river1951

river1951

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All Content by river1951

  1. LVNs in hospice

    river1951 posted a topic in Hospice, Palliative

    Hi, We are evaluating how adding LVNs to our staffing could help stretch our RNs. Since we have no experience, if I could hear from anyone who uses LVNs this way it would be very helpful. Thank you in...

  2. LVNs in hospice

    river1951 replied to river1951's topic in Hospice, Palliative

    Thanks to you all for your helpful replies.

  3. Question about fentanyl patch

    river1951 replied to sukichaz's topic in Hospice, Palliative

    As far as utilazation goes, the patient who revokes loses the rest of that benefit period, which is fairly meaningless since there is no limit on numbers of benefit periods. You have to find a good...

  4. symptom management for dummies

    river1951 replied to captain morgan's topic in Hospice, Palliative

    People who have pain can have high pain and still talk- some folks will always rate their pain as a 10. But we still must treat- I would use immediate release morphine elixir and have them give him...

  5. methadone therapy for cancer pain?

    river1951 replied to ceelynncee's topic in Hospice, Palliative

    Methadone can work very well for cancer pain. Best of luck to you and your brother.

  6. March 17, 2007 CHPN exam

    river1951 replied to chris_at_lucas_RN's topic in Hospice, Palliative

    It is the certification in hospice and palliative

  7. March 17, 2007 CHPN exam

    river1951 replied to chris_at_lucas_RN's topic in Hospice, Palliative

    Way to go all of

  8. hospital admissions

    river1951 replied to hcan's topic in Hospice, Palliative

    It sounds ridiculous and stupid, if I understand you correctly. So they are transferring the patient to the inpatient hospice unit to preserve their stats? I get their rationale, but their hearts must...

  9. What does it mean...

    river1951 replied to jerseyRN's topic in Hospice, Palliative

    Yes, it is different things to different people, sorta like the parable about the blind men and the elephant. For me, it is about letting folks know they do not walk alone, and then being there for...

  10. I'm getting ready to grad. from the nursing program in 2 weeks and i need your help

    river1951 replied to weatherby's topic in Hospice, Palliative

    do you feel powerless, strongest no 5-4-3-2-1 i can't solve the problem so i feel powerless 5-4-3-2-1,strongest no i feel overloaded 5-4-3-2-1 3 my job interferes with my personal life 5-4-3-2-1 4...

  11. Patient doesn't tell she is getting cataract surgery

    river1951 replied to AtlantaRN's topic in Hospice, Palliative

    This is totally unrelated to her hospice diagnosis, so I'm pretty sure hospice would not be billed for it. Medicare sshould still cover it, just as it would any other unrelated diagnosis.

  12. Managing symptoms for a �good death�

    river1951 replied to NRSKarenRN's topic in Hospice, Palliative

    Michael et al, Fatigued with it, I know was being a wise butt being fatigued with human nature- it is very limiting. That of course is why we just need to help each other along thru this difficult...

  13. Question about dyspnea

    river1951 replied to sukichaz's topic in Hospice, Palliative

    "Your hospice should not be revoking the patient during this procedure. It is related to the patient's comfort and should be paid for by your hospice. The procedure is not that expensive and should...

  14. Managing symptoms for a �good death�

    river1951 replied to NRSKarenRN's topic in Hospice, Palliative

    Point well made. I am so simplistic, that at times I have thought the lack of caring equals lack of being able to put yourself in another's place, not the denial you will ever be in that place...

  15. Palliative sedation position paper

    river1951 replied to IDidIt2007's topic in Hospice, Palliative

    Over medicated? If she had no symptoms. I don't understand why any hospice nurse would medicate. So you will have to tell me more so I can understand what you mean. Hospice doesn't mean medicating...

  16. Question about dyspnea

    river1951 replied to sukichaz's topic in Hospice, Palliative

    We do palliative pleural taps all the time and it sounds as if that could be of help. Also positioning and tiny does of oral morphine- very helpful. If this hospice is not interested in helping you...

  17. Palliative sedation position paper

    river1951 replied to IDidIt2007's topic in Hospice, Palliative

    There are those black and white thinkers who cannot flex. For ethical principles, I have always been taught it is the desired end of the treatment that makes a difference- If we sedate to relieve...

  18. Checking Out Hospice Nursing

    river1951 replied to flowersRN's topic in Hospice, Palliative

    Don't give up. We encourage ride alongs if a nurse has never done any home care especially. Good to know if it's the right thing before jumping in. Where are you in the country?

  19. From OB to Hospice?!

    river1951 replied to mommy2boysaz's topic in Hospice, Palliative

    My thought is that birth and death are not that far apart. Your teaching skills are very important as well as your ability to listen or just be present. I would think oncology would be a great

  20. Managing symptoms for a �good death�

    river1951 replied to NRSKarenRN's topic in Hospice, Palliative

    At some point the doctors have to give it up! They don't know everything and for some MDs (perhaps many) that is a difficult realization- one never addressed in some cases. I do find, as a hospice...

  21. Is this practicing without a license??

    river1951 replied to rnkalee's topic in Hospice, Palliative

    At our hospice we do realize docs look to us to know what to do without pesting them to death. Our solution is to call, let them know our plan and request a return call if the doctor wants something...

  22. Fentora

    river1951 replied to saribeth's topic in Hospice, Palliative

    not stupid, yes it does. We had a patient on the Actiq which also caused lots of buccal

  23. Pay for old timers

    river1951 replied to GerryG's topic in Hospice, Palliative

    In California, it's in the 30's per hour, but you can't buy a house here on that! So think before you move anywhere for better money.

  24. Managing symptoms for a �good death�

    river1951 replied to NRSKarenRN's topic in Hospice, Palliative

    Leslie- that is soo hard. I will hold you in my heart and thoughts. I agree self awareness is the way to peace, but I see that for nearly everyone, self awareness is depressing, being human we are all...

  25. Managing symptoms for a �good death�

    river1951 replied to NRSKarenRN's topic in Hospice, Palliative

    Well, I can't explain it. Fool that I am, I actually thought lots of people would be talking about their patients and how they were able to help them resolve issues so they could have relax and be...