curiousauntie

curiousauntie

LTC, Sub-Acute, Hopsice

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All Content by curiousauntie

  1. DOH survey frequency

    curiousauntie replied to rubysasha's topic in Hospice, Palliative

    I worked at my last hospice job for 7 1/2 years. During that time we were surveyed...not once! Honestly, we did not have one Medicare audit or one visit from the state DOH! We did have CHAP audits, 3...

  2. Dealing with calls from work

    curiousauntie replied to Katniss88's topic in General Nursing

    From a sign my sister has over her desk..."Poor planning on managements part does not constitute an emergency on my part". Read it, learn it, live

  3. Heartland Hospice

    curiousauntie replied to rubysasha's topic in Hospice, Palliative

    I work for Heartland Hospice. It is owned by HCManorCare, who has LTC, Subacute rehab, AL, Home Care and Hospice and even out patient Pt/OT offices. How good the office is depends on how good your...

  4. Written warning for a care plan written prior to my employment

    curiousauntie replied to LTCNS's topic in Geriatric, LTC

    There's no reasoning except they needed a scapegoat to show they addressed the problem. You need to write a statement that can be attached to the write up stating your 3 weeks of employment, that the...

  5. Where are all the nurses?

    curiousauntie replied to CapeCodMermaid's topic in Geriatric, LTC

    The local hospital will be laying off another round of nurses in June....I am hopeful, although I don't think hospital nurses could handle the patient load on a sub acute floor! I like that last...

  6. DNH order, LTC???

    curiousauntie replied to mmcelhi2's topic in Geriatric, LTC

    Very simply, if he was not to be sent to the hospital, he should have had a DNH order. In the middle of an emergency you don't have time to read POLST forms. That's why we have DNR, DNH, DNI orders....

  7. Start of Care/Admission Process Ideas

    curiousauntie replied to tbroz1229's topic in Hospice, Palliative

    Our goal is to have the nurse there within 4 hours of receiving a referral/md order. No admission nurse, but if possible the case manager who will have the patient will do the admission, or the...

  8. Massage and Music therapies

    curiousauntie replied to NC29mom's topic in Hospice, Palliative

    We have 2 massage therapist who do wonderful work. I know of one other office who has an on-call music therapist and our office has a vigil volunteer who provides music therapy once the patient is...

  9. When do you get Narc orders?

    curiousauntie replied to casi's topic in Hospice, Palliative

    We cannot order meds in a facility. We can leave "Suggestions for care from Hospice nurse" with what we would use, but cannot call the MD and actually get the order. The facility nurses have to do...

  10. Too Much Suffering

    curiousauntie replied to GundeRN's topic in Hospice, Palliative

    I'm hoping you mean that NOT having a DNR for an Alzheimer's pt is immoral...I get that feeling from the rest of your

  11. Teaching material for Care Kits?

    curiousauntie replied to joyprn's topic in Hospice, Palliative

    tammyG. That's a scary thought. I can't count the number of times that care kit was a difference between an easy and a horrible death. As a full time on-call nurse, the meds in there; morphine,...

  12. Should we teach unlicensed caregiver . . . . .

    curiousauntie replied to Spidey's mom's topic in Hospice, Palliative

    What about liquid haldol? We have it in our comfort kits and it works wonderfully. 2mg/ml. We usually start with 0.5ml/1mg. I personally wouldn't want to try to stick a combative, agitated pt. IM or...

  13. On Call

    curiousauntie replied to heartnurse2012's topic in Hospice, Palliative

    I'm 40 hours a week, salaried, and with 7 years seniority, at $33/hr. But I lost OT when I changed to on-call, so actually lost pay each week as I always had between 3-6 hours of OT each week when I...

  14. Hospice/Palliative care nursing certification

    curiousauntie replied to Melnee's topic in Hospice, Palliative

    The tests are varied, with (I think) questions from 5 different aspects if hospice. I do remember ethics, medications, legal aspects, disease process...the test hand book breaks it down. And for each...

  15. On Call

    curiousauntie replied to heartnurse2012's topic in Hospice, Palliative

    Our company has 2 dedicated on-call nurses. For the past year, I have been one of them. I work 7 days, Mon evening to the following Mon morning, covering the hours the office is closed, including...

  16. Prn nurses

    curiousauntie replied to Mommy&RN's topic in Hospice, Palliative

    Isn't there someone in the office, either the DON or a team leader who can have a list made up prior to your day to work? We have 2 prn nurses in our (small) office and one of the case managers keeps...

  17. How much is too much morphine?

    curiousauntie replied to Neomikeyboy's topic in Hospice, Palliative

    The PCA pumps that we use have a basal rate and a prn amount (the "button"). We teach the patient and family when the button is needed to use it. It can be pushed only so often (q __ minutes) for...

  18. When to turn in nursing notes

    curiousauntie replied to crscott08's topic in Hospice, Palliative

    Our office wants timesheets turned in within 48 hours and our notes must be with the timesheet. We also are NOT e-charting. All paper, all the time, and I have the carpel tunnel to prove

  19. Hospice/Palliative care nursing certification

    curiousauntie replied to Melnee's topic in Hospice, Palliative

    Go to the Hospice and Palliative Care Nurses Assoc. website. There you will find the links to becoming a member, the store where you can buy the Core Curriculum and the Study Guide, the handbook for...

  20. Teaching material for Care Kits?

    curiousauntie replied to joyprn's topic in Hospice, Palliative

    We do basic teaching when the comfort kit is placed in the home, with the first instruction to not open it unless the nurse tells them to. Once we need to open it, I do a note book, with marked...

  21. Case Managing a patient who doesn't want you.

    curiousauntie replied to sharmankes's topic in Hospice, Palliative

    SuesquatchRN, Just what I would do. I have found that sometimes just doing a "just the facts,ma'am" visit for a few times, never overstepping HIS boundries, may lead him to trust you a bit and allow...

  22. Medicare Diagnosis Changes

    curiousauntie replied to Stella1688's topic in Hospice, Palliative

    Symptom management at end of life? Emotional support, education and assistance to the family members who are caring for the patient? Just because there is no real clear cut "diagnosis" does not mean...

  23. Medicare Diagnosis Changes

    curiousauntie replied to Stella1688's topic in Hospice, Palliative

    I too agreed with getting rid of debility...until this weekend when I did an evaluation on a man who would have fit debility perfectly but had no other documented diagnosis to meet eligibility....

  24. squamous cell carcinoma wound pain

    curiousauntie replied to NC29mom's topic in Hospice, Palliative

    I had a patient a few years ago with a very painful wound. We used a morphine get that was placed on the wound bed then the wound was packed. We did it once a day and the caregiver did it in the...

  25. Hospice nurses required to take marketing territory?

    curiousauntie replied to jlynn2303's topic in Hospice, Palliative

    What in the world does your marketer do if not market to facilities and doctors? That is the main job description for our marketers. To ask the full time case managers to do this on top of all your...