Welcome. Your experience will depend upon where geographically you are practicing, whether or not you are visiting patients in the hospice inpatient unit or in the field. You may travel with different disciplines in order to give you an idea of the interdisciplinary approach. You may be invited to attend the IDT meeting (InterDisciplinary Team meeting).
If you visit in the home with the case manager you should expect that the RN will introduce you and say why you are there. (He/she may have already notified the patients and families to expect a student ride-a-long). H/she will enter the home, appropriately stow their bag, and proceed with their visit process.
During the visit certain things are common;
~The RN CM will greet the patient and family, often warmly, and may have chit chat about social things that have gone on.
~H/she will look at the med POC and the medications available in the home
~h/she will assess how the meds are being given, if they are effective, if the goals for the medication POC are being met and why or why not.
~the nurse will order any meds that are on short supply to insure that the patient has an adequate supply
~some level of a physical exam will occur. however, dependent upon the POC that may appear very cursory to you and may not include things that you consider standard, like recording VS.
~sometimes the RN will do things like change or irrigate a foley, draw blood, empty a pleura vac, assess and redress wounds, suction or clean the trach, complete ilieostomy or colostomy care, administer medicastions, apply compression stockings or lymphedema wraps (if trained), etc. Basically any skilled need the patient may have.
~the nurse may phone and speak to the MD, or may order an intervention from the signed Standing Orders without speaking to the MD. The CM may contact other disciplines at that time if there is any need identified during the visit.
~the nurse will assess the overall needs of the patient and family, determine if the current POC is working and if there are additional problems, interventions, or goals that should be added, changed, or discontinued.
The visit may be brief or quite long...it depends upon the patient, family, and nurse. Most try to complete the visit and their documentation in about an hour.