pnhopeful

Thanks and congrats! I did pass. I would say reading the HPNA core curriculum and study guide along with the practice test were all very relevant.

Hi all! I will be taking the RN cert Tues. I have been getting all the practice questions correct in the HPNA study guide for the hospice generalist and palliative nurse but didn't do so hot on the practice test purchased from HPNA website. I have studied up on the subjects I didn't do well in on the practice test. Is knowing the study guide questions enough to pass? I am also skimming the core curriculum.

Hi! I am curious what your dress code is and what kind of facility it is you work in. I am specifically curious if the central Ohio hospitals allow small nose studs for nurses. However, please chime in if you live anywhere in Ohio and let me know if you work at a SNF, hospital, home health etc...Thanks!!!

What symptoms are typically treated with roxanol in the minimal responsive to unresponsive patient? Rapid respirations? Grimacing? What about moaning with personal care? I would use it in all 3 scenarios, but want other's input. What point is it prudent to do ATC vs PRN?

To the experienced hospice nurse...are you typically going to see ATC roxanol in someone in the active stage? My insticts would say typically, yes. Just would like to hear others' input.

Yes! So true! Total uphill battle. Thank you :-)

Thanks all! Believe me, I know this is wrong and that is why I am disturbed. I have been reading some resources myself, but they are too advanced for the people I am referring to. I am looking for some really basic straight forward stuff. As in, easy to read. I have found some helpful tidbits/ info and passed it on to coworkers already, but looking for more. The Fast Facts posted above look handy.

I wish you could come and educate at this hospice! They are RNs and think they are hospice trained. Where I live one does not have to be CHPN to work in hospice. I would love to attend a symposium or class regarding this issue.

Lets just say their pain assessments are different than mine. Them missing non-verbal s/s of pain among other issues! I think they believe breathing 50 breaths a minute is just fine and dandy. I am considering a change, but before I do I am looking for some easy and quick educational materials for staff/family.

Thanks all! What resources or classes or books would you recommend to despell these kinds of myths? Like a hospice 101 crash course! And yes, the med director does not take charge of the hospice. In other words he lets the uninformed nurses call the shots.

I have been running into this a lot lately with my hospice nurse coworkers. Patients' declines and decrease in level of consciousness are being chalked up as "over-medication". This misconception is happening with actively dying patients as well as those with simply an increase in or uncontrolled pain. The patient is typically medicated PRN with morphine for pain or SOB. These are patients who are on starting doses of 5mg range. The knee jerk reaction from this particular small hospice company is that the patients are over sedated from pain meds. I expect this from lay people, but is difficult to deal with from professionals. No one in the company is hospice certified, including the medical director. I have seen a few deaths with uncontrolled symptoms that make me cringe to think about. How would you deal with people who attribute normal declines involving increase in sleep/increase confusion to morphine???

We have a census of approx 225 with a designated triage nurse, 2 RNs on call for weeknights M-Th and 3 RNs on call for weekends Fri 5 pm -Mon 8 am. We also have a designated admissions nurse also. Case Managers rotate call for holidays that fall on weekdays. If call is brutal, sounds like you need more help!

Thanks for the reply!

HealthyNurse, this is interesting info. I started another thread about reform and home care. I would love to hear your input if you have time.

I saw the thread about the new face to face rule. Is that going to affect many of your patients? Does anyone know if the "face to face" visit can just be a general visit or does it have to be in regards to home care? For instance, can the client have been seen 2 weeks ago for headache and then be admitted to HH for PT due to weakness? Is there a new procedure for auditing? I have heard the state inspectors are cracking down on fraud and have closed some agencies. Also, what is your opinion on the future for the smaller, private home health agencies? I am a RN and the owner of our HHA seems to be in panic mode. I am afraid they are in the dark and I have concerns about my job. The market is flooded with nurses, so that is another bummer. Thanks for your opinions/input!