LVNs in hospice

mc3, ASN, RN · Jun 9, 2007

Hello, I'm an LPN who has worked in hospice for almost 4 years. I work with an RN Case Manager. We split the case load 50/50 and alternate weeks, so each pt has an RN visit x1 every 2 weeks - the hospice I worked for in another state didn't officially have RN Supervisory visits, but the RN usually saw ea pt about once every 4-6 weeks. The only difference in paperwork is that she co-signs my monthly summary sheets that are sent to pt MD's. I do recerts, care plans, final care plans, and all other paperwork that she does. Here in FL, LPN's can pronounce if they work for hospice. I have central line training, do blood draws, etc. Am also certified by HPNA. Hope that helps!

mc3, ASN, RN · Jun 9, 2007

Oh, and our case load is 26 patients right now, plus 15 extras we see once a month or so (free service from our hospice).......

mc3

aimeee, BSN, RN · Jun 9, 2007

We utilize our LPN's mostly in our nursing home practice. They act under the direction of an RN Case Manager. The RN visits once every 2 weeks for an assessment of the patient and to check the chart etc. The LPN does the other needed visits and calls to collaborate with the RN every time there is a change to the care plan. In our state the LPN's cannot pronounce. We also utlize LPN's for Continuous Care coverage.

EmptytheBoat · Jun 9, 2007

Hello River,

Here in Louisiana, LPN's are used as mc3 describes in Florida,

LPN partnered with RN to manage a case load. I've mostly

worked with a part-time LPN, or a shared LPN (with other RN

case managers) and has worked very well. I've not worked with

a LPN who did recerts, IDT reviews, or updated care plans, but

would welcome. Some of the Hospices I've worked with have used

LPN's on-call and has worked well. LPN's may pronounce death in

Louisiana. Take care.

river1951 · Jun 11, 2007

Thanks to you all for your helpful replies.

river

curiousauntie · Jun 15, 2007

I am in New Jersey. We are a small office, 2 full-time case managers and 2 part-time. We have 2 LPNs. The RNs carry 14-16 patients each (full-time) and 8-10 for the part-timers. The LPNs carry around 20 each, but usually only see each patient one time a week. At least half of my case load is seen at least 2 times a week. We also use the LPNs to suppliment the CHHA load, as we always need more help there. (The area where I am is near the shore, so there are always decent paying jobs that do not include pee and poo and blood.) We make sure to schedule the LPNs between our visits so that if they get a total of 3 visits a week, they are spaced out to check them out on Monday and to tuck them in on Friday. I don't know how we could function without them...

ShayRN · Jun 18, 2007

Our home care team uses LPN's much the same way as already stated and also suppliments the bath team when needed. At our inpatient facility we use them on nights and they pretty much have their own assignment. Since our patients only require a head to toe assessment QD, the LPN's take their own patients.

Hospice Nurse LPN, BSN, RN · Jun 19, 2007

We also use the LPNs to suppliment the CHHA load, as we always need more help there.

What about the pay? Are the LPN's paid their regular wage or at the CHHA wage?

mc3, ASN, RN · Jun 24, 2007

You use the LPN's to supplement the HHA's? Is that really a good use of resources?? No offense, but if my agency asked me to supplement the HHA's I would politely refuse..I have too much work of my own I should be doing. If it's slow, I'll help out another nurse...

ShayRN · Jun 25, 2007

Why? I have no problem helping out where needed. I give baths, clean beds filled with BM and change linens, PRN. In hospice it is about the patient, not the nurse.

mc3, ASN, RN · Jun 25, 2007

Yes - of course - that goes without saying. My point is that if I have extra time (after everything has been done that I can do - including helping the CNA - I offer my assistance to another nurse.

I've been doing this for many, many years - I don't need a lecture on what a hospice nurse does!