curiousauntie

curiousauntie

LTC, Sub-Acute, Hopsice

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All Content by curiousauntie

  1. New to hospice

    curiousauntie replied to MomRN0913's topic in Hospice, Palliative

    Strong assessment skills are a good base, but the difference is WHAT you do with the assessment. In ICU you treat, treat, treat to look for a cure, or at least to improve to the point of transferring...

  2. AFTT and what your hospice covers

    curiousauntie replied to AtlantaRN's topic in Hospice, Palliative

    I am assuming that the med you are talking about is Questran. I have had patients who used it for diarrhea with good results. It gels the stool and really helps. If the patient has c. diff, it...

  3. On Call rate

    curiousauntie replied to jyhn's topic in Hospice, Palliative

    If we do a whole shift of on-call (5pm to 8:30am) Mon to Fri, we get $50, plus paid for any calls out, door to door and mileage door to door. If you work the whole 40 hour week, any time out would be...

  4. Foley Care in Hospice

    curiousauntie replied to AZHospice's topic in Hospice, Palliative

    Back in the day when I worked LTC, we also would change monthly. But in hospice, we look at the catheter, if there are any problems (leaking, pain, need for flushes, increasing signs of mucous in the...

  5. Im Pagan and a Hospice Nurse....

    curiousauntie replied to SaylahStarr's topic in Hospice, Palliative

    Might be the best solution! I worked with a nurse who was what I call a "HippaChristian". Her husband was a minister and she was all about her faith...because only her faith counted. When she was...

  6. Aggressive treatment?

    curiousauntie replied to Meliss214's topic in Hospice, Palliative

    Is the patient on hospice? If so, call the hospice nurse. I am sure she will echo what Ashley said. The DON is not the person who should be making the call about treatment...unless she also is the...

  7. Certification Exam

    curiousauntie replied to OCNRN63's topic in Hospice, Palliative

    If you look in the HPNA site there is a "handbook" for the cert exam. It gives the percentage breakdown of the areas of the exam. Since each exam is different (I believe it is randomly generated as...

  8. Productivity in Hospice?

    curiousauntie replied to JuiceRN's topic in Hospice, Palliative

    Our productivity is based on the percentage of time with patients vs. time in the office or traveling. We have to have 50% face to face patient time. This is usually doable if you have 4 to 5 visits...

  9. Certification Exam

    curiousauntie replied to OCNRN63's topic in Hospice, Palliative

    I took the test in June after 4.5 years of hospice experience. I found the test HARD. Since it is recommended that you have at least 2 years hospice experience before you take th test, there are no...

  10. Good or Bad Luck with Hospice Pharmacia?

    curiousauntie replied to Vtachy1's topic in Hospice, Palliative

    I usually have great success with HP. Every once in a while I will have someone who just doesn't get what I am asking, and will be talking about oranges while I am talking about apples (or even...

  11. Wound care puzzle

    curiousauntie replied to ErinS's topic in Hospice, Palliative

    Wounds like this may be best treated with a wound vac. Although it will be expensive and I am sure the facility will expect hospice to pay for it, it may be more cost effective in a way in that you...

  12. Clamped Chest Tubes

    curiousauntie replied to tplazio's topic in Hospice, Palliative

    I've dealt with patients with tubes that are attached to a vacuum bottle ( it looks like a bowling pin) that are used for malignant pleural effusions and acities. My patient needed draining every...

  13. Apparently visiting hospice nurses have to visit even in the ice storms LOL

    curiousauntie replied to Vtachy1's topic in Hospice, Palliative

    Snow? No problem unless it is deeper than my truck's clearance! I actually love to drive in snow. Well, let me qualify that. I love to drive in the snow during the day. Not at night so much. I...

  14. On-call staffing solutions for a growing hospice

    curiousauntie replied to nyx1121's topic in Hospice, Palliative

    As a case manager who has had 2 on-call (7 on, 7 off) nurses for the past 2 years (one nurse each week) and for the 3 years before that only one nurse on call (same 7 on, 7 off) so I had to do 2 or 3...

  15. Thought-provoking article on "hospice abuse"

    curiousauntie replied to heron's topic in Hospice, Palliative

    No, we don't pick and chose patients with less complex diagnoses. If anything, we tend to jump fast as there are many competing hospices in our area. If we aren't the first ones there, the patient...

  16. Reporting med errors...

    curiousauntie replied to Time4dilaudidyet's topic in Patient Medications

    Wow. I have never heard of a nurse being fired for a med error unless they had been written up for errors in the past. Fired for one error? That would make me think about 20 times about reporting...

  17. ICWP and Hospice at the same time????

    curiousauntie replied to AtlantaRN's topic in Hospice, Palliative

    Yes, I have had patients in hospice who had what we here in Jersey call "waver programs". They are Medicaid programs that the patient who has a little too much income or property for Medicaid, but...

  18. Safety issues with TR patients

    curiousauntie replied to stargatewtchr's topic in Hospice, Palliative

    And I guess I will also answer your question We cannot take care of the patient if we are injured, so I would say that we need to protect ourselves...and in an agitation situation, the more you can...

  19. Safety issues with TR patients

    curiousauntie replied to stargatewtchr's topic in Hospice, Palliative

    Sorry for your awful night. You didn't say if you work in a facility or in home settings, but either way, terminal agitation should be treated as an emergency situation. It may take a few hours to get...

  20. Nursing bag for hospice RN?

    curiousauntie replied to crossingfingers10's topic in Hospice, Palliative

    I don't know about other people, but don't ever come to my house and put news paper on my couch to put your bag down! especially if it is a rainy day..... We are supposed to use news paper as well, i...

  21. Thought-provoking article on "hospice abuse"

    curiousauntie replied to heron's topic in Hospice, Palliative

    Please, let's not start that "not-for-profit=goodness and light, and for-profit=the dark side" argument again. We all must abide by the regulations of Medicare, neither side gets a pass on...

  22. Nursing bag for hospice RN?

    curiousauntie replied to crossingfingers10's topic in Hospice, Palliative

    Forgot to add... I wish I could have a wheeled case, but my company does not want the home care nurses to use one. I am not sure why, but I am sure part of it is infection

  23. Nursing bag for hospice RN?

    curiousauntie replied to crossingfingers10's topic in Hospice, Palliative

    I carry a bag that is provided by my company. It is about the size of a messenger bag with multiple zippered compartments, but no flap. The biggest compartment holds my clipboard (a lightweight one!...

  24. Lasix use in CHF?

    curiousauntie replied to gorgenurse's topic in Hospice, Palliative

    PsychNurseWannaBe, Hospice should never be "just a payor source". First of all, the hospice nurse is, or rather, should be well trained in end of life care, both for the patient and the family. As...

  25. Lasix use in CHF?

    curiousauntie replied to gorgenurse's topic in Hospice, Palliative

    Georgenurse Don't think of lasix as "treatment". Think of it as a "comfort measure". If your patient is having crackles, then there is a good chance breathing difficulties are not far behind. Having...