angieRN

I prefer nutty and corny to describe poop.

I can't decrease them because of company policy saying that we must provide 2 visits/week to facility patients to help communication and coordination of care. I think it's a bunch of bull if you ask me. We're supposed to provided the same level of care to home and facility patients, but essentially, we're giving a higher level of care to our facility patients.

I was a pediatric nurse for 18 months before starting in hospice (almost 6 yrs. now) Because of my background, I am usually selected to care for any pediatric patients. It is VERY taxing on the staff involved. I would do some hospice work first to see how you handle that before making the jump into pediatric palliative care. If that were all you were doing, I can see the burnout happening very quickly. Thankfully, we don't get many cases. I had 2 years in between my last 2.

My question is with a caseload of 12-18 does your agency require a minimum of 2 visits per patient per week? I have this requirement, so with a caseload of only 14, my weekly visits are at 34! There are some that could certainly get by with one weekly visit to ease the pain, but I'm not allowed to decrease them. I have 2 that need 3x week and one that is 5x week.

It could just be fluid collecting there from her CHF. Depending on the level of dementia...we've told patients with edema in areas that question why, that the fluid is being kept there like "money at a bank" so that the heart doesn't have to "look after it". It makes the heart's work easier.

I think what you did was the right thing and totally acceptable. If that particular employee questions your actions, you can explain to them that in order to be your best for all of your patients, you have to set boundaries. If that isn't a good enough explanation for them, I would pass it along to the appropriate supervisor.

Thank you so much! I was thinking on the low end of that and salary.com was a great help even though it didn't have a peds specialty listed specifically.

The first time I had to put a scalp IV in myself, I was horrified. I quickly came to favor that site if it looked to be the most favorable option. I also had good luck with them holding out longer. However, I always tried to explain to parents prior to insertion to minimize the trauma of seeing it the first time.

Hello! I have unexpectedly (but very thankfully) been asked to interview for a nurse manager position. It is a 27 bed pediatric unit in a magnet hospital. Because I did not seek this out on my own, I have not truly ever considered what a reasonable salary would be. Any input on the situation would be appreciated. I realize specifics are inappropriate so ballparks and the general area would be great. Thanks!

We also do 4 drops every 2-4 hours prn.

I usually say, "Yes, it can be a hard job at times, but very rewarding." That pretty much covers it! Angie

Hmmm..we're having caseload/visit issues as well. I don't think it's unreasonable to see your stable patients once weekly, and for a while, we did that as well. Now we're back to the same as your company. Twice weekly, no matter what. They want our caseloads at 14 per RN with only 1 LPN floating amongst 5 nurses. So that's at least 28 visits/week, plus team meetings, careplanning, etc. It's getting hairy! Angie:banghead:

In the home setting we do the same as above, usually 2-3x/wk and prn for the nurses. We're usually pretty specific on the # of days for CNAs. In the facility, we have to be very specific down to which days of the week and AM or PM for Nsg, CNA. SW and Chaplain can be a little less specific.

I ususally add in besides the normal "I can't discuss this information with you....blah, blah, blah" "I don't discuss my other patients just as I don't discuss [Name] and all of the private details of what goes on when I'm in your home." Most people are understanding and if they choose to be mad, so be it! Angie