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- by AtlantaRN Aug 21, '12Asked to come in n meet w branch director n mgr clinical practice. Word is a facility complained about me this weekend. Said that i said "we dont do continuous care," and they said when i returned their call i asked "is she dead yet.". I would NEVER say anything crazy like that to a customer!! I asked nurse to describe her symptoms and i was on route to evaluate. When i arrived, pt transitioning and mouthbreathing vitals stable, sat 99 on 2l, no secretions, pt did not meet criteria for continuous care. ((to make matters bad- in the same room was a competitor hospice w a hospice aide doing a 12 hr cc shift on a pt that wasnt having symptoms.)). I explained to facility lpn n charge rn criteria for cc, she verbalized an understanding, said they were short staffed, why cant we do like x-company does. I cant break regulations. I went back the following day, pt the same, sat 98, encouraged nurse to use roxanol more than once a shift for any pain or dyspnea. Different nurse verbalized an understanding, 2 days later x- company gets family to sign pt onto hospice after she has been with us 15months?! Its CRAZY. I didnt do anything wring, but if facility upset, someone has to pay. Please keep me in your prayers. This really hurts my feelings.
- Aug 21, '12 by tewdlesGood luck. Competitive hospice is a tough field!
- Aug 21, '12 by nurseinmoI have seen this happen as well. I think sometimes when those "other" hospice agencies are trying to build in a new area they go above and beyond what they would normally provide to try to boost their reputation if you know what I mean. I am currently working LTC but trying to get into hospice within the same corporation and I see it all the time.
- Aug 22, '12 by westieluvI've seen it too. I recently worked for a small community hospice in a smallish city (30,000 people) and a hospice owned by a large hospital system in a nearby city was trying very hard to "claim our turf". They would kind of lurk around the various facilities that we provided services to and wait until something was presented that we couldn't offer, such as a hospice aide 24/7, or a very expensive piece of specialty equipment, and then they would swoop in and promise the moon because they had the financial backing to do so. It's hard to compete with that, and we did lose some footing in those facilities, unfortunately.
- Aug 22, '12 by MomRN0913I'm new to hospice and work for a non-profit organization. We were talking about contnuous care, and apparently, according to Medicare regulations, CC is for symptoms that can not be controlled and require an RN for conintuous monitoring.
Usually happens when there is imminent death and does not happen for more than a day really.
It seems that a lot of families also hospice as custodial care. They want someone to "watch" their loved ones and dont want to hire private care. I've seens some cases who couldn't care if the nurse came around, they wanted to know when the aide was going ot be there to turn their loved one.
You can only do what is defined within your comany guidelines. Good luck.
- Aug 22, '12 by tothepointeLVNQuote from MomRN0913What chaps my booty sometimes is when the family does have a private caregiver / CNA and when the CC nurses come on they stop doing their job completely despite still getting paid. I don't mind doing my job but I think you should do yours also. Had one case that went on CC for a month and the family had hired 24/7 CNA's 3 shifts a day because and I quote "they didn't want the nurses to have to do the dirty work" and just wanted us to concentrate on the other interventions. Well the overnight CNA's would come on shift find themselves a comfy chair slept. So that was a big waste of the families money.It seems that a lot of families also hospice as custodial care. They want someone to "watch" their loved ones and dont want to hire private care. I've seens some cases who couldn't care if the nurse came around, they wanted to know when the aide was going ot be there to turn their loved one.
- Aug 22, '12 by MarRN2012AtlantaRN, i'm glad that your bosses understand you enough to know what you can or can not do. It takes good credit and you must have that. I know that i'm going off topic here, but i'm currently living in FL and would like to move down to GA. My younger brother lives down there near the Atlanta area and i'm planning to visit the area within two weeks or so. Can you please tell how's the job market is down there for new grad RN? I worked as a LPN for 4 years mostly in LTC but i've never work in the hospital; are the hospitals hiring new grad RN without hospital experiences? I'll appreciate any feedback regarding any nursing opportunities in nearby area including affordable housing. Thanks