curiousauntie

curiousauntie

LTC, Sub-Acute, Hopsice

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All Content by curiousauntie

  1. On-call hospice nurse

    curiousauntie replied to lwheatley's topic in Hospice, Palliative

    I have been doing the 7 on 7 off for the past year. Prior to that I was a full time case manager for 6 years. The on call "team" is me and the nurse who does the other 7 days, and although I know I...

  2. Pronouncing patients death

    curiousauntie replied to ambrosial's topic in Hospice, Palliative

    Sorry, OFF should be LTC...loving that

  3. Pronouncing patients death

    curiousauntie replied to ambrosial's topic in Hospice, Palliative

    In NJ an RN can pronounce death in long term care facilities or if the patient is at home only if they are on hospice. I'm presently in hospice, but also worked in OFF for many years. We then initiate...

  4. Help!? Any nurses who don't have to talk for their job?

    curiousauntie replied to afox's topic in Nurse Disabilities

    My husband had vocal cord paralys after his 3rd cervical spine fusion (this last one fusing 3 vertabre) due to the prolonged time he was intubated. His was only one cord, so he could still speak,...

  5. Hospice and GIP admissions

    curiousauntie replied to NC29mom's topic in Hospice, Palliative

    But we have gotten multiple "guidance" communications that we should not be using them for billing. We have spent the last couple of months finding a more appropriate diagnosis or working on...

  6. Medicare Diagnosis Changes

    curiousauntie replied to Stella1688's topic in Hospice, Palliative

    The problem with "protein calorie malnutrition" would seem to be that it is also more of a syndrome, or symptom...what is causing it? "Debility" should be allowed to a very small extent. Like an...

  7. What meds to keep

    curiousauntie replied to laderalis's topic in Hospice, Palliative

    I would say to look at the pt, look at the med...what will happen if they stop the med? I take thyroid medication. If my TSH is just slightly elevated, I feel like CRAP. I tell family members that the...

  8. Approximate number of calls during on-call

    curiousauntie replied to alyiana's topic in Hospice, Palliative

    Our census is between 40-50, and at present I am one of 2 "On-Call" nurses. We each work 7 days, Mon evening/overnight to the following Monday morning, esentially covering for the hours the office is...

  9. Pt care- can't get my charting done!!!

    curiousauntie replied to martymoose's topic in Patient, Colleague Relations

    "Do it on your own time" Hummm...very illegal for a company to tell a worker to work for free in the state I live in. And charting is "working for free". Just a

  10. Question about the FAST scale

    curiousauntie replied to amagicalmind's topic in Hospice, Palliative

    I have been taught that the "5-6 words" means just that. 5 or 6 different words. They don't have to make a sentence, don't have to be connected to each other in any way, just able to be understood as...

  11. Gastric cancer and NGT

    curiousauntie replied to tnguy31's topic in Hospice, Palliative

    We just had a young patient, Asian also, with stomach cancer with mets. Admitted to us with the NG tube. No pain, no nausea, and did feel hungry all the time, but if he ate, he DID have nausea. (It...

  12. Foley question

    curiousauntie replied to MomRN0913's topic in Hospice, Palliative

    I also agree with you. For all the reasons you and 4_Sq give. Skin intact and daughter is obviously taking good care of Mom. Your director needs to tell you what makes her think it would make it...

  13. blame the morphine

    curiousauntie replied to pnhopeful's topic in Hospice, Palliative

    I think they believe breathing 50 breaths a minute is just fine and dandy. That is just unbelievable! I run into this in long term care facilities, but not as often as I used to. But when the...

  14. Any Deaf, Hard of hearing Nurses?

    curiousauntie replied to Marvie's topic in Nurse Disabilities

    Hi everyone. I am 51 years old, have been an RN for 27 years, most of it in long term care or sub acute rehab, but the last 6 years in hospice. I have slowly been losing the hearing in my left ear...

  15. LPN Hospice Certification question

    curiousauntie replied to Patton1514's topic in LPN, LVN Corner

    Actually, HPNA does not "require" 2 years, it "suggests" 2 years. I worked in hospice for 4 years (I'm an RN) before I took the exam, and studied HARD for it, and when I finished it, was not sure if...

  16. Computer charting in hospice

    curiousauntie replied to coogabooga's topic in Hospice, Palliative

    twedles, how is Horizon? My company uses Horizon and has been promising to switch from paper documentation for the past 4 years, and now is saying by 2014 (the date CMS says everyone has to be...

  17. No dnr

    curiousauntie replied to aphillipi's topic in Hospice, Palliative

    In NJ the DNR must be signed by the patient or POA and the MD, even hospice patients. If there is no bedside DNR, the healthcare provider in the home must start CPR and call 911. We have quite a few...

  18. Assisted living- what happens when patients need more care?

    curiousauntie replied to lexilou's topic in Hospice, Palliative

    I think it has been said already, but CC is for out of control symptoms. And should end once the symptoms are under control. My company will do CC, but we have to show symptoms that are not...

  19. Inpatient hospice patient on a Med-Surg floor

    curiousauntie replied to IdislikeCODEbrowns's topic in Hospice, Palliative

    jul 23 by hey_suz the night nurse's response seems strange i don't find the response strange. it is one i have heard many times, usually on med/surg floors where we are doing inpatient...

  20. New Grad and New Hospice Nurse

    curiousauntie replied to havnewt's topic in Hospice, Palliative

    I have been in hospice 5 plus years and the best advice I can give you will answer one of your questions. If you are lucky enough to have dedicated on-call nurses, do not keep your work cell phone on...

  21. What does the inside of YOUR car/trunk look like, LOL?!?

    curiousauntie replied to mhowell's topic in Hospice, Palliative

    And how in the world do you do patient visits using the subway? I guess I am so much of a South Jersey Girl/Piney (I am in "really" South Jersey, there isn't even a bus that comes within 15 miles of...

  22. What does the inside of YOUR car/trunk look like, LOL?!?

    curiousauntie replied to mhowell's topic in Hospice, Palliative

    I don't carry supplies. It is too easy to think I have something I need...then I look for it and I don't. My front passenger seat has a file case for my travel charts (hipaa compliance!) And my...

  23. Glucose control in hospice

    curiousauntie replied to coogabooga's topic in Hospice, Palliative

    If the patient is new to hospice, and they or the family feel it is necessary to check glucose, I go with some gentle teaching...5 times a day is a bit excessive, maybe cut to 2 times, a fasting and...

  24. Newbie hospice nurse, newbie agency

    curiousauntie replied to Stella1688's topic in Hospice, Palliative

    Hpna suggests 2 years of case management prior to taking the exam. It is VERY difficult, and that was with 4.5 solid years of hospice experience. You are "allowed" to take ot any time you want, but at...

  25. What is your typical response?

    curiousauntie replied to Vtachy1's topic in Hospice, Palliative

    I like your htn analogy. It might be the thing that works! (And on a side note, loving the allnurses android app. This is my first post from my