[RNandlovingit]

I have only been a hospice nurse for a little over a month. I absolutely love my job!!! with that said. I am "green" to the field of hospice nursing and would love to hear tips and advice from you experienced nurses! I am one of those people who wants to always know everything and take care of my patient to the best of my ability but there is so much I dont know! And this is the only nursing I ever want to do again!! So thanks in advance for any words of wisdom!!!!

[tencat]

Hi! I think the best thing I can tell you is to make sure to take care of yourself, too. And make sure you set boundaries for yourself. Take vacations, even mini-vacations for a weekend or overnight. It is a very demanding job that can suck up your life if you let it. If you're not caring for you, it's hard to care for others. That being said, hospice is very rewarding and I love it.

[Em1995]

Nursegirl...welcome to Hospice Nursing! I've found a lot of sharing amongst fellow hospice nurses on the internet. This is a great forum in which to learn and to share. Does your agency have a protocol book for symptom control? It's good to have one available, but as you know hospice nursing is much more than this. I wish you many blessings in this heartfelt career!

[RNandlovingit]

Originally Posted by Em1995

Nursegirl...welcome to Hospice Nursing! I've found a lot of sharing amongst fellow hospice nurses on the internet. This is a great forum in which to learn and to share. Does your agency have a protocol book for symptom control? It's good to have one available, but as you know hospice nursing is much more than this. I wish you many blessings in this heartfelt career!

We dont have protocol books.. How I would love that. I have a 10 page handout with common drugs used in hospice..thats about it. I think our Clinical educator is working on putting a book together for the newbies..but until then....lol

[Em1995]

If you send me your snail mail address, I'll send you a copy of ours! All of our patients benefit when ALL of us share our pearls of wisdom with one another! Just send it as a privatge message.

[RNandlovingit]

Em1995
i tried to private message you and it wouldnt work...lol .. could you pm me first?

[Em1995]

Nursegirl...I sent you an e-mail!

[SweetSue16]

I have been working as a case manager for a not-for profit hospice since May 07. I took a paycut when I accepted the job. I have 11 patients for now. 8 patients are in LTC facilities. During the past summer most of the case mangers were caring for 14 or 15 pt's. The paper work is overwhelming and very repetitive. Many deadlines exist that include team meetings, supervisory visits, skilled nursing visits routine and in emergencies. Phone calls. We make medication and treatment decisions from standing orders while in the field. We are sometimes in filthy surroundings or unsafe situations. All 37 years of my nursing experience is utilized every day. Unfortunately I can't pay my bills on the hospice salary. Hospice pt's must be re-certified for contiued eligibility every 2 months. The re-cert must show decline. Currently I have 1 patient with a diagnosis of debility. She has been in hospice for a year. She has not declined. Our census is down. Staff has been told no mini-teams, no discharges. I am being told to re-certify her. I am having a lot of trouble with this situation.

[Em1995]

SweetSue...you cannot recertify a patient if they are not showing a decline. Do you find anything that indicates a decline? Any weight loss? Increased sleeping? Increased infections? UTI's? Decline in mobility? Increased confusion? Do any of the co-morbidities effect the patient's status?
Whatever....if there is no measureable decline, you cannot re-certify this person. If your agency is telling you that you "have to keep this person on your service" and you cannot document a legitimate reason, then I would look at working for another agency as this would be fraudulent.

[SweetSue16]

EM1995.... I requested a miniteam in Dec regarding my pt's no decline status. The clinical coordinator went to to the nursing home and scoured her chart. She called the hospice medical director, who ordered a lab draw for albumin. The result was actually an improvement from an Oct. resullt. Her arm and thigh measurements are unchanged. She has had no infections, no skin break down. No change in cognitive or functional decline. Her pps is 30% , fast score is 7f. These scores have not changed since admission. The clincal coordinator will have to do the re-cert. Thanks for listening