LeeCRNP

Hi Benjamin It looks like you are probably done your fellowship by now. It would be great if you are willing to provide an update as to what you are doing now and how valuable you felt your experience as a fellow was. I read what you did post and found it interesting. Best wishes to you as you continue on in your career!! Laurie

I've been on AN since 1999. Hello to everyone!! ???

Although it has been quite a few years since I took the exam, I would highly recommend the Barkley course materials. At the time I took the exam, they did not have the online streaming videos so I ordered the CDs and listened closely, as well as going through the study guide. Here is the link: https://www.npcourses.com/product/adult-gerontology-acute-care-NP-online-streaming-course/ Best of luck to you! Laurie ?

Thanks to all who have contributed to this thread. I think it is great that there are nurses who feel comfortable doing med-surg, LTC, and many of the "non-traditional" specialties that nurses seem to eschew in favor of the "glamour" of ER or ICU. Before I became a nurse, I did prehospital (EMT). When I got to nursing school, I felt pretty comfortable dealing with patients as I had the experience of being in some emergent situations. As a nurse, I've done telemetry/stepdown and ICU and as an NP of 15 years, I've done cardiac, pulmonary, infectious disease and currently, hospice and palliative care. I love my patients but the traveling is tough. I do feel like I am helping my patients but I'm not sure I can continue the brutal traveling that is required of me in my current position. I guess my message is that everyone is different and has their own talents and interests and should pursue the path that they feel will give them the most fulfillment. That path may change over time and that is OK. God bless everyone of you who are on the front lines and caring for all our patients, whether they have become infected with COVID or not! Please take care of yourselves and your families!!

Lukewarm I know it's been quite some time since anyone replied to this thread but if you want another idea for learning policy, consider joining a local chapter of a nurse's association in your area (either ANA or a specialty group). Also, probably the state chapter for ANA might offer opportunities to be involved with a committee that looks at legislation that may affect nurses. I am an NP and have been a member of my state NP group's policy committee. As NRSKaren mentioned in a prior post, there are also various fellowships for health policy. I think the consideration period for a lot of them may be ending soon but they would start a new year in the fall. If you want more specific information, please feel free to PM me and I will share what information I have found. Good luck!! ? Laurie

In reference to the last sentence...yes, in their eyes we aren't "valuable" but if they didn't have us at all, they'd be up s*** creek!! ?

I currently work for a hospice/palliative care company and we do have marketers but to date (and I've only been there about 2.5 months) I have NEVER seen our marketers "fish" for patients as far as looking in their charts. They go to different facilities to educate the staff as to the differences between hospice and palliative care. It is left to the clinical staff (myself and my fellow NP) to evaluate patients on our palliative service and if they are appropriate for hospice, we then refer them. Having previously worked for a company that did house calls, I would say that if this "marketer" is looking in patient charts, that would be a red flag to me--as in a potential HIPAA violation. It's one thing if the NPs or MD refer appropriate patients for hospice eval but to have someone with no clinical background looking thru charts to find "hospice-appropriate" patients strikes me as very unethical, at the very least.

First, congrats to you, WinterWolf90, for completing your NP program!! As MikeFNPC advised, find out if your new city (Lubbock) has an NP group there (may be part of a statewide group). Additionally, AANP (the national NP organization) has job listings (you may have to join as a member to look at the job listings, though). Another site that has NP job listings is HealtheCareers.com. I personally feel I've had better luck with job searching by going to the website for the hospital/health care agency directly and looking at their job listings. I tend to think the listings are more up to date than if you use a site like indeed or Careerbuilder, etc. In any case, I wish you the best with your move and job search! Please come back to AN and let us know where you land!!

OP--I am sorry to hear you were sick at work. I don't think you handled things well but when you are sick, you are not always thinking clearly. I agree with Kooky Korky...I don't think you should get fired for this incident but you definitely need to be aware of the procedures to follow regarding who to call should this situation (or a similar one)arise again. I pray that your manager will show some mercy and not terminate you but if that's the case, I pray that you learn from this and when you are applying for the next job, you have the courage to say "I made a mistake, I learned from it and I will not let it happen ever again." Godspeed to you and please let us know how things turned out for you! I think everyone here hopes for the best for you!

(Reply to comment #9) Me too. A sad situation for everyone involved

I think everyone is different and if you truly have a passion for hospice care, you have nothing to lose by applying and if the hospice agency is interested, maybe they will bring you in for an interview. If you are lucky enough to get an interview, you need to ask good questions about what kind of orientation you will get, how long orientation will be, etc. That being said, if it doesn't work out at this time, consider volunteering for a hospice in your community as you work to gain the nursing skills needed to become a great hospice case manager. I can't think of any agency that would turn away a volunteer! As ohiomatka said above, another option would be to apply for a hospice/palliative care unit in an inpatient facility. Finally, if you have another semester of school, is there a way you can do a clinical rotation in hospice? Just a thought :) Best of luck to you whatever you decide!! Laurie

For those of you who are case managers for home hospice--if your company uses Relias for your online training, there is a module on case management that probably would be helpful.

A resource to consider is the Hospice and Palliative Nurses Association Home. Good luck and welcome to the hospice world! Laurie

Another resource to consider is the Hospice and Palliative Nurses Association https://advancingexpertcare.org. Good luck and welcome to the hospice world! Laurie

My company uses HospiceSoft by Optima Healthcare Solutions. While it offers lots of space for narrative descriptions, it can be labor intensive at times.

Hi Dani I am a nurse practitioner who has acute care training but I have been working in hospice for the past 10 months (in addition to doing primary care home visits). Typically NP's in hospice are utilized to do face-to-face visits for re-certification but my current manager actually utilized me in a case management role for about 5 months earlier this year, which is unusual for an NP. I have to say, though, that I learned a lot about hospice that way and got to know my patients. If you want more details, you could PM me for specifics. I found this page that talks about education for APN's interested in hospice/palliative care. Hospice Nurse | How to become a Nurse Practitioner. Also, I believe Massachusetts General Hospital offers a fellowship for nurse practitioners interested in palliative care. Here is the link for more information on that program: Palliative Care Nurse Practicum/Observership - Massachusetts General Hospital, Boston, MA As I said, if you have further questions, please do not hesitate to PM me. Good luck in your decision, regardless of what you decide!! Laurie

Best of luck to you in your new job in hospice!! Please check back on this group and let us know how it is going!

Hi everyone, hope all of you are well. I have a few questions for the community here. 1. For those RN's that are case managers--does your agency also use CRNP's as case managers or are the nurse practitioners exclusively utilized for face-to-face visits for recerts? 2. Again, for case managers, especially those coming from other specialties: 1) How long was your orientation? 2) Did your orientation include going out with other nurses--not just other CM's but the on-call nurses as well? 3) Did the orientation follow the "core curriculum" for hospice and palliative care RNs or did your organization have their own materials that were given to incoming CM's when they started work? 3. Another question for the CM's--what is your typical caseload? 4. What is the communication like between team members? The organization I work for has a daily conference call Mon-Fri but more often than not, nurses may not find out that one of their patients has passed until they hear it on the "stand-up" call. Does the weekend administrator on-call notify the case managers if one of their patients dies? 5. What EMR system does your hospice company use? That's all the questions I can think of at the moment. There may be a follow-up post down the road :)--of course I had a few questions in my head but they seemed to escape as I was composing this post, LOL. I will thank everyone in advance for responding to my post. Laurie--hospice RN/CRNP

I agree, it sounds like you were on top of things and the resident was very slow to respond. I hope the resident gets a chewing-out by his attending!! Although I agree you did nothing wrong, if you have a union, I hope you had a union rep with you. Clearly the clinical coordinator was NOT on your side! Unbelievable! Sounds like you need to move on from that unit, whether to another unit in the hospital or another hospital altogether! Good luck!

If I had known about it when I was younger, I would have gone the CSI route. I may still do that ;-)

To ESME12--Thanks for these resources. I am a nurse looking to do something else and moving into the CISM area is of great interest to me.

Good luck to you, I hope this position works out for you! :) Laurie

Nervous1 If you go to AACN's site (American Association of Critical-Care Nurses), then go to the NTI section, they have a portion of the site that talks about "return on investment" and how to convince administrators to allow nurses to go to NTI and even get them to help pay for the conference. Check it out! I wish you the best Laurie

Sob24 Sorry for the delayed reply-I usually get notification about a message but somehow didn't this time. I work for a company called Univita and in general, I don't mind being an IC except that I am paid per visit and if patients cancel their visits, I am out of luck paywise. I am at the mercy of the scheduling team--if they get visits scheduled, I'm ok but if not...it hits me in the wallet. I usually do my own taxes. I keep track of my mileage and able to deduct that amount as I do not get reimbursed for it by my company . So if you are really looking to do this work (which is not difficult but also not very challenging), I would recommend finding a company that offers a salaried position. That way you know you will have a steady income. I know United Health Care offers salaried positions for this work. Good luck and please don't hesitate to write back if you have any other questions :) Hope you and your family have a Happy Thanksgiving :) Laurie ([email protected])

If you had difficulty with Fitzgerald's material, I recommend considering Tom Barkley's courses. He offers both live courses as well as home study. I used his materials for the acute care exam in late 2011 and found that the material he covered was pretty much what was tested. Money well spent . His home study materials aren't cheap BUT he claims a high pass rate on the exams. His website is Barkley & Associates Certification Review/Clinical Update Continuing Education. He does offer materials for the adult-gero exam as well as acute care and several others. Good luck! :) Laurie