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When we compare oxycodone and roxanol we generally see the same symptom relief from one to another. I do not think having morphine instead of oxycodone would have made her more comfortable, but she...

I think there is a big difference between being a daughter and being a nurse. I think that most of what you were doing is what we often see family members doing- helping to bathe their loved ones,...

Our company uses several nurses with minimal hospice/homecare experience to do our intake. These nurses get orders, build the charts in the computer and coordiante care with md offices and insurance...

We have a conflict of interest policy that does not allow employees to work in the same function for a different company.

I believe your hospice experience can be variable depending on the acuity of clients a hospice takes, the diagnoses, and the nurse. Hospice is generally not a field heavy in 'nursing tasks' such as...

Apply for all those jobs that say 1-2 years, and apply at assisted livings and nursing homes. You really need that solid 1-2 years of acute care or SNF experience when working hospice because of the...

Well, my thought is that they are not hiring obese nurses and they are not hiring nurses who smoke. Where do we the draw the line on high risk behavior? Should we still hire nurses who drink...

i am paid per visit, about $43 per visit credit (this is expected to cover about 75 minutes of time). I make very good money compared to the nurses that work in local hospitals, where the hourly...

I would take a month and feel out your coworkers. Find someone who you feel you can talk to, and bring it up. I work in a state with what I would describe as a 'stifling' religious culture, of...

Been there, done that. Shame on the hospice companies for continuing to allow this abuse of the system. It is actually fairly common in the hospice I work for to d/c pts. The primary reason is all...

I am surprised they are requiring prior hospice experience. We actually prefer someone that has really solid base nursing experience, but no or little hospice experience so we can teach them our...

Okay, so I hope I can give you some reasons as to WHY we see a lot of what we do. Dyspnea: you will find very quickly that people with dyspnea handle morphine and ativan together very well. In...

I think that this would depend on a few issues. One of them being is there one certifying agency that all insurances in your area recognize (I honestly do not know if this matters, but just a...

What is your productivity? I went to the conference in San Diego and I was very surprised at how low productivity was for many hospices, compared to what I am often doing. I do not necessarily feel...

Although this pt appears to be entering his dying process, the ostomy over the wound seems to have promoted some healing- I think it has just kept the wound the right moisture without being packed...

So my gentleman with the liver failure with the giant hip wound has some new things going on. The wound is getting worse daily. In addition to getting bigger, the drainage continues to increase,...

It depends on if someone is using narcotics. If someone is on narcotics we usually start with Senna-S, 1-4 tabs daily. If that does not work we will usually use lactulose. If someone is not on...

The best in a long time: Had a pt hit the call light. When the nurse (I work hospice and was just standing in the hall) went in to ask what she wanted the pt responded: "You better keep your voice...

Wounds related to terminal diagnosis: 1. Any wound related to cancer 2. Pressure sores in a debility pt 3. Surgical wounds related to primary diagnosis (so a wound from paracentesis in a liver...

I am feeling like the best bet may be to just turn over the wound care to the facility, and help with dressing changes to relieve their burden and so I can do my wound assessment. In my experience,...

Hello everyone! I love wound care, but am in the midst of a puzzle. I admitted a 50-something year old man with liver failure. Hx of etoh and Hep C. So he has a dehiscence post I&D of his right...

We use aspira drains. They can be placed anywhere fluid needs to be drained, so we occasionally see chest tubes, but usually we see them for ascites drainage. They have this nifty port that you...

Go and work on a medical or step-down floor. You will get to take care of lots of people who are dying, while improving your skills. This job would be terribly intimidating if I had not had a solid...

A few hints on informational visits. I talk slower and in a lower voice than normal- this seems to be less intimidating. I also allow 30 minutes of my visit for them to tell me what is going on. ...

I am not sure what kind of wound you are looking at, but I do hospice and we have a wound care nurse we consult with and then we do the dressings, even though I don't have detailed wound care...