Ditto Amy 100%
I worked on an 18 bed subacute/longterm vent/trach unit for several years. We pretty much did everything: from palitive care and terminal weaning to pulmonary rehab and extubation to providing a "home" for stable vents that needed to much to be at home.
Some families (and staff) have a hard time getting into "hospice mode" because of the vent, (I think) the vent contributes to hope for recovery..."as long as they are breathing". A down side was that due to reimbursement issues we were limited to "Hospice Consults"...the upside was that many of us were able to do an unpaid sort of intenship with Hospice so that we gained some experience in medication management and psychosocial/spiritual support.
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