Quote from ertrek84
What is a typical day for a Hospice RN that works in the Hospice, not doing house calls?
I am a RN working at our hospice's hospice house and do not normally do house calls. Our house is split into two units, general inpatient and residential. There are 10 beds on each unit. A typical day for me looks something like this when I work day shift: I get into work around 6:45am and check which unit I am assigned to. If I am on the GIP unit I head over and get a detailed report from the midnight nurse regarding the status of each patient, their disease progress, family issues, and general health. We then go and count each patients' narcotics (kept in their bathroom in a lockbox) and briefly observe the patient. I check their meds with the kardex and do an overview of the meds they will receive that shift. Next, I perform a head to toe assessment with a focus placed on the pain assessment, skin assessment, any signs of anxiety or restlessness, respiratory, and anything related to their diagnosis (lung ca --> lungs and breathing, colon or and GI ca --> bowel sounds, distention, tenderness, etc). Typically, at least one patient has some sort of need or change in medication. I address these issues as best as I can and decide what I need to bring up to the physician or the NP. If the needs are serious (i.e. increased pain that cannot be treated due to frequency of pain medication or lack of medication order) I make a call to the physician to get a one time dose order, medication order change, or whatever they deem necessary. The NP comes to the unit by 9am and the physician arrives shortly after. I give them an update on each patient, and inform them of any changes in status or needs. The rest of my day is composed of passing medications, general care you would see in the hospital, etc. Patient education is a large part of job as it is in the home. Much of what we do on the GIP includes some sort of education. Family education often finds itself to become even more important especially toward the end of a patient's disease progress--educating on pain, medications, anxiety, and the signs of progressing disease and what to expect at the end of life. Emotional and family support becomes a large part of what I do on a daily basis as well. Depending on the patients on the unit there may also be discharges and the RN on the floor takes the lead on the admissions that come in to the unit as well. I also participate as the RN in interdisciplinary team (IDT) meetings once a week when I work days. Each day is different and there are several variations of the day listed above. The residential unit is generally the same but more similar to a "nursing home" without being a nursing home.
Hopefully this helps!