LPN's in hospice?

  1. Does your hospice use LPN's? The hospice I work for doesn't. Im wondering how we could utilize them since they can't assess for death?? We have 2 fulltime RN case mgrs that work mon-fri and take call. Also have 1 RN that only takes call a couple days a month. We are a small hospice.....census 15-30 pts and usually only cover one county. Call is usually quite except when a pt is actively dying and then the family can get antsy and may call more especially if its the weekend.
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  2. 18 Comments

  3. by   akanini
    I know 2 LPNs that work in hospice and all they do is give medication.
  4. by   sclpn
    Im mostly wondering about LPNs working in the field. (seeing pts in their home) giving meds is usually done by pts or family members.....was considering if they could be used for on call or seeing pts when one of the case mgrs needed to be off
  5. by   LGD2011
    The hospice my agency used assigned an RN, LPN, HHA, MSW, and chaplain to every patient, but they are a very large agency. The RN was considered the primary nurse and would alternate home visits with the LPN. Either could make med changes (with dr approval). I'm not sure who they used for on call. If death occurred while the LPN was there, an RN would have to come out and pronounce.
  6. by   Hospice Nurse LPN
    I work for a small company (20-30 pts) and we use myself and another LPN to make all the home (and LTC) visits. The RN does supervisory visits Q2 weeks. LPN's rotate call and have an RN backup. In my state, LPN's are allowed to pronounce a death. The RN must do all admissions.
  7. by   okielpn75
    In our company the LPN is the PRIMARY nurse. The RN rarely puts eyes on the patient. No nurse in our state is allowed to pronounce. All of our nurses are required to call a doctor to notify of absence of vital signs and receive an order to release the body. Our Rn's do not take call so the LPN's are the only ones in the field. How do nursing homes where you live do deaths? RN's usually don't work the night shift so they make an RN come in the middle of the night or on the weekend? Seems silly and a waste of time.
  8. by   Hospice Nurse LPN
    Quote from Hospice Nurse LPN
    I work for a small company (20-30 pts) and we use myself and another LPN to make all the home (and LTC) visits. The RN does supervisory visits Q2 weeks. LPN's rotate call and have an RN backup. In my state, LPN's are allowed to pronounce a death. The RN must do all admissions.
    Actually, what we report to the coronor is absence of v/s, no respirs, eyes fixed and glazed, etc.
  9. by   poorelinda-LPN
    The hospice I work for uses LPN's in the homes. The RN is the Case Manager for the home pt and they alternate visits. One week the LPN sees the pt and then the next week the RN sees the pt. We have approximately 100+ home pts so we have 5 RN Case Managers and 3 LPN's that work in the field. It works and sometimes could use another LPN because their case loads average 25-30 pts a piece.
  10. by   curiousauntie
    We use an LPN as follow up to the RN. We (RN) must see each patient weekly and if there are issues in the home or the patient or family needs the additional support, the LPN will do a second visit. She is assigned a "case load" but at times she is pulled to do home health aide care if someone calls out and we cannot get another home health aide to take on the extra patients. She also does wound care (she is excellent in wound care, much better than a lot of RNs who have not had long term care experience). In NJ an LPN cannot pronounce death and in my hospice she cannot get MD orders, not a state thing but a company thing. She can re-order medications from Hospice Pharmacia and she does fill Medi-Minders and count narcotics in the occasional home where we are worried about diversion.

    I LOVE my LPN, she is a god-send when things are going haywire and you are in a different county, 40 miles away and someone needs to put eyes on a patient. Her assessment skills are top notch and she is very knowledgeable in pain management and symptom management. I keep telling her to get certified as I know she would pass the test on the first try.
  11. by   ahsweeney
    Quote from sclpn
    Does your hospice use LPN's? The hospice I work for doesn't. Im wondering how we could utilize them since they can't assess for death?? We have 2 fulltime RN case mgrs that work mon-fri and take call. Also have 1 RN that only takes call a couple days a month. We are a small hospice.....census 15-30 pts and usually only cover one county. Call is usually quite except when a pt is actively dying and then the family can get antsy and may call more especially if its the weekend.
    I work at an acute care hospice facility, so my situation will be different from those out in the field. We are a 16-bed inpatient center and we utlilize LPNs. There is always an RN on also to pronounce. The LPNs do everything except pronounce.
  12. by   SappyRN
    We use LVNs. We have about 200 patients on servic. We have 2 full time LVNs and 2 part time. They go into the field and make routine visits when someone is on vacation. They also help when the caseloads are high. Yhe LVNs cannot " pronounce" but inbtexas they are allowed to report the signs and symptoms of death and write a telephone order for death pronouncement by the MD. Our LVNs are awesome and work very hard. They are much appreciated.
  13. by   Hmayse
    I've been a hospice nurse for two years now. I love it. There is nothing else I would rather do. I am an on call nurse (LPN) on the weekends I start Friday at 5p until Sunday at 8p. I do routine in home or facility visits. Pain assessment visit. Assess the need for crisis care. I staff crisis care, administer medication, phone triage etc.
  14. by   tschoenholz
    I am an RPN (same thing as an LPN) and I work at 2 hospices. I do everything the RN does and I can pronounce death where I work. The RN's will sometimes take the patients if they are actively dying but not always since I can handle them just fine. I don't see why you couldn't hire LPN's and have them do everything the RN does but just call an RN to pronounce when the patients do die.

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