curiousauntie

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 or 4 times, but coming from LTC, they were a cake ...

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 it!

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 administrator and DPS (director of professional servi...

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 mds is just now due and how you plan to address h...

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 sentence. I worked in LTC for 22 years befor moving to ...

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. And with no way to speak to a family member or MD, ...

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 on-call (me;)) will do it in the evening or weekend. I ...

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 actively dying. I think both modalities are wonderfu...

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 that as the facilities say we are not their employee ...

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 post.O:-)

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, ativan. haldol and compazine are frequently needed when ...

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 SQ.

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 was a case manager. But as on-call, my mileage star...

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 of the testing periods (there are 4 "test windows"...

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 Sat-Sun. The other dedicated on-call nurse works the n...

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 a list in the nursing office for the case manager...

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 the prn dose on top of the basal rate then is "locke...

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 it!

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 the test and all kinds of other info. One of the s...

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 sections for each med we are using for the family to wr...

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 you to finally break through. Write as much of a...

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 the patient will just fall asleep and never wake up...

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. Granted, if I had had more health history and MD notes,...

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 evening. It helped with the pain, did not get absorbe...

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 other duties is unbelievable. And to add that type...