mom4josh

You can find that information on Epic's website. I think it's also in their training companions.

"If I only had a brain..."

I'm hoping you don't have children. Oh, and you have to wipe not only the butts with poop, but the poop you have to wipe off of YOURSELF when the patient throws it at you or explodes on your leg!

This has been a huge deal for our facility lately. It has come down the pike numerous times something to the effect of "Thou shalt not weareth thy scrubs outsideth the worketh facility-eth." I'd bet that most facilities have such rules, but just not enforced. I, personally, chooseth to keepeth my jobeth!

Yay! I got a position with my hospital as an Application Coordinator! I will be learning EPIC (which means going to Wisconsin in the dead of winter) and will begin an 18 month journey to get our hospital up and running. So excited! Any tips or advice from anyone who has taken this path would be greatly appreciated.

I just got off the phone and made up a new one! SAD: Stupid A$$ Doctors! Grrr... Tell me again why THEY get paid the big bucks?

Thanks everyone for your responses. I guess I was having a bad day... :uhoh21:

Grrr... so frustrated! I work with a social worker, and part of our job is to do initial consultations with potential hospice patients. I was checking some charting yesterday on a patient when we did a visit together, and I found a note in the computer from our social worker... exact wording as my note. It's so blatantly not hers, because she does not use capitalization or correct punctuation (and I do), and I almost always write pretty much the same blurb unless there is a problem or something out of the ordinary. It's just a short three-line note. But I am furious! It's the principle of it. I need advice. Should I confront her? Should I let it go? Anyone have anything like this happen? Thanks for the suggestions.

I am a very strong advocate for telling the entire family the truth. My own mother died when I was 22, and I had no idea it was serious enough to take her life. Nobody else seemed surprised, especially her physician. Sucked.

We have had similar situations in our hospital. These patients sometimes seem "forgotten" by nursing staff. "Oh, they're hospice," has been overheard more than a few times, like they somehow don't deserve the same caring attention if not more than other patients. Just yesterday I had to write up a nurse for leaving a heparin gtt running for 15+ hours after they went on hospice (meaning they had a new case number without the heparin on their profile), without PTTs having been drawn for >48 hours. Then, today, same patient, I found out that a "now" order wasn't given until four hours later (and it was charted "audible congestion" - wouldn't have happened if the med was given on time and at frequency of order). You wonder sometimes how some nurses keep their license for so long. Sorry this happened to your patient. Please make sure that management is made aware of this.

I can relate. Deep breath... Hope you don't have to work tonight. Sounds like you could use a night or two off. Hang in there. Just think of it as ignorance. But, you definitely need to let management know about meeting times. There should be at least one opportunity either right before or after work to attend these.

Our policy simply states, "Hair must be worn in a way that prevents contamination and does not present a safety hazard." Seems rather non-specific to me. But I've noticed that this organization is quite lenient on some of their policies, yet very strict on others. There are some nursing staff who wear artificial nails, other office staff who wear thong-type shoes. I know it takes a lot to enforce, but if they stuck to the policies all the time it would not be an issue. Getting off my soapbox now...

I understand that they must be given a choice. My concerns are when the case managers recommend another hospice or when another hospice solicits within the hospital. Sorry if I didn't make that clear.

Hi! I have been an RN for almost 10 years, having received my ADN (three years) at Northwestern State University of Louisiana in 2001. I worked med/surg, then oncology for nine years, and have been in my current position since March of this year. After working oncology, I knew that I wanted to work in hospice but didn't want all the driving from house to house. This is as close to my dream job as I will ever get! The hours are great (M-F 8-5), it's close to home, and I get all my exercise in walking around the hospital all day! It's very fulfilling for the most part, as we become very close with some of the families whose loved-ones are on hospice here in the hospital. We also do consults and get people set up for home hospice. All in all a great job! Hope you find yours, too!

In your hospital, do they allow another hospice to come to visit patients to solicit hospice? We have hospice services at our facility, and we we do in-patient, home, and nursing home hospice. Sometimes, however, when the docs order a hospice consult, the case managers call a referral to an outside hospice, rather than refer in-house. This doesn't seem like it should be allowed, as it is taking business away from us. Any advice or recommendations would be greatly appreciated!

I am a hospice clinical nurse specialist in the hospital M-F 8-5. I admit patients to hospice in the hospital, and do education visits for patients who want to go home or to a nursing home with hospice. We make rounds on each in-patient every day, do death pronouncements/visits, and follow each patient as needed to adjust meds.

I have been an interviewer in one of these peer interviews, sometimes individually and sometimes in a group. They are very helpful in getting a better sense of how the person interacts with those with whom they may be working. Most of the time, the person being interviewed seems more relaxed and might reveal something that the manager does not pick up on. However, it also gives you a chance to see if you like them, and they may let you know something about the boss which may affect your decision. As stated by the previous poster, it works both ways! In general, I think it's a good idea.

ARE YOU KIDDING ME???

I also have a patient like this. She has been anuric for three weeks, unresponsive with respirations about 5-6/minute with morphine 15 mg/hr. I told her family to tell her it was okay for her to go. They did... but she's still here! I don't know what to tell them either!

I live in Central Texas (between Dallas and Austin). We get .51/mile plus $60 phone reimbursement. Oh, and gas is ~ $3.60 right now.

I don't know what a revisit nurse it. We are paid $0.51 per mile.

I am a hospice nurse and I admit patients to the hospital for end of life care. The reason I did not want to be a case manager was due to all of the driving (because it's incredibly hot in Texas and I hate it!). I'm pretty sure though that our case managers have to rotate taking call and can work some pretty long days. Some of our nurses have 15 or more patients. What they told me when I started was that orientation was as long as I needed it to be (within reason, of course). That turned out to be a month. I think the best questions you need to ask during your interview are: maximum number of patients you can have, how much call, is there mandatory overtime, how much orientation, is there an acuity scale for the patients (and are you given patients accordingly). I know I wouldn't do that for anything, just because I love staying at the hospital. Wishing you much success! PM me if you have more questions.

Don't feel bad. I suck sometimes, too. And I've been at this a while. But when I don't get a lot of practice, I get sucky again. I don't start them often on night shift, especially when I work in rehab (patients don't usually have IVs there) or NICU (I only float there occasionally, so haven't been checked off on babies). Hang in there. Some of us are better at other skills than others. I can put a foley in a 400 lb. woman no problem. I'll bet you have some skills your co-workers can't boast of, too!

A seasoned nurse taught me this trick: pull the blankets up from the feet so the patient doesn't get cold by being completely uncovered. Take a warm, soapy wash cloth and clean the area thoroughly, trying to visualize where you're headed. Then, wash your hands start the procedure. Amazing how much this has helped me.

All of our rooms are private. Since I work 7p-7a, I usually leave the door closed just before latching. This way, when I make rounds, I don't wake anyone when opening the door. However, if the patient is confused, elderly, or a high fall risk, the door stays open, at least half-way. BTW, this is just my own personal policy. Our hospital doesn't have a policy on this subject.