ray2512

This is so typical. Hospice administration wanting to inflict as much emotional damage as possible to employees seeking greener pastures. It is so odd that hospice administrators depend so much on compassionate employees yet so often they are so heartless.

If you don't know how to maintain your boundaries in hospice, you will burn out very quickly. Don't go against your natural inclination just because your a hospice nurse. Maintain your boundaries in every area of your life! Be strong and don't let people take advantage of you. Overcome this tendency to try and please everyone and it will be growth for you. Hospice is a good place to grow! Good Luck

Have you tried gabapentin. 300mg first day, second day bid, third day tid.

You didn't say where the pain was. But if it is in his shoulder its probably brachial plexus. Nuerontin would be the med for that nerve pain. 300 mg tid to start can go up from there.

I have a big problem. I must prove that our clients are not getting adequate care due to understaffing. I need to have my evidence by tomorrow afternoon about 3 pm. Here is the problem. I am having to explain not getting documentation done, quantitively or quality, I'm not sure. And there was a concern report that I was "not responding in a timely manner". We have a inpatient unit that is full most the time with 16 clients and having daily deaths and admissions. We only have 2 nurses staffed in the day time. Please let me know what your staffing is. It is way to busy to meet everyones needs and do perfect documentation too. Everyday there is some sort of crisis going on. Our home care staff have 20-21 clients per RN with four RNs on a team with one (sometimes) LPN helping. Understaffing seems to be an agency wide problem. But the management does not seem to make a connection between the needs of dying clients/families and staffing levels. I don't get my half hour lunch half the time and my breaks are usually cut short or non existent. I have been working there for 6 weeks and have only used the bathroom twice. I work three 12 hour shifts a week. My feet ache for hours when I get home. Please help!!!!!!!!!!!!!!!

Even low doses of decadrone 2-4 mg daily are helpful in increasing appitite. Considering the possible side effects, thats plenty.

Maybe its time to start a National Hospice Nurses Union!

Amen bro

I think the reason most of it is negative is because it's an oppurtunity to vent. In many settings, such as my own even positive feedback is taken as a bad attitude. One in which you can be fired for even if your a great nurse. Oh, by the way, WWIII has already started!

I have had 18-19 client mostly at home for the last several months. I drive an average of 700 miles every two weeks. We have lpns that assist but most of the time they are filled up so I don't get to use them much. I usually do one night of call either for primary or admissions about every two weeks as well. I have been doing hospice for almost 14 years now and still love it, but I think management takes advantage of me because they know how much it means to me. I've wanted to quit a half a dozen times, but manage to keep chugging along. I have seen many many nurses come and go. It really takes about two years for a hospice nurse to put it all together and be proactive. If you make it past the two year point you will probably make it. Learning how to prioritize and keeping a tight schedule are key. Support each other, and tell at least one person a day that their doing a great job and it will come back to you as well. Try not to get down on yourself when things don't go as well as you would like. Your only human, people are dying, thats life and its not always pretty. Keep your shin up, but sometimes you just need a place to go and cry.

I will soon be a team leader soon as they hire a nurse to take my case manager position, which takes a long time since our HR is so slow. I have the feeling that the new team leaders will help design the job some what, but I already know about somethings we will be doing. Timesheet approval, but we have a new software for that. Nursing competencies. Productivity reports and making sure everyone is making enough visits. Teaching new nurses and probably doing some inservices. Attending leadership meetings and what we call Home Care Solutions, which is sort of a think tank to make improvements in customer service. Probably will have to take customer complaints, and complaints from nursing homes and do the resulting teaching and perhaps disciplinary stuff just to name a few. And oh yeh, carry 5 to 7 clients!

I went to hospice as a GN and had no nursing experience at all. Infact sometimes its better if you havent had a lot of curitive experience. Hospice is much different from any other kind of nursing. I have been in hospice now nearly 14 years and still find it interesting and challenging. The only way to get experience for hospice is to do hospice. They dont expect you to know everything about hospice, they will train you anyway, there is a lot to unlearn and relearn.

First of all do you have a inpatient hospice? Secondly do you have an inpatient contract with the hospital? Maybe they just wanted the client to go to an inpatient unit instead of back to assisted living or a nursing home. If your agency has a inpatient contract with the hospital you can just keep the patient on hospice and all you have to do is make daily visits to the hospital. The contract involves receiving inpatient reimbursement from the medicare hospice benifit, then paying the hospital that rate. Another thing is I dont recommend reglan for hospice clients, when there is something preventing GI movement or an obstruction thats what reglan does, reverse peristalsis.

All you really have to do is be quite and smile a lot. That goes a long way. Is that really such a strugle. Give some words of wisdom occasionally, think about what you say before you say it. Don't feel you have to change everything right now. When things fail around you, people will remember what you said and how you said it. Eventually you will win thier ear and respect.

I dont think there are any laid back nursing jobs, but you might consider hospice.