings where it is my job "to paint a picture" of the pt and why they qualify for hospice. I know these pt's qualify, I am just having trouble coming up with something new every other week to say. I am consistently saying pt. pale, poor turgor, temportal wasting, max assist with ADL's, stares blankly, verbal but confused--talks non-sensically much of the time etc. This particular pt. is non ambulatory, she eats well, no skin breakdown. Are there any other phrases I could use? I feel like I am saying the same thing over and over.
Thanks ]]> Hospice Nursing danyd http://allnurses.com/hospice-nursing/idg-meeting-question-438510.html http://allnurses.com/hospice-nursing/intractable-pain-question-438343-new.html Wed, 11 Nov 2009 02:24:27 GMT I have a middle aged woman with advanced vulvar cancer on my caseload. Co-morbs of HTN, smoking. ... I have a middle aged woman with advanced vulvar cancer on my caseload. Co-morbs of HTN, smoking. She has significant pelvic/perineal tumor burden which is the source of her pain. It is mixed nociceptic and neurpathic. She came to me using Percocets at her max with continuous pain 7-9/10. She has remains on that same dosage today, it is her safety blanket. We have moved her through morphine, to methadone which was somewhat more effective with the neuro pain. She has now, unfortunately started having some visual hallucenations and I fear that the methadone has exceeded its risk/benefit ratio. She was too sedated on Neurontin and had a systemic allergic reaction to Elavil. Her pain control is currently averaging 4-5/10 with exacerbations. It is the neuropathic pain that is most difficult for her. She lives independently and is very cognitively approp for age. She is sleeping reasonably well with pharma help. She uses Ativan periodically but not routinely. Safety at home with good pain control are her immediate goals. I believe that the best palliative options for this woman are in the arena of intrathecal, epidural, nerve block. Obviously, these are expensive options...so I need to advocate an intelligent and informed plan of action which ends (soon I hope) in good pain control for this woman. I do not think that simply switching from methadone to say...dilaudid...will solve this problem as the neuro pain is key to her quality of life. Any suggestions for a next step? ]]> Hospice Nursing tewdles http://allnurses.com/hospice-nursing/intractable-pain-question-438343.html http://allnurses.com/hospice-nursing/hospice-place-me-438325-new.html Wed, 11 Nov 2009 01:25:51 GMT I returned to a hospital setting a few years ago after a lifetime of raising a family, running a... I returned to a hospital setting a few years ago after a lifetime of raising a family, running a daycare, and managing a women's substance abuse program in the justice system. I was overwhelmed by the lack of patient interaction which is why I entered nursing to begin with. I left that job and did not think there was a place for me as an RN. My recent personal experience with hospice (my mother) has me very interested in returning to work in the field. What courses/classes/materials are available so I may prepare for the certification exam? I got nothing from google except I did find this wonderful site:) I am a person of faith and believe this would be the perfect place to use my skills. ]]> Hospice Nursing farmgirl63 http://allnurses.com/hospice-nursing/hospice-place-me-438325.html http://allnurses.com/hospice-nursing/help-family-denial-438081-new.html Tue, 10 Nov 2009 05:14:36 GMT I'm not the case manager for this family ( but I've had to deal with this family while on call) but here's the situation. Pt has benign meningiomas and all treatments are exhausted. Pt has had to be moved to SNF. The family is in denial about pt's condition. The pt is becoming agitated, causing problems for the staff, etc. We get calls routinely from this family. they don't want us to medicate pt because they don't want pt sedated. Only pain meds allowed by family are Tylenol and Ibuprofen. They have allowed Ativan. They want us to boss the staff around at this SNF because they aren't happy. They want us to be there constantly, even though we have told them we do not offer round the clock services. We have talked to the staff about going slow with pt, taking the time to givept meds, taking time to feed pt. Pt is becoming very obstinate and noncooperative. The staff is working with us, yet they also have to do what is best for their staff, and they certainly aren't going to take well to us bossing them, just because the family wants things their way. That's just not acceptable, yet that's what this family is asking us to do.

This family has frustrated me to no end, because it doesn't matter what we say! They are in total denial about pt's condition causing mental changes that affect pt's behavior.
What are we going to do when pt needs some Haldol or something?

I'm new at this hospice nursing, so some advice would be welcome. I spent 2.5hrs last weekend with them, and felt like I got chewed up by the spouse and kids. ]]> Hospice Nursing CareForYou http://allnurses.com/hospice-nursing/help-family-denial-438081.html http://allnurses.com/hospice-nursing/happy-hospice-month-437807-new.html Mon, 09 Nov 2009 03:44:23 GMT Wishing a Happy Hospice Month to all those nurses, aides, social workers, chaplains, doctors and of... Wishing a Happy Hospice Month to all those nurses, aides, social workers, chaplains, doctors and of course, our volunteers. I hope you have as much support and caring about each other in your hospice as I do with my co-workers. May God as you understand him bless all our "Hospice hearts"! ]]> Hospice Nursing FLArn http://allnurses.com/hospice-nursing/happy-hospice-month-437807.html http://allnurses.com/hospice-nursing/paediatric-palliative-care-437461-new.html Sat, 07 Nov 2009 10:21:20 GMT Hi everyone I was just wondering if anyone can help. I am a nurse and currently work on a... Hi everyone

I was just wondering if anyone can help.

I am a nurse and currently work on a very busy med/surg ward for young children. I have been a qualified nurse for a year now and have always had a keen interest for palliative care work. A job at a local hospice for children has recently opened up.

I was just wondering if:

1. Any of you work in a hospice relating to paediatrics.
2. If you could tell me your views on this type of work.
3. Whether on the whole you enjoy working in this field.
4. What I am likely to expect from what you've experienced.

I apologise if this makes no sense at all, just wanted a little personal insight into this type of work really. I imagine it to be such a special place to work and really can see myself working in a hospice.

Any advice/insight etc, would be very much appreciated.

Thanks Laura ]]> Hospice Nursing Stargirl1980 http://allnurses.com/hospice-nursing/paediatric-palliative-care-437461.html http://allnurses.com/hospice-nursing/the-right-car-437375-new.html Fri, 06 Nov 2009 23:09:04 GMT Hey my fellow RNs!

I am have been offered a job as a hospice nurse. I'm very grateful and very excited to start. However, I figure I'll have to get a new car. Right now I drive a 98 Subaru Outback that's in pretty good condition but I understand with the constant driving I'm going to have to upgrade.

Question: Do you guys recommend buying or leasing your car? ]]> Hospice Nursing RN1981 http://allnurses.com/hospice-nursing/the-right-car-437375.html