You are never out of line advocating for your patient. However you should realize that the husband will need to agree, and if he's not ready for this, it won't happen. As far as when the patient is ready? First of all, an evaluation can be done by a hospice agency at any time. If the patient doesn't meet criteria, they will tell you. The primary criteria for hospice is that a physician is willing to certify that in his/her opinion, given that the disease follows an expected course, the patient has a life expectancy of 6 months or less. If a physician agrees with this, the hospice agency will do a complete assessment to confirm that the patient is eligible for hospice services.
I understand your frustration with the full code status. This is one of the reasons I chose to leave the hospital and get into hospice nursing. I once had an experience of a patient who was dying from brain cancer in the hospital, but the physician refused to accept this. We pleaded with the MD to order DNR, but he refused (this was before it became federally mandated that we discuss advanced directives with every patient). The patient arrested and we coded the patient to no avail. I was so angry afterwards, and decided then and there that when I had the opportunity, I would move into hospice nursing.
Jan 1 by areenseeYou are never out of line advocating for your patient. However you should realize that the husband will need to agree, and if he's not ready for this, it won't happen. As far as when the patient is ready? First of all, an evaluation can be done by a hospice agency at any time. If the patient doesn't meet criteria, they will tell you. The primary criteria for hospice is that a physician is willing to certify that in his/her opinion, given that the disease follows an expected course, the patient has a life expectancy of 6 months or less. If a physician agrees with this, the hospice agency will do a complete assessment to confirm that the patient is eligible for hospice services.