Pbrown1414

Pbrown1414 has 37 years experience and specializes in Hospice.

Latest Activity

1. What is your time expectation for info, eval, consents and admission?

   Pbrown1414 replied to Pbrown1414's topic in Hospice

   I am not new to Hospice or admissions, having worked on and off for 17 years in hospice and 37 in nursing. I find that I am taking longer than most anyone else with the full admission when eval, info, consents, and admission are needed. I am somewh...

2. What is your time expectation for info, eval, consents and admission?

   Pbrown1414 posted a topic in Hospice

   I have been a nurse for a long time, and 17 years in Hospice. Even in a not for profit Hospice, I have found that the expectations for admissions and "making them fit" is somewhat overwhelming. I am leaving my last job, disappointed that I never f...

3. Hospice Challenges with SNFs/ALFs?

   Pbrown1414 replied to HazelnutCream's topic in Hospice

   1. the facility is paid for basic care and medications, wound care, procedures, tube feeding maintenance, via the room and board payment by the patient or Medicaid/other insurance. that would mean that the hospice nurse would not be responsible in ...

4. Impaction question

   Pbrown1414 replied to feelix's topic in Hospice

   I have never known a hospice to refuse a patient that is on tube feeding. We have an obligation to allow pts and families to direct their own care to the extent that they understand palliative versus curative. In most cases, tube feeding is conside...

5. Impaction question

   Pbrown1414 replied to feelix's topic in Hospice

   of course, if the patient refuses treatment. But would they? Are they able? Do they have a POA that can make that "informed" decision? The nurse does not have the authority to tell the family to stop the feeding. That is a physicians order. Pe...

6. Impaction question

   Pbrown1414 replied to feelix's topic in Hospice

   Oh my God! this is terrible hospice nursing! Comfort first. What is comfortable about constipation and impaction? Has the nurse even checked? Is the patient active? There are only a few reasons not to treat, but at least you check to see if tha...

7. Inpatient Hospice Ethical Dilemma?

   Pbrown1414 replied to CNSnurse's topic in Hospice

   Actually, in some states at least, it is legal as long as the physician discloses his interest prior to referral.

8. Inpatient Hospice Ethical Dilemma?

   Pbrown1414 replied to CNSnurse's topic in Hospice

   Well I don't know how they came to their decision, but it was the right one to make. The doctor should be reported to the AMA, and possibly you should talk to the nursing board about your responsibility as an advocate for the patient and family. At...

9. Day 1: 2016 Nurses Week Caption Contest

   Pbrown1414 replied to allnurses's topic in General Nursing

   Is there anybody in there?

10. I don't thnk these patients are appropriate

    Pbrown1414 replied to Raviepoo's topic in Hospice

    YOu know, getting Hospice paid for was a struggle, surely we can find a way to pay for graduated care within the Hospice framework. It would hopefully include the dme, hha and nurse visit in just a different framework. Many of our Home Health nurse...

11. I don't thnk these patients are appropriate

    Pbrown1414 replied to Raviepoo's topic in Hospice

    Well, as the original comment suggests, we are under the auspices of the medicare conditions of participation, and there are specific guidelines for the diagnosis of Alzheimers dementia. Fast of 7a or lower, and documentable decline, wt loss, non am...

12. David Bowie

    Pbrown1414 replied to ktwlpn's topic in Hospice

    Sirius has a channel devoted just to him. Really good. I too, hope he had hospice. Every one of us deserves to have the support of hospice while they travel down that last road.

13. Hospice nurses charting on facility forms

    Pbrown1414 replied to oomalava2's topic in Hospice

    We are allowed to write orders in facility charts as long as we write them appropriately. This is usually in the contract with the facility. You should have a meeting with the facility DON/Admin, and find out what the rules are for their facility. ...

14. My WORST mistake in hospice...sniff

    Pbrown1414 replied to BerryhappyRN's topic in Hospice

    I am sorry, I did not speak to the issue. I have been known to allow facility nurses to text me or call direct. Sometimes I regret it, but usually not. In a busy world, I need all the help I can get, and so does the facility nurse. Mistakes are m...

15. My WORST mistake in hospice...sniff

    Pbrown1414 replied to BerryhappyRN's topic in Hospice

    I have mixed emotions about texts. I never use a patients name or personally identifiable information, but have sent info to physicians in order to get timely responses. I have used texting back and forth from office during visits, when the info is...