holistic1028

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1. How far to too far to drive?!!

   holistic1028 posted a topic in Hospice

   My agency seems to not have a set boundary of when they will decline to care for a patient. They wanted me to admit a patient that was an hour and 30 minute drive from office to hospice and I believe that is way too far to provide quality service! Ju...

2. Hospice in group homes

   holistic1028 posted a topic in Hospice

   I'm a little confused since I've never worked hospice with patients in group homes. It seems that my current agency have some kind of unwritten agreement that the hospice nurse will fill pill boxes scheduled AND as needed amongst some other things. ...

3. Certification of Terminal Illness Physician narrative

   holistic1028 replied to holistic1028's topic in Hospice

   I do that..is what I'm saying..ALL of that is in my narrative on why they meet criteria ..SEE what your saying is how its supposed to be..this doctor actually wants someone else to write his brief narrative ..all he wants to do is sign ...

4. Certification of Terminal Illness Physician narrative

   holistic1028 posted a topic in Hospice

   I know this may sound crazy but the hospice agency I work with now has a MD director that expects for his narratives to be written by the nurse and he signs! The nurse DON that was doing it for him no longer works there and now I am the only hospice ...

5. On call?

   holistic1028 replied to lifelearningrn's topic in Hospice

   No, and since they didnt inform you ahead its not right to insist you take on-call. Yes they should have had a back -up plan. Are they going to be paying you on-call availabilty hours and for after hour visits??

6. Transferring a patient

   holistic1028 posted a topic in Hospice

   Question, are there CMS guidelines on transferring a hospice patient? If so can someone pls send me a link? This agency I currently work for have no clue what CMS guidelines are for anything and it scares me. I have to learn all on my own, I am okay ...

7. Taking Patients down to the Morgue

   holistic1028 replied to cd365c's topic in Hospice

   I never said anything about dark humor, nothing "dark" about it. But i enjoyed reading it... like a mini novel. Yes REALLY

8. Taking Patients down to the Morgue

   holistic1028 replied to cd365c's topic in Hospice

   Omg the last poster have me LMAO! Felt like I was reading a mini novel.. good writing

9. Bridging 2 stage 4s with wound vac

   holistic1028 replied to holistic1028's topic in Wound

   Great idea! and makes much sense. I will try this next time I do it. Thanks for your response

10. So what's the one piece of advice you wish someone told you...

    holistic1028 replied to vampiregirl's topic in Hospice

    I would say the main thing to remember is to take ownership of the patient as case manager HOLISTICALLY. If you notice patient or family needing psychosocial support refer to sw asap, spiritual support refer to chaplain asap. Stay very organized, get...

11. Bridging 2 stage 4s with wound vac

    holistic1028 posted a topic in Wound

    I currently have a home health case to apply wound vac. This patient has 2 stage 4s.. 1 to upper sacral area and the other to lower left ischium. I am new at bridging and it seems like I keep getting a leak, not a constant noise but intermittently ev...

12. Taking pts with me to another compan

    holistic1028 replied to holistic1028's topic in Hospice

    I see, just asking bcause I've accepted an offer with a much better equipped agency but I hate to leave SOME of my cases behind

13. Taking pts with me to another compan

    holistic1028 posted a topic in Hospice

    I know it may sound cold, but is it illegal to take my patients from another hospice company I'm working for to a better one I will be starting? Not really "taking" but transfer with their consent of course.

14. SNFs and ALFs passing the buck ?

    holistic1028 replied to holistic1028's topic in Hospice

    Oh I see, so that facility hiring a licensed nurse is more for sales or for glory? Because from what I've noticed the LVN at this particular ALF sits in an office as the "director of resident services". It seems more as an office administrative posit...

15. SNFs and ALFs passing the buck ?

    holistic1028 replied to holistic1028's topic in Hospice

    I was using that only as an example regarding giving a PRN suppository. This particular patient is already on a bowel regimen of senna BID. But let's say the patient has hemorrhoids and is in pain from it, and there is an order for PRN hemorrhoid sup...