Quote from Cardiac-RN
Anyone willing to share tips for working in the field seeing hospice patients at home, SNF, or short-term inpatient?
-How you organize your day/ prioritize your cases/ keep your recert preparation on track/ communicate optimally with caregivers/ review documentation before submission to IDG and medical records etc.
I would love to be able to take what you are doing that is working very well and incorporate it!
Although Not an RN yet, I've been around many and have learned a ton of information from each one of them and have utilized the information when out on my own...
Organize: we try to do patient visits in order of who is furthest, but only in a perfect world. you have to see who is most critical first. Usually new admits require a second visit a few days after initial admission, to clarify information given to them. At admission, so much info is given, families often get confused and have more questions to ask as a day or two passes.
Carry extra supplies. It is better to have 2 catheter kits in your car then to not have any, because you will use one and then need another before you go back to the office. Keep extra supplies in your car, gloves, creams, lotions, f/a stuff, wound care stuff, sharps container, E-kit (depending on your Agencies rules for this one) Diapers, chucks.
Recerts are done: 2 90 day periods, then subsequent 60 day cert periods. You keep track of the dates of admission and count 90 days..do a recert (get it?) For Supervisory visits for the LVN and CNA..LVN I believe is 1 every 30 days, CHHA is one SVO (observation) every 14 days (two weeks) SVF (follow up) ever other 14 days..so week 1 is nothing, week 2, SVF, week 3 SVO, week 4 SVF (your reg nursing visits can be done at the same time as SVO and SVF.
Some of the Nurses I have shadowed have made notes in a note book, then transcribed them to the standard forms, others have done the notes directly on the forms at the time of visit.
Review your notes prior to turning them in, keep copies of your notes, just in case the ones you turned in get lost, also keep copy of your visit log sheet (we/ I have learned that MR looses stuff....I got to a point that I made copies of the notes and route sheets, then had MR sign my copies that x number of pgs were received..when I started to do that, amazingly none of my notes nor the RN's got lost!)
In the Home, document everything you told the Fam/PCG.
In the SNF..document like your butt depends on it. better to over document then underdocument..CYA...same with short term inpatient.
Carry Water and non perishable healthy snacks in your car.
Keep your cell phone charged, carry your charger.
Keep your phone updated with all of the necessary numbers you will need, Admin, DON, Office, fax office. MD, Alt MD., Pharmacy, DME, Fellow Nurses, and Support staff ie, Chaplain and MSW.
Extra forms all of them.
If you do admissions, then make sure you have extra admission forms especially on the weekends...Don't get caught with out, it never fails, when you are out of what ever, that specific item is needed.
Carry a Pulse ox. and extra batteries
carry a digital thermometer
BP cuff, if you use digital, extra batteries
your watch..ok I know you know this one!
extra black pens.
Hope this helps..any more questions, dont hesitate to PM me! I may not be currently physically working, but my brain is all about Hospice.
Welcome to an exciting and most rewarding adventure!