Please tell me about continuous care lvn/lpn duties

Werblessed · Oct 21, 2009

Continuous Care is where the hospice attempts to staff nursing care for ATC care when a patient is having an issue or issues that are not well managed and require a high-level of assessment and care by professional staff. Many times these are patients who elect not to be transferred to the inpatient hospice unit (if your hospice has one) for this high level of care but wish to remain at home or ALR. A R.N. must be the one to set up the initial plan of care to include all medications, interventions and teaching expectations for all other nurses to follow and document about how the patient is responding (or not responding) to what we have put into place to 'fix' the problem. The one big snaffu in this system is when we have LPNs staffed who are not able to provide IV or SQ line care or boluses so I would suggest asking about these situations and the expectation from you when/if you are assigned as a Continuous Care nurse for a patient with IV/SC medications running.

CC is one-to-one care but it can be intensive. If your patient is not responding to the interventions that were put into place by the RN, it is your responsibility to call the hospice 24/7 to report this so a RN can be dispatched to tweak the plan of care accordingly. You'll also be teaching the family/cgs in the home how to continue the care for the patient so that when CC ends (the symptoms well managed or we are unable to staff ATC) the CGs are competent to provide the care themselves. This includes bedbound care, peri-care, administration of medications, etc and is a vital function of CC nurses at the home.

Hope that helps and thank you for the care you will be providing to both patients and families in hospice care.

2busyb · Oct 21, 2009

With CC, you are called in for either caregiver support (due to sx out of control and cg are exhausted) or sx managment. Terminal agitation, pain out of control ect. It is best if you are IV certified as Hospice dose use CADD pumps SQ. Majority of the time meds are rectal, po/sl, topical. Assessments are done hourly charting VS, bed baths if pt febrile.. any nursing measures that will provide comfort for the pt.But always make sure your DR is available for any order changes (sometimes in the home you do what you gotta do ) it is not in the LVN scope to perscribes/alter meds without MD. I like it, you really do use your nursing skills both with the patient and helping with the family.

~MIA~, ASN, RN · Oct 21, 2009

Thank you so much for your replies! I got the job! I really appreciate your input/insight on CC.

I am looking forward to Hospice Nursing.

nursepammiej · Oct 26, 2009

Congrats! I have been doing crisis (continuous) care for 15 months and love it...keep us posted on how you are doing?

anolen · Mar 19, 2010

Congrats on your job. I hold the same position in Georgia and I love it.

tewdles, RN · Mar 20, 2010

congratulations!