spoiled28

Looking for information on computerized charting. We currently use Allscripts and have for years, but management feels there are better programs out for to help increase productivity. Our nurses have currently been paper charting in home and then come back to the office and chart. Trying to get them use to do curbside charting. So any thoughts on that would be helpful too. Anyone have any thoughts and programs that they like and ones to stay away from. We do home health and hospice. Thank you in advance.

She is taking Roxanol 2-3 times, it seems to happen more when she trying to do any ADLS. HHA visit daily, and her family assist her but there are still somethings she tries to do herself, simply putting on her shoes. Its the basic things she says she has always taken for granted. Only reason I mentioned Lortab is that is something she is not willing to change, she knows it works and we will continue with it. I am not for changing things that work. Prior to her hospice admission She did have 1 small open area along her incision, that had a very strong odor, that the oncologist was treating with aquacel ag covered with characol dressing. At this time there is no open areas or dressing. Wasn't sure if anyone had any other ideas regading her pain, or continue with the roxanol. Because her arm seems to be the only main complaint of pain at this time. Hip/rib pain resolved. Or ideas for her edema - the swelling seems to be more of a bother to the patient. thanks for listen and apprecaite any new ideas

Duragesic 50mcg, lortab 10mg at HS (which she will not give up), Ibu 600mg BID, roxanol prn, cymbalta, and her daily b/p meds. We did think about the lidoderm patch, but her oncologist warned us about the potential compliacations because of skin being so fragile, and potential issues if her skin breakdowns such as issues with flies/magets.. The family is aware of the possibility and does nto want anything on her skin except a spray this includes creams or lotions that would have to be rub in..

Patient that had breast cancer, that had already spread to bone prior to her seeing the Dr., so surgeon did a simple mastectomy 4/09. Now she is on Hospice and having tremendous pain in her arm related to massive swelling. We have tried a light tubigrip compression the largest size F is to tight. Also have tried ace wrap but she didn't tolerate it and unwrap it. This is the only site she reports having pain is in her arm. Have tried a local lidocaine spray, with little luck. Any other ideas. We also have to be very careful because along her incision and all over her arm and uper chest she has skin mets. Please help

New hospice pateint that was dx with imflamatory breast cancer and now has skin metastsis. Skin mets along her mastectomy incision line and now they are growing at a very rapid rate on her arm, and chest. She has no open areas currently but in the past has had an open area and had problems with flies. The flies seem to surround her, and this is distrubing to the patient and her family. Her arm from her mastectomy side is very swollen and painful. Pain is now under control with motrin, and duragesic patches. But I'm looking for help or ideas on what to do for her skin, especially if she develops another open lesion. Does anyone have any ideas?

Please help! I've been a hospice nurse for 6 yrs and this is my first ALS pt with uncontrolled pain. We have tried morphine (Roxanol 15-20mg Q 1 hour) at times and finally was able to get ahead of his pain. Refuses to go in for inpatient IV therapy pain management or to have IV pain meds at home. We have tried ativan along with pain meds and also have him on duragesic patches 100 mcg. Any ideas to go along with current therapy, would be appreciated.:redbeathe

Does anyone know of a ICD 9 coding class for home health coming up? Our biller/coder quit and now my boss is wanting one of us Rn to take the class and become the company coder. PLEASE HELP:idea:

A friend of a friend told me about this small travel company named AUREUS MEDICAL GROUP has anyone else had any good or bad experiences with them??? Getting ready to start traveling in Aug. :wink2:

Thanks guys its always good to get some new ideas. We use a topical compound of haldol, decadron, ativan and reglan, it most genreally works great for our patients, just not this time. The family is dtermined to keep her at home, she has not been able to keep any food down for over 1 week and now she's afraid to drink. But thanks for all the great ideas

I have been doing Hospice care for about 5 years now. I recently had a patient with CA of the gallbladder and had uncontrolled n/v. We tried topical compounds, PO meds (Phenegran, reglan and finally switched to Zofran) with still very little relief from the vomting. We also tried Scaplomine transderm scope patches. Any body with any other ideas??? She refuses anything rectally and refuses any injections or IV or line placement.... For anyone new getting started in Hospice it has been one of the toughest and yet MOST REWARDING decisions I ever made.

I am also looking to start travel nursing in Aug 06. All the information is helpful but so confusing. I have sent in two appliation with two companys, one says they pay is top but then I wonder from some of the reading about their benifits. thanks for asking.....

A friend that I was visiting with about travel nursing recommended it!!!