RachelRN25

Thanks Westieluv! Your comment was good and helped put some pieces of that puzzle together in figuring how the Medicare/Hospice system. Thanks! :)

Thanks!! Yes, that does help! It sounds like it varies quite a bit from agency to agency. I always thought Medicare rules were pretty black and white when it came down to what was covered. I guess I'll just have to ask my company that I work for what they do. Thanks again! :)

Hi there. Relatively new RN to hospice here and I had a question about Medicare guidelines for Hospice. What is technically allowed under Medicare Hospice? Certain labs? Xrays? CT scans? Labs and Xrays that relate to why their on hospice? I've gotten different answers from people at my work and our hospice doc is big on CT scans and labs. And is it true that if a family panics, calls 911 and ends up in the hospital that hospice pays the bill?? Seems extreme to me especially if hospice wasn't aware they were going to the hospital in the first place. Thanks everyone! :)

When I went through the new grad program at JMMC about 3 years ago there were around 45 of us! It has dwindled so much and many of the floors are way overstaffed as it is. I did hear it's only internal applicants this upcoming round and with very few slots. Those of you that are discouraged about not finding a dream job, try applying elsewhere to nursing homes and other less desirable places. I know when I started my career as a nurse I couldn't find hospital work as a new grad. I worked for a year at a SNF, got some experience and then landed at JMMC. Nothing wrong with working your way up! There ARE jobs out there! Just maybe not quite your dream job. It's not forever. Just a place to start and get some experience.

I'm a new hospice nurse and seem to always get asked by family members how much longer their loved one has before they die. This question obviously gets asked more frequently when they start to go downhill. I'm always very hesitant to say anything specific, even if I have an inkling of how much longer it will be. Yet, I feel as if it's a disservice to not tell the family if I feel that death is coming around the bend. Yet I don't want to mislead them. I feel as if I'm in a catch 22 all the time. How do you respond to that question?

Thanks for your reply! The license thing is definitely forefront in my mind! It IS totally MY responsibility if something goes wrong with these LVN's seeing my patients! That's another big reason I'm thinking on leaving. Too much of a liability risk. I'll have to check my state laws about this. Thanks.

When I mention I'm a hospice nurse, people usually reply with a wince and shudder and remark about how hard that is and how they could never do it. I never quite know how to respond in these situations. I usually mumble something about how I've always had an interest in hospice nursing or something generic. I'm curious how others respond to the inquiries?

I'm new to home health and been with a home health company for about 6 months, Amedisys, and initially really enjoyed it. Lately though we've had a lot of staff turn over and I'm one of the only RN's left. My office is so referral happy and I do around 4 admissions a week, not to mention all the recerts and ROC's and I am drowning in paper work. I'm so busy doing all these OASIS visits that the LVN's have to do practically all my revisits and I feel as though I never see my patients! I feel as though I'm only seeing my patients on admit, maybe 1-2 times during the cert and at discharge! I never get to intensively work & educate my patients and follow their progress. I'm pay per visit and these OASIS visits pay a bit more than regular visits, but take so much more time and have a ton of paperwork attached. So basically I feel pressured to do work 10-11 hr days to make enough money, then head home for more hours of paperwork. Plus our territories are HUGE and I'll routinely drive 60-75 miles a day! I've never had home health experience and am ready to quit. Is this typical of home health nursing?

I heard they are not accepting outside applicants for the New Grad program. Just internal applicants. They have really pared down how many new grads they take! When I went through the program 3-4 years ago they had like 35 of us, but just last year they only took like a dozen.

I'm looking for some advice. I've been working on a busy med/surg floor for about 2 years and have lately been thinking about transferring to the ICU. My hospital has a nice orientation program in place. Currently, I am feeling tired of running around like crazy and hardly knowing my patients, throwing pills at them and not being able to throughly assess them. A big reservation of going into ICU is also missing patient contact. I really enjoy that in Med/Surg and feel like everyone would be intubated in the ICU. Is this correct? I am wondering if I would fit into an ICU environment. Could you list some personality traits and characteristics of people that enjoy and are successful in the ICU? Thanks in advance for all your help!:nuke:

Anybody have it? What do you have? I keep getting mailed all these letters that give me offers to protect my license and/or getting sued and I'm wondering if I should get some. I work in California in a hospital on a busy medical floor. Thanks! :)

I recently just transfered to evening shift from working night shift for on a busy med/surg floor in a hospital. There are many differences with evening shift, one of the primary being having a whole bunch more patient and family interaction and questioning. Having just come from nights, I'm still getting used to how to handle this. An issue came up with a family yesterday having to do with why my patient was admitted and wanting to know the plan of care. I let them see the doctors orders and interpreted them for the family in explaining what sort of tests we were going to do and such. They still weren't satisfied and the patient being a direct admit from a doc's office, that doc had already gone home and I told them the on call would not be able to give them a good answer. I offered to let them read the doc's progress notes or interpret them for the family and they agreed. At that point I asked my charge and a few veteran nurses what they thought about me sharing all of this information with the family, and they were just aghast with how much information I had already shown to the family members! They suggested not sharing anything more and telling them to wait for the doctor in the morning to see the patient. It was not right according to HIPPA and stuff. So, my question is how much information do you with patients and/or family members? The patient was willing to let the family see the orders, etc., but did I have a right to show them?? The veteran nurses told me to never share info with family members unless they are the POA, which they weren't. I just hate not being able to give them a little bit of piece of mind in this situation. Any thoughts would be much appreciated! Thanks! :)

Thanks for all your help! :) I'm still curious about FFP and Platelets though...how fast do you usually run these in? Thanks :)

Hi, I'm a new nurse on a busy medical floor and have a question about giving blood products. I've heard so many different answers when it comes to at what rate to run blood, FFP, and platelets. I know they are all different, yet can't seem to find a policy on it at work. What rate do you run these 3 blood products? Thanks! :)

It was an ischemic stroke. I gave cozaar I think?